Bill Text: IN HB1209 | 2011 | Regular Session | Introduced
Bill Title: Coverage for tamper resistant opioids.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2011-01-10 - First reading: referred to Committee on Insurance [HB1209 Detail]
Download: Indiana-2011-HB1209-Introduced.html
Citations Affected: IC 27-8-33; IC 27-13-7-21.
Synopsis: Coverage for tamper resistant opioids. Specifies
requirements for coverage of tamper resistant opioids under a policy of
accident and sickness insurance or a health maintenance organization
contract.
Effective: July 1, 2011.
January 10, 2011, read first time and referred to Committee on Insurance.
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A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
Chapter 33. Coverage for Tamper Resistant Opioids
Sec. 1. As used in this chapter, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1.
Sec. 2. As used in this chapter, "tamper resistant opioid" means an opioid drug that is:
(1) formulated to limit at least one (1) form of tampering that is intended to allow abuse of the drug; and
(2) approved by the federal Food and Drug Administration under a new drug application that includes data collected through at least one (1) human abuse potential study that supports the drug's characterization as a drug with reduced abuse potential in comparison to an opioid that:
(A) is not a tamper resistant opioid;
(B) has been approved by the federal Food and Drug
Administration; and
(C) serves as a positive control.
Sec. 3. A drug product that is not a tamper resistant opioid:
(1) is not considered to be therapeutically equivalent to a
tamper resistant opioid; and
(2) shall not be substituted for a tamper resistant opioid.
Sec. 4. A policy of accident and sickness insurance that provides
coverage for a prescription drug shall not exclude or limit benefits
for a brand name tamper resistant opioid unless the exclusion or
limitation is the same as or less restrictive than an exclusion or a
limitation that applies to benefits for other prescription drugs
under the policy of accident and sickness insurance.
Sec. 5. Coverage of a brand name tamper resistant opioid under
a policy of accident and sickness insurance is not subject to prior
authorization if there is not available on the market a generic
tamper resistant opioid that has been approved by the federal Food
and Drug Administration.
Sec. 6. Coverage of a tamper resistant opioid under a policy of
accident and sickness insurance shall not be contingent on previous
use of a drug product that is not a tamper resistant opioid.
(1) formulated to limit at least one (1) form of tampering that is intended to allow abuse of the drug; and
(2) approved by the federal Food and Drug Administration under a new drug application that includes data collected through at least one (1) human abuse potential study that supports the drug's characterization as a drug with reduced abuse potential in comparison to an opioid that:
(A) is not a tamper resistant opioid;
(B) has been approved by the federal Food and Drug Administration; and
(C) serves as a positive control.
(b) A drug product that is not a tamper resistant opioid:
(1) is not considered to be therapeutically equivalent to a tamper resistant opioid; and
(2) shall not be substituted for a tamper resistant opioid.
(c) An individual contract or a group contract that provides coverage for a prescription drug shall not exclude or limit benefits for a brand name tamper resistant opioid unless the exclusion or
limitation is the same as or less restrictive than an exclusion or a
limitation that applies to benefits for other prescription drugs
under the individual contract or group contract.
(d) Coverage of a brand name tamper resistant opioid under an
individual contract or a group contract is not subject to prior
authorization if there is not available on the market a generic
tamper resistant opioid that has been approved by the federal Food
and Drug Administration.
(e) Coverage of a tamper resistant opioid under an individual
contract or a group contract shall not be contingent on previous
use of a drug product that is not a tamper resistant opioid.
