§ 22-3-7-17.4 — Repackaged drugs; maximum reimbursement amount

Indiana § 22-3-7-17.4

• Jurisdiction: Indiana
• Art. 3: WORKER'S COMPENSATION SYSTEM
• Ch. 7: Worker's Occupational Diseases Compensation

Text

4. (a) As used in this section, "legend drug"
has the meaning set forth in IC 25-26-14-7.
(b) As used in this section, "repackage" has the meaning set forth in
IC 25-26-14-9.3.
(c) This subsection does not apply to a retail or mail order
pharmacy. Except as provided in subsection (d), whenever a
prescription covered by this chapter is filled using a repackaged legend
drug:
(1) the maximum reimbursement amount for the repackaged
legend drug must be computed using the average wholesale price
set by the original manufacturer for the legend drug;
(2) the medical service provider may not be reimbursed for more
than one (1) office visit for each repackaged legend drug
prescribed; and
(3) the maximum period during which a medical service provider
may receive reimbursement for a repackaged legend drug begins
on the date of the disablement and ends at the beginning of the
eighth day after the date of the disablement.
(d) If the National Drug Code (established under Section 510 of the
Federal Food, Drug, and Cosmetic Act, 21 U.S.C. 360) for a legend
drug cannot be determined from the medical service provider's billing
or statement, the maximum reimbursement amount for the repackaged
legend drug under subsection (c) is the lowest cost generic for that
legend drug.

Legislative History

As added by P.L.275-2013, SEC.16. Amended by P.L.99-2014, SEC.6.