LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 6503 NOTE PREPARED: Feb 20, 2025
BILL NUMBER: SB 140 BILL AMENDED: Feb 19, 2025
SUBJECT: Pharmacy Benefits.
FIRST AUTHOR: Sen. Charbonneau BILL STATUS: As Passed Senate
FIRST SPONSOR: Rep. McGuire
FUNDS AFFECTED:XGENERAL IMPACT: State
XDEDICATED
FEDERAL
Summary of Legislation: This bill requires an insurer, a pharmacy benefit manager (PBM), or any other
administrator of pharmacy benefits to ensure that a network utilized by the insurer, PBM, or other
administrator is reasonably adequate and accessible and file an annual report regarding the networks with
the commissioner. It sets forth certain limitations and requirements with respect to the provision of pharmacy
or pharmacist services under a health plan.
This bill allows any insured, pharmacy, or pharmacist impacted by an alleged violation to file a complaint
with the commissioner. It provides that the commissioner may order reimbursement to any person who has
incurred a monetary loss as a result of a violation.
This bill prohibits a health carrier and a PBM from contracting to provide services under a policy of health
insurance coverage if the health carrier has an ownership interest in the PBM. It prohibits a PBM from
providing services under a policy of health insurance coverage for a health carrier that has an ownership
interest in the PBM.
This bill requires, if a PBM is used with regard to a state employee health plan, the State Personnel
Department to either create a PBM or contract with an insurer, a PBM, or other administrator.
This bill also repeals a superseded provision relating to equal access and incentives to pharmacies within a
PBM’s network.
Effective Date: January 1, 2026; July 1, 2026.
Explanation of State Expenditures: The bill’s requirements will increase workload for the Department of
Insurance (DOI), State Personnel Department (SPD), and the Indiana Board of Pharmacy, but should be able
to be implemented using existing staffing and resources of the agencies and within the regularly scheduled
meetings of the Board. [The DOI is funded through a dedicated agency fund.]
The bill’s requirements may result in changes to costs for any future contracts between the State Employee
SB 140 1 Health Plan (SEHP) and pharmacy benefit managers (PBM). Any resulting change in future costs will depend
on the terms of the contracts.
Additional Information: The bill allows, but does not require, SPD to create a PBM to fulfill the PBM
requirements for the SEHP. If created, this option would result in an indeterminate increase in workload for
SPD and an indeterminate impact on costs for the SEHP.
The Board of Pharmacy met 14 times in CY 2024 with the Board’s Rulemaking Subcommittee meeting an
additional eight times in the year.
Explanation of State Revenues: The bill establishes that a health carrier contracting with a PBM in which
the health carrier has an ownership interest is considered to be an unfair and deceptive act in the business
of insurance. 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.
Explanation of Local Expenditures:
Explanation of Local Revenues:
State Agencies Affected: Department of Insurance; Indiana Board of Pharmacy, Professional Licensing
Agency; State Personnel Department; all state agencies.
Local Agencies Affected:
Information Sources:
https://www.in.gov/pla/professions/pharmacy-home/pharmacy-board/#Current_Year_Board_Agendas.
Fiscal Analyst: Jason Barrett, 317-232-9809.
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