Loading chat...
IN HB1158
Bill
Status
1/8/2018
Primary Sponsor
Steven Davisson
Click for details
AI Summary
HB 1158 Summary
-
State employee plans, health insurers, and health maintenance organizations must compile and update maximum allowable cost (MAC) lists for generic drugs, updating pharmacies at least every 7 calendar days with changes consistent with market pricing and availability.
-
Health plans must establish appeal procedures allowing pharmacies to appeal reimbursement amounts within 15 days, with plans required to respond within 15 days and adjust reimbursement for all similarly situated pharmacies if appeals are decided in favor of the pharmacy.
-
Health plans cannot prohibit pharmacies from disclosing pricing information and affordable alternative drug options to patients, and cannot require patients to pay more than the least of: plan deductible/copayment, contracted pharmacy reimbursement amount, or uninsured price.
-
The Indiana Board of Pharmacy must adopt rules by July 1, 2018 to implement telemedicine services for pharmacists and pharmacies.
-
Manufacturers and wholesale drug distributors are exempted from pharmacy licensing requirements when delivering FDA-approved peritoneal renal dialysis supplies directly to patients or healthcare providers upon receipt of a physician's prescription through a licensed pharmacy.
Legislative Description
Pharmaceutical matters. Requires a state employee plan, health insurer, and health maintenance organization (health plans) to perform certain activities with respect to a maximum allowable cost list used for prescription drug reimbursement, including: (1) compilation and updating of the list; and (2) pharmacy appeals. Prohibits certain actions by health plans concerning pharmacy disclosure of pricing information and the amount payable upon receiving a prescription drug. Requires the board of pharmacy to adopt rules to implement the telemedicine law. Exempts from the law regulating pharmacists and pharmacies the delivery of peritoneal renal dialysis related supplies by manufacturers and wholesale drug distributors
Last Action
First reading: referred to Committee on Insurance
1/8/2018