Current through P.L. 171-2024
Section 12-15-5-5 - Office may provide drug coverage; requirements for drug coverage in managed care(a) The office may provide a prescription drug benefit to a Medicaid recipient in a Medicaid risk based managed care program.(b) If the office provides a prescription drug benefit to a Medicaid recipient in a Medicaid risk based managed care program:(1) the office shall develop a procedure and provide the recipient's risk based managed care provider with information concerning the recipient's prescription drug utilization for the risk based managed care provider's case management program; and(2) the provisions of IC 12-15-35.5 apply.(c) If the office does not provide a prescription drug benefit to a Medicaid recipient in a Medicaid risk based managed care program, a managed care organization shall provide coverage and reimbursement for outpatient single source legend drugs subject to IC 12-15-35-46, IC 12-15-35-47, and IC 12-15-35.5.Amended by P.L. 152-2017,SEC. 5, eff. 7/1/2017.As added by P.L. 231-1999, SEC.1. Amended by P.L. 101-2005, SEC.1.