§ 5-10-8-18 — Prescription drug coverage

(a) The definitions in section 17 of this
chapter apply throughout this section.
(b) This section applies to a state employee health plan that uses a
formulary, cost sharing, or utilization review for prescription drug
coverage.
(c) A state employee health plan shall not remove a prescription
drug from the state employee health plan's formulary, change the cost
sharing requirements that apply to a prescription drug, or change the
utilization review requirements that apply to a prescription drug unless
the state employee health plan 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
covered individual for whom the prescription drug has been
prescribed during the preceding twelve (12) month period.
(2) At the time a covered individual 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
covered individual:
(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.2.