Citations Affected:
IC 5-10-8-13
;
IC 12-15-5-7
;
IC 27-8-31
;
IC 27-13-37.5.
Synopsis: Mail order and Internet pharmacy designation. Allows the
designation of a mail order or an Internet based pharmacy to provide
prescription drugs under Medicaid or other health plans. Prohibits a
denial of coverage for a covered prescription drug solely because the
prescription drug was obtained from a pharmacy other than a
designated mail order or Internet based pharmacy.
Effective: July 1, 2003.
January 9, 2003, read first time and referred to Committee on Health and Provider
Services.
A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
SECTION 1.
IC 5-10-8-13
IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2003]: Sec. 13. (a) As used in this section, "covered individual"
means an individual who is entitled to coverage under an employee
health benefit plan.
(b) As used in this section, "employee health benefit plan"
means a group plan of self-insurance, policy, or contract that:
(1) provides coverage for prescription drugs; and
(2) is established, purchased, or entered into by an employer
for the benefit of the employer's employees.
(c) As used in this section, "employer" means the following:
(1) A public employer.
(2) A state educational institution (as defined in
IC 20-12-0.5-1
).
(d) As used in this section, "mail order or Internet based
pharmacy" has the meaning set forth in
IC 25-26-18-1.
(e) An employee health benefit plan that provides coverage for
prescription drugs may designate a mail order or an Internet based
pharmacy to provide prescription drugs to a covered individual.
(f) An employee health benefit plan may not deny coverage for
a prescription drug that is covered under the employee health
benefit plan solely because a covered individual obtains the
prescription drug from a pharmacy other than a pharmacy
designated under subsection (e).
SECTION 2.
IC 12-15-5-7
, IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2003]: Sec. 7. (a) The office or a managed care organization that
has a contract with the office under
IC 12-15-12
may designate a
mail order or an Internet based pharmacy (as defined in
IC 25-26-18-1
) to provide prescription drugs to a recipient.
(b) The office or a managed care organization described in
subsection (a) may not deny payment for a prescription drug that
is covered under Medicaid solely because a recipient obtains the
prescription drug from a pharmacy other than a pharmacy
designated under subsection (a).
SECTION 3.
IC 27-8-31
IS ADDED TO THE INDIANA CODE AS
A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2003]:
Chapter 31. Mail Order and Internet Pharmacy Designation
Sec. 1. As used in this chapter, "insurer" refers to an insurer (as
defined in
IC 27-1-2-3
) that issues a policy of accident and sickness
insurance.
Sec. 2. As used in this chapter, "insured" means an individual
who is entitled to coverage under a policy of accident and sickness
insurance.
Sec. 3. As used in this chapter, "mail order or Internet based
pharmacy" has the meaning set forth in
IC 25-26-18-1.
Sec. 4. As used in this chapter, "policy of accident and sickness
insurance" has the meaning set forth in
IC 27-8-5-1.
Sec. 5. (a) An insurer that provides coverage for prescription
drugs may designate a mail order or an Internet based pharmacy
to provide prescription drugs to an insured.
(b) An insurer may not deny coverage of a prescription drug
that is covered under a policy of accident and sickness insurance
solely because an insured obtains the prescription drug from a
pharmacy other than a pharmacy designated under subsection (a).
SECTION 4.
IC 27-13-37.5
IS ADDED TO THE INDIANA CODE
AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2003]: