Indiana Code 27-1-24.5-23. Drug price data
(1) Information identifying the national drug pricing compendia or sources used to obtain the drug price data.
Terms Used In Indiana Code 27-1-24.5-23
- Department: means "the department of insurance" of this state. See Indiana Code 27-1-2-3
- maximum allowable cost: means the maximum amount that a pharmacy benefit manager will reimburse a pharmacy for the cost of a generic drug. See Indiana Code 27-1-24.5-7
- maximum allowable cost list: means a list of drugs that is used:
Indiana Code 27-1-24.5-8
- pharmacy: means the physical location:
Indiana Code 27-1-24.5-11
- pharmacy benefit manager: means an entity that, on behalf of a health plan, state agency, insurer, managed care organization, or other third party payor:
Indiana Code 27-1-24.5-12
- pharmacy services administrative organization: means an organization that assists independent pharmacies and pharmacy benefit managers or health plans to achieve administrative efficiencies, including contracting and payment efficiencies. See Indiana Code 27-1-24.5-15
(b) The department shall adopt rules under IC 4-22-2 concerning the manner in which a pharmacy benefit manager shall communicate the following to contracted pharmacy services administrative organizations:
(1) Drug price data should be used to establish drug reimbursements by pharmacy benefit managers as described in subsection (a)(1).
(2) The comprehensive list of drugs described in subsection (a)(2).
(c) The department may, concerning a maximum allowable cost list, consider whether a drug is:
(1) obsolete;
(2) temporarily unavailable;
(3) to be included on a drug shortage list; or
(4) unable to be lawfully substituted.
As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.80.