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

Indiana § 12-15-5-5

• Jurisdiction: Indiana
• Art. 15: MEDICAID
• Ch. 5: Services Provided

Text

(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.

Legislative History

As added by P.L.231-1999, SEC.1. Amended by P.L.101-2005, SEC.1; P.L.152-2017, SEC.5.