§ 27-13-38-7 — Prescription drug coverage

Indiana § 27-13-38-7

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 13: HEALTH MAINTENANCE ORGANIZATIONS
• Ch. 38: Patient Protection; Drugs and Devices; Drug Utilization

Text

(a) The definitions in IC 27-13-7-23 apply
throughout this section.
(b) A health maintenance organization shall not remove a
prescription drug from the health maintenance organization's
formulary, change the cost sharing requirements that apply to a
prescription drug, or change the utilization review program
requirements that apply to a prescription drug unless that health
maintenance organization does at least one (1) of the following:
(1) At least sixty (60) days before the removal or change is
effective, send written notice of the removal or change to each
enrollee for whom the prescription drug has been prescribed
during the preceding twelve (12) month period.
(2) At the time an enrollee for whom the prescription drug has
been prescribed during the preceding twelve (12) month period
requests a refill of the prescription drug, provide to the enrollee:
(A) written notice of the removal or change; and
(B) a sixty (60) day supply of the prescription drug under the
terms that applied before the removal or change.

Legislative History

As added by P.L.19-2016, SEC.6.