Indiana’s Senate Enrolled Act 140 (2025) takes effect for commercial plan contracts on or after January 1, 2026. Reimbursement must be no less than the greater of the rate the PBM pays its own affiliated pharmacies, or — for pharmacies that do not hold a liquor permit (typically independents) — NADAC plus the professional dispensing fee from the Indiana Medicaid fee-for-service program. Pharmacies holding a liquor permit are floored at actual acquisition cost plus a “fair and reasonable” dispensing fee.
The dispensing-fee amount is set by reference to the Medicaid rate (and a commissioner determination of the average cost to dispense), not fixed as a dollar figure in the statute. Enforcement runs through complaints to the Indiana Department of Insurance rather than a dedicated MAC appeal window.