By State Sen. Mark Messmer (R-Jasper)
Most Hoosiers get their health insurance through employer-sponsored plans.
In these cases, an employer contracts with a third-party administrator to administer and process employee medical claims, and a pharmacy benefit manager to administer and process prescription drug claims.
Both employees and employers have a financial interest in making sure these third-party administrators and pharmacy benefit managers operate in the most cost-effective way possible.
That's why I supported House Enrolled Act 1259 this year. This allows employers to request an audit of the third-party administrators and pharmacy benefit managers once per year.
These audits must include information on the number of claims received and paid, rebate amounts for pharmacy benefit managers, and any fees charged to employers related to administration of the plans and claims processing.
This will allow employers to have access to all the information they need on claims being paid and how their insurance partners are making money from administering the plans.
While some employees may worry their personal medical information could be obtained by their employer, this data is subject to federal HIPAA laws and must be kept confidential. The point of this information is to ensure third-party administrators and pharmacy benefit managers are not unnecessarily increasing insurance prices.
These provisions of House Enrolled Act 1259 went into effect on July 1.
As always, constituents can reach out to me with any questions or concerns they may have by filling out a "Contact Me" form on the IndianaSenateRepublicans.com/Messmer website or by phone at 800-382-9467.
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State Sen. Mark Messmer (R-Jasper) represents Senate District 48, which
includes Crawford, Dubois, Gibson, Perry, Pike and Spencer counties.
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