§ 27-13-9-5 — Prescription drug information card

Indiana § 27-13-9-5

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 13: HEALTH MAINTENANCE ORGANIZATIONS
• Ch. 9: Information to Enrollees or Subscribers

Text

(a) This section applies to a health maintenance
organization that provides coverage for prescription drugs or devices
and issues a card or other technology for claims processing.
(b) The card or other technology issued by a health maintenance
organization must contain uniform prescription drug information that
complies with the requirements established under subsection (c).
(c) Prescription drug information cards or other technology must
meet either of the following criteria:
(1) Be in a format and contain information fields approved by the
National Council for Prescription Drug Programs (NCPDP) as
contained in the National Council for Prescription Drug Programs
Pharmacy ID Card Implementation Guide in effect on the October
1 most immediately preceding the issuance of the card.
(2) Contain the following information:
(A) The health benefit plan's name.
(B) The enrollee's name, group number, and identification
number.
(C) A telephone number to inquire about pharmacy related
issues.
(D) The issuer's international identification number or ANSI
BIN number, labeled as RxBIN.
(E) The processor control number, labeled as RxPCN.
(F) The insured's pharmacy benefits group number if different
than medical group number, labeled as RxGRP.
Only those fields listed in clauses (A) through (F) that are
required for proper adjudication of the claim must appear on the
card. If the card is used to adjudicate non-pharmacy claims, then
the designation "Rx" listed in clauses (D) through (F) is not
required to be used by the issuer.
(d) A health maintenance organization may not be required to issue
a prescription drug information card or other technology to a person
more than one (1) time during a twelve (12) month period.
(e) The prescription drug information cards or other technology
issued under this section may be used for health care service coverage
other than the coverage to which this chapter applies.

Legislative History

As added by P.L.230-2001, SEC.3. Amended by P.L.1-2002, SEC.123.