Legislation


HB 1327 – Indiana

Status: In Process
Year Introduced: 2024
Link: https://iga.in.gov/legislative/2024/bills/house/1327/details

Requires a hospital, physician group practice, insurer, third party administrator, and pharmacy benefit manager to file with the Indiana department of health (department) a report that includes information regarding each person or entity that has an ownership interest, in whole or in part, or a controlling interest in the hospital, physician group practice, insurer, third party administrator, or pharmacy benefit manager. Requires the department to publicly post a searchable consolidated document on the department’s website that contains the information. Sets forth penalties for a violation of the reporting requirements. Requires the department to submit an annual report of violations of the reporting requirements to certain members of the general assembly. Allows a contract holder to request an audit of a pharmacy benefit manager up to one time each quarter. Prohibits a third party administrator, health plan, or pharmacy benefit manager from charging a fee if the plan sponsor opts out of an additional offered service. Requires a contract with a third party administrator, pharmacy benefit manager, or prepaid health care delivery plan to provide that the plan sponsor has ownership of the claims data. Allows a plan sponsor that contracts with a third party administrator, the office of the secretary of family and social services that contracts with a managed care organization to provide services to a Medicaid recipient, or the state personnel department that contracts with a prepaid health care delivery plan to provide group health coverage for state employees to request an audit up to one time each quarter. Provides that a violation of the requirements concerning audits of a third party administrator, managed care organization, or prepaid health care delivery plan is an unfair or deceptive act or practice in the business of insurance and allows the department of insurance to adopt rules to set forth fines for a violation.


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