Indiana House Bill 1604
Session 2025
Cost sharing; out-of-pocket expense credit.
Became Law
Became Law on May 6, 2025
Sponsors
First Action
Jan 21, 2025
Latest Action
May 6, 2025
Origin Chamber
House
Type
Bill
Bill Number
1604
State
Indiana
Session
2025
Motion Text
HB 1604 - McGuire
House Roll Call Votes
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Summary
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) to prescription drugs that: (1) are covered under a health plan; (2) are life-saving or intended to manage chronic pain; and (3) do not have an approved generic version. 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. Requires a health plan to credit toward a covered individual's deductible and annual maximum out-of-pocket expenses any amount the covered individual pays directly to any health care provider for a medically necessary covered health care service if a claim for the health care service is not submitted to the health plan and the amount paid by the covered individual to the health care provider is less than the average discounted rate for the health care service paid to a health care provider in the health plan's network. Requires a health plan to: (1) establish a procedure by which a covered individual may claim a credit; and (2) identify documentation necessary to support a claim for a credit.
Enrolled House Bill (H)
Introduced House Bill (H)
Fiscal Note: HB1604.04.ENRS.FN001
Sort by most recent
05/06/2025
House
Public Law 237
05/06/2025
Office of the Governor
Signed by the Governor
04/29/2025
Senate
Signed by the President of the Senate
04/24/2025
Senate
Signed by the President Pro Tempore
04/23/2025
Senate
Conference Committee Report 1: adopted by the Senate; Roll Call 493: yeas 45, nays 2
04/23/2025
House
Rules Suspended. Conference Committee Report 1: adopted by the House; Roll Call 521: yeas 91, nays 0
04/23/2025
House
Signed by the Speaker
04/22/2025
House
CCR # 1 filed in the House
04/22/2025
Senate
CCR # 1 filed in the Senate
04/17/2025
Senate
Senate conferees appointed: Carrasco and Qaddoura
04/17/2025
Senate
Senate advisors appointed: Randolph Lonnie M and Walker K
04/15/2025
House
House dissented from Senate amendments
04/15/2025
House
House conferees appointed: McGuire and Shackleford
04/15/2025
House
Motion to dissent filed
04/15/2025
House
House advisors appointed: King, Barrett, Campbell and Dant Chesser
03/26/2025
Senate
Returned to the House with amendments
03/25/2025
Senate
Senator Bohacek added as cosponsor
03/25/2025
Senate
Third reading: passed; Roll Call 293: yeas 44, nays 3
03/25/2025
Senate
Senator Rogers added as cosponsor
03/25/2025
Senate
Senator Yoder added as cosponsor
03/24/2025
Senate
Second reading: ordered engrossed
03/20/2025
Senate
Committee report: amend do pass, adopted
03/20/2025
Senate
Senator Qaddoura added as cosponsor
03/20/2025
Senate
Senator Ford J.D. added as cosponsor
03/18/2025
Senate
Senator Hunley added as cosponsor
03/13/2025
Senate
Senator Randolph added as cosponsor
03/03/2025
Senate
First reading: referred to Committee on Insurance and Financial Institutions
02/18/2025
House
Referred to the Senate
02/17/2025
House
Third reading: passed; Roll Call 187: yeas 95, nays 0
02/17/2025
House
Senate sponsors: Senators Carrasco, Walker K, Freeman
02/13/2025
House
Second reading: ordered engrossed
02/11/2025
House
Committee report: amend do pass, adopted
01/27/2025
House
Representative Shackleford added as coauthor
01/21/2025
House
Coauthored by Representatives King and Morris
01/21/2025
House
Authored by Representative McGuire
01/21/2025
House
First reading: referred to Committee on Insurance
Sources
IN Legislature
Open States
Record Created
Jan 16, 2025 1:04:44 AM
Record Updated
Oct 8, 2025 6:34:45 AM