Indiana § 12-15-5-5 Office may provide drug coverage; requirements for drug coverage in
managed care

Indiana Statutes

§ 12-15-5-5 — Office may provide drug coverage; requirements for drug coverage in managed care

Indiana·Art. 15 MEDICAID·Ch. 5 Services Provided

(a)The office may provide a prescription drug benefit to a Medicaid recipient in a Medicaid risk based managed care program.

(b)If the office provides a prescription drug benefit to a Medicaid recipient in a Medicaid risk based managed care program:

(1)the office shall develop a procedure and provide the recipient's risk based managed care provider with information concerning the recipient's prescription drug utilization for the risk based managed care provider's case management program; and

(2)the provisions of IC 12-15-35.5 apply.

(c)If the office does not provide a prescription drug benefit to a Medicaid recipient in a Medicaid risk based managed care program, a managed care organization shall provide coverage and reimbursement for outpatient single source legend drugs subject to I

Free access — add to your briefcase to read the full text and ask questions with AI

(a) The office may provide a prescription drug
benefit to a Medicaid recipient in a Medicaid risk based managed care
program.
(b) If the office provides a prescription drug benefit to a Medicaid
recipient in a Medicaid risk based managed care program:
(1) the office shall develop a procedure and provide the recipient's
risk based managed care provider with information concerning
the recipient's prescription drug utilization for the risk based
managed care provider's case management program; and
(2) the provisions of IC 12-15-35.5 apply.
(c) If the office does not provide a prescription drug benefit to a
Medicaid recipient in a Medicaid risk based managed care program, a
managed care organization shall provide coverage and reimbursement
for outpatient single source legend drugs subject to IC 12-15-35-46, IC 12-15-35-47, and IC 12-15-35.5.

Indiana § 12-15-5-5 (Office may provide drug coverage; requirements for drug coverage in managed care) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.