Indiana Code
Chapter 5. Services Provided
12-15-5-5. Office May Provide Drug Coverage; Requirements for Drug Coverage in Managed Care

Sec. 5. (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.
As added by P.L.231-1999, SEC.1. Amended by P.L.101-2005, SEC.1; P.L.152-2017, SEC.5.

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