Citations Affected: IC 25-26; IC 27-8.
Synopsis: Mail order and Internet pharmacy designation. Allows
insurers to designate a mail order or Internet pharmacy to provide
prescription drugs to an insured. Prohibits an insurer from requiring as
a condition of coverage that an insured purchase prescription drugs
from a designated mail order or Internet pharmacy. Prohibits an insurer
from applying a higher co-payment or deductible if an insured does not
purchase prescription drugs from an in-network designated mail order
or Internet pharmacy.
Effective: July 1, 2001; July 1, 2002.
January 9, 2001, read first time and referred to Committee on Health and Provider
Services.
February 15, 2001, reported favorably _ Do Pass.
February 20, 2001, read second time, amended, ordered engrossed.
A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
SECTION 1.
IC 25-26-18-3
IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2002]: Sec. 3. A mail order or Internet based pharmacy shall
employ a pharmacist licensed in Indiana who shall be responsible
for the dispensing of all prescription drugs into the state of Indiana
by the company.
SECTION 2.
IC 27-8-28
IS ADDED TO THE INDIANA CODE AS
A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2001]:
Chapter 28. Insurer Designation of Mail Order and Internet
Pharmacies
Sec. 1. This chapter applies to every:
(1) policy of accident and sickness insurance (as defined in
IC 27-8-5-1
), whether written on an individual basis, a group
basis, a franchise basis, or a blanket basis;
(2) group contract (as defined in
IC 27-13-1-16
) or individual
contract (as defined in
IC 27-13-1-21
) through which a health
maintenance organization furnishes health care services; and
(3) health care plan of a state or local governmental entity
that provides coverage for health care services on a
self-insurance basis;
that is issued, delivered, executed, or renewed in Indiana on or
after July 1, 2001.
Sec. 2. As used in this chapter, "insurer" means a company, a
firm, a partnership, an entity, an association, an order, a society,
or a system:
(1) making any of the kinds of insurance;
(2) entering into any of the kinds of contracts; or
(3) providing any of the coverage;
described in section 1 of this chapter.
Sec. 3. As used in this chapter, "insured" means an individual
who is entitled to coverage under a policy, contract, or plan
described in section 1 of this chapter.
Sec. 4. As used in this chapter, "mail order or Internet based
pharmacy" has the meaning set forth in
IC 25-26-18-1.
Sec. 5. (a) An insurer that provides coverage for prescription
drugs may designate a mail order or Internet based pharmacy to
provide prescription drugs to an insured.
(b) An insurer may not:
(1) require an insured to obtain prescription drugs from a
pharmacy designated under subsection (a) as a condition of
coverage; or
(2) impose:
(A) a higher co-payment;
(B) a higher deductible; or
(C) another co-insurance requirement;
upon an insured if the insured obtains prescription drugs
from an in-network pharmacy not designated in subsection (a)
that agrees to provide all pharmaceutical services for the
same price and under the terms and conditions that apply to
a pharmacy designated in subsection (a).