In Review: The Indiana General Assembly convened January 9 and wasted no time filing legislation impacting the industry and calling hearings on significant legislation. Within the first week PCMA is already tracking legislation addressing fiduciary mandates, an upheaval of prior authorization/gold carding, prohibitions on spread pricing, audits, and disclosure mandates to plan sponsors.

Up Next: On Tuesday morning, HB 1327 (Disclosure/Audit) is scheduled to be heard in the House Public Health Committee. The legislation requires PBMs (in addition to hospitals, physician group practices, and third party payors) to submit a report to the Indiana Department of Health disclosing ownership information. Additionally, HB 1327 contains contractual requirements between PBMs and plan sponsors addressing audits between PBMs and ‘contract holders’, fees, and ownership of claims data. The bill is being pushed by the Indiana Employer’s Forum. PCMA is weighing testimony during the committee meeting as we await member feedback. Finally, SB 3 (Prior Authorization) will be heard in the Senate Health and Provider Services Committee on Wednesday, January 17.  SB3, in short essentially prohibits utilization management for several healthcare services, including prescription drugs. PCMA, among other stakeholders will likely testify. As a reminder, the Indiana Senate has been historically troublesome in how quickly they move legislation.

If you have any questions, please contact Connor Rose at crose@pcmanet.org.