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Bill Apr 25, 2026

Limitation on cost sharing.

Requires an insurer, an administrator, and a pharmacy benefit manager to apply the annual limitation on cost sharing set forth in the federal Patient Protection and Affordable Care Act under 42 U.S.C. 18022(c)(1). Provides that an insurer, an administrator, and a pharmacy benefit manager may not directly or indirectly set, alter, implement, or condition the terms of health insurance coverage based in part or entirely on information about the availability or amount of financial or product assistance available for a prescription drug. Requires, before December 31 of each year, each insurer and administrator to certify to the insurance commissioner that the insurer or administrator has fully and completely complied with the cost sharing requirements during the previous calendar year.

https://openstates.org/in/bills/2025/HB1252/
Ben Smaltz State Representative Matthew S Lehman State Representative Cosponsor
HEALTH CARE FACILITIES; Pharmacies HEALTH CARE PROFESSIONALS; Pharmacists HEALTH; Billing and Costs HEALTH; Generally HEALTH; Prescription Drugs and Medications INSURANCE; Health Insurance
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