Requires certain pharmacists or pharmacies to provide the amount of the national average drug acquisition cost for a generic drug on the written materials provided to an individual at the point of sale of the generic drug.
Provides that an insurer: (1) must pay a health care provider the full amount due for health care services under the health care provider's agreement with the insurer, including any cost sharing; (2) has the sole responsibility for collecting cost sharing from a covered individual; and (3) upon request of the covered individual, must collect cost sharing throughout the policy year in increments defined by the insurer. Prohibits an insurer from taking certain actions regarding the collection of cost sharing. Requires each insurer to certify to the insurance commissioner, before December 31 of each year, that the insurer has fully and completely complied with the requirements during the previous calendar year.
Maddy summaryThis resolution (HR 13) formally recognizes the 250th anniversary of the United States of America and acknowledges historical Irish ties to the founding events. It does not create new laws, alter policies, or directly affect any individuals or groups. The bill serves solely as a commemorative statement by Congress, with no implementing mechanisms or concrete policy changes. It was introduced by Rep. O'Brien and co-sponsored by multiple representatives, passing its first reading on January 27, 2026.
Provides that a public school that participates in a federally funded or assisted meal program: (1) may not serve, sell, or allow a third party vendor to serve or sell a food or beverage that contains certain ingredients on school property on a school day; and (2) shall post any breakfast or lunch menu and ingredients on the school's website. Establishes exceptions.
Prohibits a hospital from billing for an administered drug an amount that exceeds the lesser of the following: (1) 120% of the Medicare reimbursement rate for the administered drug. (2) The amount the hospital bills for the administered drug on June 30, 2026. Creates an exception. Requires a hospital to update the Medicare reimbursement rate for an administered drug on January 1 and July 1 of each year.
Requires practitioners who perform gender transition procedures to report on a quarterly basis certain information to the practitioner's regulating board concerning the gender transition procedures. Requires the submitted reports to be provided to the professional licensing agency (agency) to be compiled as an annual report. Requires the agency to post the annual report on the agency's website and submit the report to the general assembly.
Repeals provisions requiring a state employee health plan, policy of accident and sickness insurance, and health maintenance organization contract to provide certain post-mastectomy coverage. Requires a state employee health plan, policy of accident and sickness insurance, and health maintenance organization contract to: (1) provide coverage for breast reconstruction surgery and all modalities, types, and techniques of a health care service provided for the breast reconstruction surgery; and (2) provide access to an adequate breast reconstruction surgeon network. Prohibits a utilization review entity from denying a claim for breast reconstruction surgery for which prior authorization was granted unless the utilization review entity provides a formal declaration of compelling evidence of health care provider fraud in the prior authorization or claim submission process.
Requires (rather than allows) the development of programs designed to increase Medicaid reimbursement. Specifies that the reimbursement rates for a state directed payment program must be at least the Medicare reimbursement rates. Requires the office of the secretary of family and social services to perform a reconciliation of the capitation attributable to the incremental hospital fee. Prohibits money in the incremental hospital fee fund from being used to fund Medicaid. Amends the permissible use of funds collected under the hospital assessment fee. Removes language that allowed the hospital assessment fee to be used to fund a state directed payment program that depended upon the collection of the managed care assessment fee. Changes the definition of "prices" concerning the hospital statewide average rate study and pricing (study). Amends the requirements to conduct the study and the date by which the study must be completed.
Prohibits a utilization review entity from requiring prior authorization for ambulance services provided: (1) to a covered individual; (2) by a nonparticipating ambulance service provider; and (3) within 12 hours after the ambulance services are requested. Prohibits a utilization review entity from requiring prior authorization for emergent response services or urgent response services that are provided: (1) to a covered individual; (2) in good faith; and (3) within 24 hours after the emergent response services or urgent response services are requested. Provides that a policy of accident and sickness insurance that provides coverage for emergency medical services must provide reimbursement for emergency medical services that are, among other things, performed or provided during a response initiated through the 911 system or an equivalent telephone number, a texting system, or any other method of summoning emergency medical services. Provides that a policy of accident and sickness insurance that provides coverage for emergency medical services must provide reimbursement for emergency medical services that are, among other things, performed or provided when an individual is determined to require emergency medical services by a physician. Provides that an individual contract and a group contract that provide coverage for emergency medical services must provide reimbursement for emergency medical services that are, among other things, performed or provided during a response initiated through the 911 system or an equivalent telephone number, a texting system, or any other method of summoning emergency medical services. Provides that an individual contract and a group contract that provide coverage for emergency medical services must provide reimbursement for emergency medical services that are, among other things, performed or provided when an individual is determined to require emergency medical services by a physician. Repeals certain code provisions addressing advanced life support services.
Requires a food manufacturer that offers certain food products for sale in Indiana to ensure that each food product includes a warning label disclosing specified ingredients in the food product. Sets forth labeling requirements. Allows the attorney general to bring an action for a violation of these provisions.
