Requires an insurer, a pharmacy benefit manager, or any other administrator of pharmacy benefits to ensure that a network utilized by the insurer, pharmacy benefit manager, or other administrator is reasonably adequate and accessible and file an annual report regarding the network with the commissioner of the department of insurance (commissioner). Sets forth certain limitations and requirements with respect to the provision of pharmacy or pharmacist services under a health plan. Allows any insured, pharmacy, or pharmacist impacted by an alleged violation to file a complaint with the commissioner. Provides that the commissioner may order reimbursement to any person who has incurred a monetary loss as a result of a violation. Requires, if a pharmacy benefit manger is used with regard to a state employee health plan, the state personnel department to either create a pharmacy benefit manager or contract with an insurer, a pharmacy benefit manager, or other administrator. Prohibits a third party administrator from: (1) requiring, as a condition of a plan sponsor entering into a contract with the third party administrator, that the plan sponsor enter into a contract with a particular pharmacy benefit manager; or (2) charging a different fee for services provided by the third party administrator to a plan sponsor based on the plan sponsor's selection of a particular pharmacy benefit manager. Urges the legislative council to assign to the appropriate study committee the task of studying the topic of contracts for pharmacy benefit coverage under the Medicaid program and a state employee health plan.
us/states/in
Indiana General Assembly
2025
SB 140
Indiana SB 140 (2025)
bill
AGENCIES; Department of Insurance (IDOI)
GENERAL ASSEMBLY; Legislative Council
HEALTH CARE FACILITIES; Hospitals
HEALTH CARE FACILITIES; Pharmacies
HEALTH CARE PROFESSIONALS; Licensing (Including Behavioral and Mental Health)
Requires an insurer, a pharmacy benefit manager, or any other administrator of pharmacy benefits to ensure that a network utilized by the insurer, pharmacy benefit manager, or other administrator is reasonably adequate and accessible and file an annual report regarding the network with the commissioner of the department of insurance (commissioner). Sets forth certain limitations and requirements with respect to the provision of pharmacy or pharmacist services under a health plan. Allows any insured, pharmacy, or pharmacist impacted by an alleged violation to file a complaint with the commissioner. Provides that the commissioner may order reimbursement to any person who has incurred a monetary loss as a result of a violation. Requires, if a pharmacy benefit manger is used with regard to a state employee health plan, the state personnel department to either create a pharmacy benefit manager or contract with an insurer, a pharmacy benefit manager, or other administrator. Prohibits a third party administrator from: (1) requiring, as a condition of a plan sponsor entering into a contract with the third party administrator, that the plan sponsor enter into a contract with a particular pharmacy benefit manager; or (2) charging a different fee for services provided by the third party administrator to a plan sponsor based on the plan sponsor's selection of a particular pharmacy benefit manager. Urges the legislative council to assign to the appropriate study committee the task of studying the topic of contracts for pharmacy benefit coverage under the Medicaid program and a state employee health plan.
Version chain
The bill's text revisions, in order — the diff chain from filing to enrollment.
Engrossed Senate Bill (H) (committee substitute) — source
Engrossed Senate Bill (S) (committee substitute) — source
Enrolled Senate Bill (S) (committee substitute) — source
Introduced Senate Bill (S) (committee substitute) — source
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