Sec. 4.5. (a) As used in this section, "legend drug" has the meaning set forth in IC 25-26-14-7.
(b) As used in this section, "repackage" has the meaning set forth in IC 25-26-14-9.3.
(c) This subsection does not apply to a retail or mail order pharmacy. Except as provided in subsection (d), whenever a prescription covered by IC 22-3-2 through IC 22-3-6 is filled using a repackaged legend drug:
(1) the maximum reimbursement amount for the repackaged legend drug must be computed using the average wholesale price set by the original manufacturer for the legend drug;
(2) the medical service provider may not be reimbursed for more than one (1) office visit for each repackaged legend drug prescribed; and
(3) the maximum period during which a medical service provider may receive reimbursement for a repackaged legend drug begins on the date of the injury and ends at the beginning of the eighth day after the date of the injury.
(d) If the National Drug Code (established under Section 510 of the federal Food, Drug, and Cosmetic Act, 21 U.S.C. 360) for a legend drug cannot be determined from the medical service provider's billing or statement, the maximum reimbursement amount for the repackaged legend drug under subsection (c) is the lowest cost generic for that legend drug.
As added by P.L.275-2013, SEC.3. Amended by P.L.99-2014, SEC.1.
Structure Indiana Code
Article 3. Worker's Compensation System
Chapter 3. Worker's Compensation: Notice of Injury; Treatment; Compensation Schedule; Payments
22-3-3-1. Notice of Injury; Time
22-3-3-2. Notice of Injury; Contents; Signature
22-3-3-3. Limitation of Actions; Radiation
22-3-3-4. Medical Treatment Pending Adjudication of Impairment
22-3-3-4.5. Repackaged Drugs; Maximum Reimbursement Amount
22-3-3-4.7. Formulary; Reimbursement for "N" Drug
22-3-3-5.1. Collection of Medical Expense Payments; Civil Penalties; Good Faith Errors
22-3-3-5.2. Billing Review Service Standards
22-3-3-5.2-b. Billing Review Service Standards
22-3-3-6. Physical Examination; Physician's Statement; Autopsy
22-3-3-7. Temporary Disability Benefits; Installment Payments; Termination; Overpayment
22-3-3-7.5. Average Weekly Wages of Public Employee; Determination
22-3-3-8. Temporary Total Disability or Total Permanent Disability; Awards
22-3-3-9. Temporary Partial Disability; Awards
22-3-3-10-b. Injuries Schedule
22-3-3-11. Partial Disability; Refusing Employment; Notice
22-3-3-12. Subsequent Permanent Injuries; Aggravation; Awards
22-3-3-13. Second Injury Fund; Employee Compensation; Employer Assessments; Penalties
22-3-3-14. Subsequent Injuries; Two Awards
22-3-3-15. Subsequent Injuries; Awards; Extending Period of Payment
22-3-3-16. Death While Receiving Awards; Dependents; Payment
22-3-3-18. Death Resulting From Injuries; Award; Payment to Dependents
22-3-3-19. Presumptive Dependents; Termination of Dependency
22-3-3-20. Total or Partial Dependents; Eligibility; Termination
22-3-3-22. Awards; Computation
22-3-3-22-b. Awards; Computation
22-3-3-23. Mistake in Payments; Deductions; Payments to State Employees
22-3-3-25. Lump Sum Payments; Minors; Interest Rate
22-3-3-26. Lump Sum Payments; Trustees
22-3-3-27. Jurisdiction; Modification of Award
22-3-3-28. Children and Minors; Direct Payments
22-3-3-29. Injured Employee or Dependent Under Guardianship
22-3-3-30. Incompetent Persons; Limitation of Actions
22-3-3-31. Joint Service of Two or More Employers; Apportionment of Award