Indiana § 27-1-24.5-11.5 "Pharmacy benefit management services"

Indiana Statutes

§ 27-1-24.5-11.5 — "Pharmacy benefit management services"

Indiana § 27-1-24.5-11.5

Title 27INSURANCE

Art. 1DEPARTMENT OF INSURANCE

Ch. 24.5Pharmacy Benefit Managers

This text of Indiana § 27-1-24.5-11.5 ("Pharmacy benefit management services") is published on Counsel Stack Legal Research, covering Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ind. Code § 27-1-24.5-11.5 (2026).

Text

Effective 1-1-2026. Sec. 11.5. As used in this chapter, "pharmacy benefit management services" means:

(1)negotiating the price of prescription drugs, including negotiating and contracting for direct or indirect rebates, discounts, or other price concessions;

(2)managing any aspect of a prescription drug benefit, including:

(A)the processing and payment of claims for prescription drugs;

(B)arranging alternative access to or funding for prescription drugs;

(C)the performance of drug utilization review;

(D)the processing of drug prior authorization requests;

(E)the adjudication of appeals or grievances related to the prescription drug benefit;

(F)contracting with network pharmacies;

(G)controlling the cost of covered prescription drugs;

(H)managing or providing data relating to the

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Effective 1-1-2026.
Sec. 11.5. As used in this chapter, "pharmacy
benefit management services" means:
(1) negotiating the price of prescription drugs, including
negotiating and contracting for direct or indirect rebates,
discounts, or other price concessions;
(2) managing any aspect of a prescription drug benefit, including:
(A) the processing and payment of claims for prescription
drugs;
(B) arranging alternative access to or funding for prescription
drugs;
(C) the performance of drug utilization review;
(D) the processing of drug prior authorization requests;
(E) the adjudication of appeals or grievances related to the
prescription drug benefit;
(F) contracting with network pharmacies;
(G) controlling the cost of covered prescription drugs;
(H) managing or providing data relating to the prescription drug
benefit;
(I) the provision of services related to the prescription drug
benefit; or
(J) creating or updating prescription drug formularies;
(3) the performance of any administrative, managerial, clinical,
pricing, financial, reimbursement, data administration or
reporting, or billing service; and
(4) any other services specified in a rule adopted by the
department.