Introduced Version






SENATE BILL No. 217

_____


DIGEST OF INTRODUCED BILL



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.





Gard




    January 9, 2003, read first time and referred to Committee on Health and Provider Services.







Introduced

First Regular Session 113th General Assembly (2003)


PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts between statutes enacted by the 2002 Regular or Special Session of the General Assembly.

SENATE BILL No. 217



    A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Be it enacted by the General Assembly of the State of Indiana:

    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]:


     Chapter 37.5. Mail Order and Internet Pharmacy Designation
    Sec. 1. As used in this chapter, "mail order or Internet based pharmacy" has the meaning set forth in IC 25-26-18-1.
    Sec. 2. (a) A health maintenance organization may designate, under an individual contract or a group contract that provides coverage for prescription drugs, a mail order or an Internet based pharmacy to provide prescription drugs to an enrollee.
    (b) A health maintenance organization may not deny coverage of a prescription drug that is covered under an individual contract or a group contract solely because an enrollee obtains the prescription drug from a pharmacy other than a pharmacy designated under subsection (a).

    SECTION 5. [EFFECTIVE JULY 1, 2003] (a) IC 5-10-8-13 , as added by this act, applies to an employee health benefit plan that is entered into, issued, delivered, amended, or renewed after June 30, 2003.
    (b) IC 12-15-5-7 , as added by this act, applies to a contract with a managed care organization that is entered into, delivered, amended, or renewed after June 30, 2003.
    (c) IC 27-8-31 , as added by this act, applies to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2003.
    (d) IC 27-13-37.5 , as added by this act, applies to an individual contract or a group contract that is entered into, delivered, amended, or renewed after June 30, 2003.