§ 27-1-24.5-23 — Drug price data

Indiana § 27-1-24.5-23

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 1: DEPARTMENT OF INSURANCE
• Ch. 24.5: Pharmacy Benefit Managers

Text

(a) For every drug for which the pharmacy
benefit manager establishes a maximum allowable cost to determine
the drug product reimbursement, the pharmacy benefit manager shall
make available to a contracted pharmacy services administrative
organization to make available to the pharmacies, or to a pharmacy if
the pharmacy benefit manager contracts directly with a pharmacy, in
a manner established by the department by administrative rule
described in subsection (b) the following:
(1) Information identifying the national drug pricing compendia
or sources used to obtain the drug price data.
(2) The comprehensive list of drugs subject to maximum
allowable cost and the actual maximum allowable cost for each
drug.
(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.

Legislative History

As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.80.