Sec. 25. (a) A party that has contracted with a pharmacy benefit manager to provide services may, at least one (1) time in a calendar year, request an audit of compliance with the contract. The audit may include full disclosure of rebate amounts secured on prescription drugs, whether product specific or general rebates, that were provided by a pharmaceutical manufacturer and any other revenue and fees derived by the pharmacy benefit manager from the contract. A contract may not contain provisions that impose unreasonable fees or conditions that would severely restrict a party's right to conduct an audit under this subsection.
(b) A pharmacy benefit manager shall disclose, upon request from a party that has contracted with a pharmacy benefit manager, to the party the actual amounts paid by the pharmacy benefit manager to any pharmacy.
(c) A pharmacy benefit manager shall provide notice to a party contracting with the pharmacy benefit manager of any consideration that the pharmacy benefit manager receives from a pharmacy manufacturer for any name brand dispensing of a prescription when a generic or biologically similar product is available for the prescription.
(d) The commissioner may establish a procedure to release information from an audit performed by the department to a party that has requested an audit under this section in a manner that does not violate confidential or proprietary information laws.
(e) Any provision of a contract entered into, issued, or renewed after June 30, 2020, that violates this section is unenforceable.
As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.81.
Structure Indiana Code
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"
27-1-24.5-6. "Independent Pharmacies"
27-1-24.5-7. "Maximum Allowable Cost"
27-1-24.5-8. "Maximum Allowable Cost List"
27-1-24.5-10. "Pharmacist Services"
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"
27-1-24.5-19. 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
27-1-24.5-24. 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