The Indiana application for Pharmacy Benefit Managers is now live and all Pharmacy Benefit Managers must now apply for licensure. Pharmacy Benefit Managers (PBMs) are third party companies that offer pharmacy benefit management services and function as intermediaries between health plans and pharmaceutical manufacturers. The link to the application can be found at sircon.com/indiana.
In 2020, Indiana passed SEA 241 (IC 27-1-24.5) requiring PBMs to obtain a license issued by the Indiana Department of Insurance (IDOI). The act gives the IDOI commissioner the authority to adopt rules to set forth provisions for licensure and financial requirements, application and renewal fees, pharmacy claims audits, maximum allowable cost pricing, annual reporting, and penalties for violations for PBMs. Indiana Administrative Code Title 760, Article 5: Pharmacy Benefit Manager Standards became effective March 22, 2023, and includes the requirements for licensure.
PBMs organized in the State of Indiana need to apply by clicking on “Apply for a License” in the portal, then “New Insurance Licenses.” PBMs organized outside the State of Indiana should apply through “Other Licenses.”
More information
Additional information is available on the IDOI website, including specific items that must be attached to a PBM’s application and also a PBM Compliance Checklist. Any questions about PMBs should be directed to Compliance@idoi.IN.gov.