LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 7666 NOTE PREPARED: Jan 13, 2025
BILL NUMBER: HB 1571 BILL AMENDED:
SUBJECT: Pharmacists.
FIRST AUTHOR: Rep. Goss-Reaves BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
FEDERAL
Summary of Legislation: State Health Commissioner– The bill removes the authority of the State Health
Commissioner's (Commissioner) designated public health authority to issue a standing order, prescription,
or protocol (standing order) to allow certain health practitioners to administer or dispense an immunization
or a pharmacist a smoking cessation product. The bill requires the Commissioner to issue a standing order
that allows a pharmacist to treat or screen, test, administer, or dispense for certain health conditions.
Pharmacist Matters– The bill requires the Indiana Board of Pharmacy (Board) to establish standards and
requirements for courses of education concerning Indiana and federal statutes and rules governing the
practice of pharmacy. The bill requires an individual to pass the North American Pharmacist Licensure
Examination to be eligible for licensure as a pharmacist.
Immunization Administrations– The bill allows a pharmacist to administer or dispense an immunization that
is recommended by the federal Centers for Disease Control and Prevention Advisory Committee on
Immunization Practices under a drug order, under a prescription, or according to a protocol approved by a
physician. The bill removes provisions restricting a pharmacist from administering an immunization to an
individual who is less than 11 years of age.
Civil and Criminal Immunity– The bill provides civil and criminal immunity for a pharmacist related to
filling a prescription for a drug, medicine, or other prescribed substance.
Pharmacist Matters– The bill allows a pharmacist to take certain actions relating to medication assisted
treatment. The bill sets forth requirements for pharmacy benefit managers.
Health Carrier Reimbursements– The bill establishes requirements for a health carrier regarding the
reimbursement of services and procedures that are performed by a pharmacist.
Effective Date: July 1, 2025.
Explanation of State Expenditures: State Health Commissioner Standing Orders– The Commissioner
HB 1571 1 would likely be able to issue standing orders as a routine matter of business within the Indiana Department
of Health’s existing staffing levels. [The IDOH’s administrative expenditures are currently paid from the
Tobacco Master Settlement Fund, a dedicated fund.]
Pharmacist Matters– It is likely the Professional Licensing Agency would see a workload increase to help
with rules promulgation as required by the bill. Additionally, the Agency would likely update their website
and notify affected practitioners of the bill’s changes. These are routine administrative functions and should
be to be implemented within the Agency’s existing staff and resource levels.
Immunization Administrations– If Medicaid enrollees and State Employee Health Plan members receive
additional vaccines as a result of pharmacists being able to provide a broader range of vaccines, state vaccine
and vaccine administration costs will increase. The increase is indeterminate and will depend on the number
of vaccines that would not otherwise have been provided in another setting.
Health Carrier Reimbursements– This provision will have an indeterminate impact the cost of prescription
drugs paid by health plans. The bill provides a formula for pharmacist and pharmacy provider reimbursement.
Any impact to state expenditures for the state employee health plan and the state Medicaid plan resulting
from the bill's requirements is indeterminate and will depend on the terms of future PBM contracts entered
into by the state. [The state employee health plan's current PBM contract is effective through December 31,
2026, and the state Medicaid program's PBM contract is effective through December 31, 2025.]
The bill’s requirements will increase workload for Department of Insurance (DOI), but they should be able
to be implemented with DOI’s existing staffing and resources. [The DOI is funded through a dedicated
agency fund.]
Explanation of State Revenues: Health Carrier Reimbursements– The bill expands the list of actions
considered as unfair and deceptive acts. If this bill increases the number of unfair and deceptive acts
discovered by the DOI, revenue to the state General Fund will increase from civil penalties paid by violators.
The penalty for engaging in an unfair and deceptive act is one or more of the following: (1) a civil penalty
between $25,000 and $50,000 for each act or violation and (2) revocation of a person's license or certificate
of authority if they knowingly engaged in an unfair or deceptive act.
Civil and Criminal Immunity– If fewer actions or criminal proceedings occur as a result of this provision,
state General Fund and dedicated fund revenues would decline from a reduction in court fees and fines.
Additional Information–
Civil Court Fees: When a civil case is filed, the total revenue per case could range between $100 and $122.
The amount deposited will vary depending on whether the case is filed in a court of record or a municipal
court. The following linked document describes the fees and distribution of the revenue: Court fees imposed
in civil, probate, and small claims cases.
Criminal Court Fees and Fines: When criminal court cases occur, revenue is deposited into the Common
School Fund (from criminal fines, when collected) and the state General Fund (from court fees).
Explanation of Local Expenditures: Immunization Administrations– Local government employees may
receive additional vaccines as a result of the bill, which would increase health plan costs. However, the
increase is indeterminate and will depend on the number of vaccines that would not otherwise have been
HB 1571 2 provided in another setting.
Explanation of Local Revenues: Civil and Criminal Immunity– If fewer cases occur, as a result of the bill,
revenue collected by certain local units will decrease.
Additional Information–
Civil Court Fees: When the case is filed in a court of record, the county will receive $32 and qualifying
municipalities will receive a share of $3. If the case is filed in a municipal court, the county receives $20,
and the municipality will receive $37. The following linked document describes the fees and distribution of
the revenue: Court fees imposed in civil, probate, and small claims cases.
State Agencies Affected: Department of Insurance; State Department of Health; State Board of Pharmacy;
Office of Medicaid Policy and Planning; Office of the Secretary of Family and Social Services; Professional
Licensing Agency.
Local Agencies Affected: Trial courts, city and town courts; local units of government with vaccine
coverage in their health care plans.
Information Sources: Indiana Supreme Court, Indiana Trial Court Fee Manual;
Indiana Transparency Portal;
https://www.fda.gov/vaccines-blood-biologics/vaccines/vaccines-licensed-use-united-states;
https://www.in.gov/pla/professions/pharmacy-home/pharmacy-licensing-information/#Administering_Im
munizations.
Fiscal Analyst: Chris Baker, 317-232-9851.
HB 1571 3