HB 1005

Bill Subjects

Abstract

Establishes the importation of prescription drugs program (program) for the importation of prescription drugs to be administered by the state department of health (state department). Requires the state department to apply to the federal government for approval of the program. Sets forth requirements for the vendor of the program. Sets requirements for suppliers, importers, and wholesale drug distributors of the program. Requires the state department to submit reports to the governor and the general assembly concerning the program. Establishes for participants in the program an international export pharmacy permit and wholesale drug distributor permit administered by the Indiana board of pharmacy.Provides that a facility is an off-campus location of a hospital if: (1) the operations of the facility are directly or indirectly owned or controlled by, or affiliated with, the hospital; (2) the facility provides services that are organizationally and functionally integrated with the services of the hospital; and (3) the facility provides preventive services, diagnostic services, treatment services, or emergency services. Requires hospitals, ambulatory surgical outpatient centers, and urgent care facilities to post certain health care services pricing information by billing code on the hospital's Internet web site and sets forth requirements. Requires: (1) a provider facility (including a hospital) in which a nonemergency health care service will be performed; or (2) a practitioner (including a physician) who will perform a nonemergency health care service; upon request from the individual for whom the nonemergency health care service has been ordered, scheduled, or referred, to provide a good faith estimate of the price for the nonemergency health care service not more than three business days after receiving the individual's request. Requires a provider facility or practitioner to include the address of the service facility location to obtain reimbursement for a commercial claim for health care services. Requires a health carrier (including an insurer or a health maintenance organization) to provide to an individual who is entitled to coverage from the health carrier, not more than three business days after the individual requests the information, a good faith estimate of: (1) the amount of the cost of the nonemergency health care service that the health carrier will pay for or reimburse to the covered individual; or (2) the extent and nature of the ordered nonemergency health care service a covered individual is entitled to receive. Requires the department of insurance to submit a request for information and a request for proposal concerning the establishment and implementation of an all payer claims data base and sets forth requirements. Provides that if a health carrier provides coverage to the individual through a network plan, the health carrier shall inform the individual whether the provider facility in which the nonemergency health care service will be provided and the practitioners who will provide the nonemergency health care service are included in the health carrier's network plan. Requires provider facilities to post signs in waiting rooms and to provide Internet web site notices about the availability of estimates of the amount the patient will be charged for medical services. Requires practitioners to provide notice about the availability of estimates of the amount the patient will be charged for medical services when the practitioner has ordered, scheduled, or referred the individual for a nonemergency health care service. Requires health carriers to provide Internet web site notices about the availability of good faith estimates of coverage for nonemergency health care services. Provides penalties for noncompliance by provider facilities, practitioners, and health carriers. Requires an insurance producer to disclose commission information. Prohibits health provider contracts and contracts between a provider and a pharmacy benefits manager from including provisions that prohibit the disclosure of health care service claims data to employers providing the health coverage and makes a violation an unfair and deceptive act. Provides that a fully credentialed provider shall be reimbursed by an insurer or health maintenance organization for eligible services provided at an in-network hospital if certain conditions are met.