Legislation would limit insurers' ability to change medications during plan year

Jan. 9--INDIANAPOLIS -- A Columbia City physician told a Senate committee how a diabetic patient's health was jeopardized when, because of insurance, medication to manage pain was changed to opioids.

"Now she is on opioids that makes her dialysis even more difficult," said Dr. Lisa Hatcher said as she testified Wednesday before the Senate Health and Provider Services Committee about Senate Bill 97.

The bill, authored by Sen. Vaneta Becker, R-Evansville, would prohibit a health maintenance organizations or other health insurance providers from modifying an individual's coverage on a drug during the plan year.

Becker said the bill is necessary because while under insurance and being prescribe to one drug it shouldn't be changed to another drug.

Hatcher said she has patients whose health is affected when insurers mandate changes to prescription medications she has ordered. In the case of the diabetic patient, the insurance company declined to cover the cost of the nonopioid medication but would pay for opioids.

"This bill advocates for our patients in an effective matter," Hatcher said.

Proponents of SB 97 said that changing a stable patient's drug in the middle of the year is unfair and can lead to bigger risks because of new drug interactions. It can lead to an increase in emergency room visits, doctors' visits and an overall hike in medical bills.

However, an insurance representative said insurers look for lower-priced drugs to reduce costs for all patients.

"We do believe it will increase health care costs," said Heather Willey, an attorney for CVS Caremark. SB 97, if it passes, could hike costs between $2.3 and $5.2 million.

The committee delayed action on the bill and needs more discussion.

Kiara Calloway is a reporter for TheStatehouseFile.com, a news website powered by Franklin College journalism students.

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