Sec. 8. (a) As used in this section, "maintenance drug" means a medication that is dispensed under a single prescription for a period of not less than one hundred eighty (180) days, excluding authorized refills, for the ongoing treatment of a chronic medical condition or disease or congenital condition or disorder.
(b) The office may designate:
(1) a mail order pharmacy;
(2) an Internet based pharmacy (as defined in IC 25-26-18-1);
(3) a pharmacy that agrees to sell a maintenance drug at the same price as a mail order or an Internet based pharmacy; or
(4) all the pharmacies listed in subdivisions (1) through (3);
through which a recipient may obtain a maintenance drug.
(c) If the office makes a designation under subsection (b), a managed care organization that has a contract with the office under IC 12-15-12 is not required to use a pharmacy that is designated under subsection (b).
(d) If a Medicaid recipient's physician prescribes a maintenance prescription drug, the Medicaid recipient may purchase the maintenance prescription drug from a pharmacy that is designated under subsection (b).
(e) The office shall apply to amend the state Medicaid plan if the office determines that an amendment is necessary to carry out this section.
(f) The office may require a recipient to pay the maximum copayment allowable under federal law if the recipient obtains a maintenance drug from a pharmacy other than a pharmacy described in subsection (b).
As added by P.L.246-2005, SEC.105.
Structure Indiana Code
12-15-5-1. Services and Supplies Provided; Exceptions
12-15-5-1-b. Services and Supplies Provided; Exceptions
12-15-5-2. Necessity of Federal Financial Participation
12-15-5-5. Office May Provide Drug Coverage; Requirements for Drug Coverage in Managed Care
12-15-5-7. Reimbursement for Doula Services; Rules
12-15-5-8. Maintenance Drugs; Prescriptions; Internet Based Pharmacies
12-15-5-9. Provision of Self-Directed Care Options
12-15-5-9.2. Coverage for Care Related to Cancer Clinical Trials
12-15-5-12. "Child"; Reimbursement for Specialized or Nonstandard Wheelchairs; Prior Authorization
12-15-5-14.5. Eligible Providers for Supervising Treatment Plan
12-15-5-15. Reimbursement for Students; Conditions; Policies
12-15-5-16. Reimbursement for Clinical Addiction Counselors; Clinical Supervision Requirement
12-15-5-18. Emergency Medical Service Provider Agencies; Reimbursement; Federal Approval
12-15-5-18.5. Reimbursement for Emergency Medical Services
12-15-5-20. "Intensive Outpatient Treatment Program"
12-15-5-21. Community Mental Health Centers; Governmental Units