HB 1207 – Indiana

Status: Enacted
Year Introduced: 2020
Link: http://iga.in.gov/legislative/2020/bills/house/1207

Pharmacy matters. Provides that a state employee plan, a health maintenance organization, an insurer, or a pharmacy benefits manager (health plan provider) may not require a pharmacy or pharmacist to collect a higher copayment for a prescription drug from a covered individual than the health plan provider allows the pharmacy or pharmacist to retain. Adds advanced practice registered nurses and physician assistants to the list of out-of-state providers whose prescriptions a pharmacist has a duty to honor. Allows a prescription for a patient to be transferred electronically or by facsimile by a pharmacy to another pharmacy if the pharmacies do not share a common data base. Provides that aggregated information compiled from annual reports of pharmacy benefit managers to the insurance commissioner is not confidential except for information that would reveal a specific pharmacy benefit manager’s proprietary information. Requires: (1) a state employee health plan; and (2) an insurer-provided health plan that complies with the federal Affordable Care Act; to establish a procedure under which the amount paid by a covered individual for a covered prescription drug purchased outside of the health plan will offset the covered individual’s deductible. Requires an insurer, when removing a prescription drug from the insurer’s formulary or changing the cost sharing requirements applying to the prescription drug, to give an insured for whom the drug has been prescribed 60 days notice of the insurer’s action and provide an appeal process through which the insured may request an extension of coverage for the drug through the end of the insured’s plan year.


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