Indiana Code
Chapter 35. Drug Utilization Review
12-15-35-51. Advisory Committee; Duties; Report

Sec. 51. (a) As used in this section, "advisory committee" refers to the mental health Medicaid quality advisory committee established by subsection (b).
(b) The mental health Medicaid quality advisory committee is established. The advisory committee consists of the following members:
(1) The director of the office or the director's designee, who shall serve as chairperson of the advisory committee.
(2) The director of the division of mental health and addiction or the director's designee.
(3) A representative of a statewide mental health advocacy organization.
(4) A representative of a statewide mental health provider organization.
(5) A representative from a managed care organization that participates in the state's Medicaid program.
(6) A member with expertise in psychiatric research representing an academic institution.
(7) A pharmacist licensed under IC 25-26.
(8) The commissioner of the department of correction or the commissioner's designee.
The governor shall make the appointments for a term of four (4) years under subdivisions (3) through (7) and fill any vacancy on the advisory committee.
(c) The office shall staff the advisory committee. The expenses of the advisory committee shall be paid by the office.
(d) Each member of the advisory committee who is not a state employee is entitled to the minimum salary per diem provided by IC 4-10-11-2.1(b). The member is also entitled to reimbursement for traveling expenses as provided under IC 4-13-1-4 and other expenses actually incurred in connection with the member's duties as provided in the state policies and procedures established by the Indiana department of administration and approved by the budget agency.
(e) Each member of the advisory committee who is a state employee is entitled to reimbursement for traveling expenses as provided under IC 4-13-1-4 and other expenses actually incurred in connection with the member's duties as provided in the state policies and procedures established by the Indiana department of administration and approved by the budget agency.
(f) The affirmative votes of a majority of the voting members appointed to the advisory committee are required by the advisory committee to take action on any measure.
(g) The advisory committee shall advise the office and make recommendations concerning the clinical use of mental health and addiction medications, including the implementation of IC 12-15-35.5-7(c), and consider the following:
(1) Peer reviewed medical literature.
(2) Observational studies.
(3) Health economic studies.
(4) Input from physicians and patients.
(5) Any other information determined by the advisory committee to be appropriate.
(h) The office shall report recommendations made by the advisory committee to the drug utilization review board established by section 19 of this chapter.
As added by P.L.36-2009, SEC.2. Amended by P.L.185-2013, SEC.1; P.L.205-2013, SEC.207; P.L.2-2014, SEC.65; P.L.53-2014, SEC.107; P.L.130-2018, SEC.50.

Structure Indiana Code

Indiana Code

Title 12. Human Services

Article 15. Medicaid

Chapter 35. Drug Utilization Review

12-15-35-1. "Appropriate and Medically Necessary" Defined

12-15-35-2. "Board" Defined

12-15-35-3. "Compendia" Defined

12-15-35-4. "Counseling" Defined

12-15-35-4.5. "Covered Outpatient Drug" Defined

12-15-35-5. "Criteria" Defined

12-15-35-6. "Drug-Disease Contraindication" Defined

12-15-35-7. "Drug-Drug Interaction" Defined

12-15-35-8. "Drug Utilization Review" or "Dur" Defined

12-15-35-9. "Intervention" Defined

12-15-35-10. "Overutilization or Underutilization" Defined

12-15-35-11. "Pharmacist" Defined

12-15-35-12. "Physician" Defined

12-15-35-13. "Prospective Dur" Defined

12-15-35-14. "Retrospective Dur" Defined

12-15-35-15. "Standards" Defined

12-15-35-16. "Surs" Defined

12-15-35-17. "Therapeutic Appropriateness" Defined

12-15-35-17.5. "Therapeutic Classification" or "Therapeutic Category" Defined

12-15-35-18. "Therapeutic Duplication" Defined

12-15-35-18.5. Application of Chapter

12-15-35-18.7. Formulary Requirements

12-15-35-19. Drug Utilization Review Board; Establishment

12-15-35-20. Membership of Board

12-15-35-20.1. Conflicts of Interest

12-15-35-20.5. Therapeutics Committee Established; Members; Limitations; Terms; Votes; Meetings

12-15-35-21. Board; Appointment; Term

12-15-35-22. Qualifications of Board Members

12-15-35-23. Physician Appointments; Geographic Balance

12-15-35-24. Reappointment of Members

12-15-35-25. Chairman; Compensation; Expenses

12-15-35-26. Additional Staff

12-15-35-27. Retrospective and Prospective Dur Program Responsibility

12-15-35-28. Duties of the Board; Preferred Drug List; Report

12-15-35-28.5. Therapeutics Committee Duties

12-15-35-28.7. Submitting Initial Preferred Drug List; Limitations on Restrictions; Advance Notice to Providers; Implementation; Prior Authorization Limitation; Rules

12-15-35-29. Quorum; Majority Vote on Dur Criteria and Standards for Prescribing

12-15-35-30. Local Practices; Monitoring

12-15-35-31. Intervention; Approval; Requisites

12-15-35-32. Repealed

12-15-35-32.1. Annual Report Contents

12-15-35-33. Repealed

12-15-35-34. Confidential Identifying Information; Release of Cumulative Nonidentifying Information

12-15-35-35. Prior Approval Program for Outpatient Drugs; Standards

12-15-35-36. Advisory Committees

12-15-35-37. Medicaid State Plan; Inclusion of Retrospective and Prospective Dur Program

12-15-35-38. Dur Program Guidelines and Procedures

12-15-35-39. Retrospective Dur Requisites

12-15-35-40. Prospective Dur Requisites

12-15-35-41. Board Activities Under Ic 34-30-15

12-15-35-42. Meetings

12-15-35-43. Confidentiality; Pharmacist Data and Information

12-15-35-43.5. Prohibiting the Release of Proprietary or Confidential Information Obtained Under Certain Circumstances

12-15-35-44. Confidentiality; Violations; Penalty

12-15-35-45. Outpatient Drug Formulary; Requirements

12-15-35-46. Review of Proposed Formulary

12-15-35-47. Review of Changes to Formulary

12-15-35-48. Board Review of Managed Care Organization Prescription Drug Program

12-15-35-49. Information Provided by Office

12-15-35-50. Maximum Allowable Cost Schedule for Drugs; Pharmacy Participation in Medicaid Program

12-15-35-51. Advisory Committee; Duties; Report