Sec. 7.5. (a) The office may reimburse under Medicaid for methadone if the drug was prescribed for the treatment of pain or pain management only as follows:
(1) If the daily dosage is not more than sixty (60) milligrams.
(2) If the daily dosage is more than sixty (60) milligrams, only if:
(A) prior authorization is obtained; and
(B) a determination of medical necessity has been shown by the provider.
(b) A managed care organization may reimburse under Medicaid for methadone if the drug is prescribed for the treatment of pain or pain management only as follows:
(1) If the daily dosage is not more than sixty (60) milligrams.
(2) If the daily dosage is more than sixty (60) milligrams, only if:
(A) prior authorization is obtained; and
(B) a determination of medical necessity has been shown.
As added by P.L.209-2015, SEC.12.
Structure Indiana Code
Chapter 35.5. Prescription Drugs
12-15-35.5-2. "Cross-Indicated Drug" Defined
12-15-35.5-2.5. "Unrestricted Access" Defined
12-15-35.5-3. Prohibition on Prior Authorization of Mental Health Drugs; Exception
12-15-35.5-4. Prior Authorization Requirement Parameters
12-15-35.5-5. Prior Authorization Procedures
12-15-35.5-6. Publication of Prior Authorization Decision
12-15-35.5-7.5. Reimbursement for Methadone When Prescribed for Pain; Requirements
12-15-35.5-8. Restriction of Mental Health Drugs for Individuals Less Than 18 Years of Age
12-15-35.5-9. Reimbursement for Drugs Indicated Only for Addiction Treatment