SB 136 creates two new insurance-code chapters focused on prescription drug pricing transparency. First, beginning January 1, 2026, it requires certain health plans — including the state employee health plan, accident and sickness policies, and individual or group health contracts — to disclose the national average drug acquisition cost for a generic drug in the written materials given to a covered person at the point of sale. The bill defines that cost as the average price pharmacies pay for the drug, excluding dispensing and professional fees.
Second, for pharmacy benefit manager (PBM) agreements entered into, renewed, or renegotiated after December 31, 2025, the bill requires annual notice to the policyholder if less than 85% of estimated rebates are passed through to reduce cost sharing at the point of sale. That notice must explain what rebates are, how they accrue from manufacturers to the health plan, and the aggregate amount of rebates received for the prior policy year. The notice cannot identify individual drugs or reveal drug-specific details.
Impact
The bill would amend Indiana insurance law by adding new disclosure requirements for health plans and PBM contracts under IC 27-1. It affects state employee coverage, accident and sickness insurance, and other health plans that pay for prescription drugs, and it imposes new contractual and notice obligations on pharmacy benefit managers and related entities. The practical effect is to increase transparency around generic drug pricing and rebate flows, while leaving the underlying rebate arrangements and cost-sharing structures otherwise intact.
Sentiment
The available record shows no committee transcript or vote history, so there is no documented floor or committee debate to gauge support or opposition. Based on the bill’s subject matter and structure, it appears to be a transparency-focused measure aimed at informing consumers and policyholders about prescription drug costs and rebates. The absence of recorded votes or discussion means the overall sentiment cannot be assessed from the provided materials beyond the bill’s apparent policy intent.
Contention
The main potential point of contention is the rebate disclosure requirement tied to PBM contracts, especially the 85% threshold that determines when annual notice is triggered. PBMs, insurers, and health plans may view the reporting obligation as administratively burdensome or as exposing sensitive pricing information, while consumer advocates may support it as a way to shed light on how rebates affect out-of-pocket costs. Another possible issue is the limited scope of the point-of-sale disclosure, which provides aggregate rebate information but prohibits drug-specific identification, potentially drawing criticism from those seeking more detailed transparency.