Indiana Code
Chapter 24.5. Pharmacy Benefit Managers
27-1-24.5-24. Information Necessary for Appeal

Sec. 24. (a) For every drug for which a pharmacy benefit manager establishes a maximum allowable cost to determine reimbursement for the drug product, the pharmacy benefit manager shall make available to the department, upon request of the department, information that is needed to resolve an appeal.
(b) If the pharmacy benefit manager fails to promptly make available to the department the information as required in subsection (a), the department shall consider the appeal granted in favor of the appealing pharmacy.
As added by P.L.68-2020, SEC.1.

Structure Indiana Code

Indiana Code

Title 27. Insurance

Article 1. Department of Insurance

Chapter 24.5. Pharmacy Benefit Managers

27-1-24.5-1. "Covered Individual"

27-1-24.5-2. "Effective Rate of Reimbursement"

27-1-24.5-3. "Equal Access and Incentives"

27-1-24.5-4. "Generic Drug"

27-1-24.5-5. "Health Plan"

27-1-24.5-6. "Independent Pharmacies"

27-1-24.5-7. "Maximum Allowable Cost"

27-1-24.5-8. "Maximum Allowable Cost List"

27-1-24.5-9. "Pharmacist"

27-1-24.5-10. "Pharmacist Services"

27-1-24.5-11. "Pharmacy"

27-1-24.5-12. "Pharmacy Benefit Manager"

27-1-24.5-13. "Pharmacy Benefit Manager Affiliate"

27-1-24.5-14. "Pharmacy Benefit Manager Network"

27-1-24.5-15. "Pharmacy Services Administrative Organization"

27-1-24.5-16. "Rebate"

27-1-24.5-17. "Third Party"

27-1-24.5-18. Licensure

27-1-24.5-19. Equal Access and Incentives; Prohibited Acts

27-1-24.5-19.5. Federal Drug Pricing Program

27-1-24.5-20. Acts of the Commissioner; Confidentiality

27-1-24.5-21. Annual Reporting Requirements; Trade Secrets

27-1-24.5-22. Required Information; Appeals Process; Auditing Procedures

27-1-24.5-22.5. Aggregated Information From Pharmacy Benefit Manager Reports

27-1-24.5-22.6. Filing Complaints With Department of Insurance

27-1-24.5-23. Drug Price Data

27-1-24.5-24. Information Necessary for Appeal

27-1-24.5-25. Party's Right to Audit; Amounts Paid; Consideration

27-1-24.5-26. Disclosure of Contract With Another Party

27-1-24.5-27. Contracts of Pharmacy Services Administrative Organizations

27-1-24.5-27.5. Pharmacist May Not Be Required to Collect Higher Copayment for Prescription Drug

27-1-24.5-28. Violation of Chapter