Indiana Code
Article 15. Medicaid
Chapter 35. Drug Utilization Review

12-15-35-1. "Appropriate and Medically Necessary" Defined - Sec. 1. As used in this chapter, "appropriate and medically...

12-15-35-2. "Board" Defined - Sec. 2. As used in this chapter, "board" refers to...

12-15-35-3. "Compendia" Defined - Sec. 3. As used in this chapter, "compendia" means those...

12-15-35-4. "Counseling" Defined - Sec. 4. As used in this chapter, "counseling" means the...

12-15-35-4.5. "Covered Outpatient Drug" Defined - Sec. 4.5. As used in this chapter, "covered outpatient drug"...

12-15-35-5. "Criteria" Defined - Sec. 5. As used in this chapter, "criteria" means the...

12-15-35-6. "Drug-Disease Contraindication" Defined - Sec. 6. As used in this chapter, "drug-disease contraindication" means...

12-15-35-7. "Drug-Drug Interaction" Defined - Sec. 7. As used in this chapter, "drug-drug interaction" means...

12-15-35-8. "Drug Utilization Review" or "Dur" Defined - Sec. 8. As used in this chapter, "drug utilization review"...

12-15-35-9. "Intervention" Defined - Sec. 9. As used in this chapter, "intervention" means an...

12-15-35-10. "Overutilization or Underutilization" Defined - Sec. 10. As used in this chapter, "overutilization or underutilization"...

12-15-35-11. "Pharmacist" Defined - Sec. 11. As used in this chapter, "pharmacist" means an...

12-15-35-12. "Physician" Defined - Sec. 12. As used in this chapter, "physician" means an...

12-15-35-13. "Prospective Dur" Defined - Sec. 13. As used in this chapter, "prospective DUR" means...

12-15-35-14. "Retrospective Dur" Defined - Sec. 14. As used in this chapter, "retrospective DUR" means...

12-15-35-15. "Standards" Defined - Sec. 15. As used in this chapter, "standards" means the...

12-15-35-16. "Surs" Defined - Sec. 16. As used in this chapter, "SURS" refers to...

12-15-35-17. "Therapeutic Appropriateness" Defined - Sec. 17. As used in this chapter, "therapeutic appropriateness" means...

12-15-35-17.5. "Therapeutic Classification" or "Therapeutic Category" Defined - Sec. 17.5. As used in this chapter, "therapeutic classification" or...

12-15-35-18. "Therapeutic Duplication" Defined - Sec. 18. As used in this chapter, "therapeutic duplication" means...

12-15-35-18.5. Application of Chapter - Sec. 18.5. This chapter applies to any contractor or vendor...

12-15-35-18.7. Formulary Requirements - Sec. 18.7. A formulary established by a managed care organization...

12-15-35-19. Drug Utilization Review Board; Establishment - Sec. 19. The drug utilization review board is established. As...

12-15-35-20. Membership of Board - Sec. 20. The board is composed of the following: (1)...

12-15-35-20.1. Conflicts of Interest - Sec. 20.1. (a) Each board member and each therapeutics committee...

12-15-35-20.5. Therapeutics Committee Established; Members; Limitations; Terms; Votes; Meetings - Sec. 20.5. (a) The therapeutics committee is established as a...

12-15-35-21. Board; Appointment; Term - Sec. 21. (a) The members of the board shall be...

12-15-35-22. Qualifications of Board Members - Sec. 22. Board members must have expertise in one (1)...

12-15-35-23. Physician Appointments; Geographic Balance - Sec. 23. In making the physician appointments, the governor shall...

12-15-35-24. Reappointment of Members - Sec. 24. An individual appointed to the board may be...

12-15-35-25. Chairman; Compensation; Expenses - Sec. 25. (a) The board shall annually elect a chairman...

12-15-35-26. Additional Staff - Sec. 26. (a) The secretary shall provide additional staff to...

12-15-35-27. Retrospective and Prospective Dur Program Responsibility - Sec. 27. The board is responsible for the oversight of...

12-15-35-28. Duties of the Board; Preferred Drug List; Report - Sec. 28. (a) The board has the following duties: (1)...

12-15-35-28.5. Therapeutics Committee Duties - Sec. 28.5. The therapeutics committee established under section 20.5 of...

12-15-35-28.7. Submitting Initial Preferred Drug List; Limitations on Restrictions; Advance Notice to Providers; Implementation; Prior Authorization Limitation; Rules - Sec. 28.7. (a) The board shall submit the initial approved...

12-15-35-29. Quorum; Majority Vote on Dur Criteria and Standards for Prescribing - Sec. 29. (a) A quorum consists of six (6) voting...

12-15-35-30. Local Practices; Monitoring - Sec. 30. The criteria and standards developed under section 28(a)(3)...

12-15-35-31. Intervention; Approval; Requisites - Sec. 31. (a) An intervention developed under section 28(a)(4) of...

12-15-35-32. Repealed - As added by P.L.75-1992, SEC.19. Repealed by P.L.76-1994, SEC.7.

12-15-35-32.1. Annual Report Contents - Sec. 32.1. The annual report under section 28 of this...

12-15-35-33. Repealed - As added by P.L.75-1992, SEC.19. Repealed by P.L.1-1993, SEC.132.

12-15-35-34. Confidential Identifying Information; Release of Cumulative Nonidentifying Information - Sec. 34. (a) Information that identifies an individual collected under...

12-15-35-35. Prior Approval Program for Outpatient Drugs; Standards - Sec. 35. (a) Except as provided in IC 12-15-35.5-9, before...

12-15-35-36. Advisory Committees - Sec. 36. The board may establish advisory committees to assist...

12-15-35-37. Medicaid State Plan; Inclusion of Retrospective and Prospective Dur Program - Sec. 37. The board shall, in cooperation with the secretary,...

12-15-35-38. Dur Program Guidelines and Procedures - Sec. 38. The retrospective and prospective DUR program shall be...

12-15-35-39. Retrospective Dur Requisites - Sec. 39. Retrospective DUR must: (1) be based on the...

12-15-35-40. Prospective Dur Requisites - Sec. 40. Prospective DUR must be based on the guidelines...

12-15-35-41. Board Activities Under Ic 34-30-15 - Sec. 41. The activities of the board in carrying out...

12-15-35-42. Meetings - Sec. 42. (a) The board may meet in an executive...

12-15-35-43. Confidentiality; Pharmacist Data and Information - Sec. 43. Confidential data or information obtained by pharmacists as...

12-15-35-43.5. Prohibiting the Release of Proprietary or Confidential Information Obtained Under Certain Circumstances - Sec. 43.5. (a) The board, the therapeutics committee, or the...

12-15-35-44. Confidentiality; Violations; Penalty - Sec. 44. A person who does not comply with the...

12-15-35-45. Outpatient Drug Formulary; Requirements - Sec. 45. (a) The chairman of the board, subject to...

12-15-35-46. Review of Proposed Formulary - Sec. 46. (a) This section applies to a managed care...

12-15-35-47. Review of Changes to Formulary - Sec. 47. (a) This section applies to the following changes...

12-15-35-48. Board Review of Managed Care Organization Prescription Drug Program - Sec. 48. (a) The board shall review the prescription drug...

12-15-35-49. Information Provided by Office - Sec. 49. (a) The office shall provide the board with...

12-15-35-50. Maximum Allowable Cost Schedule for Drugs; Pharmacy Participation in Medicaid Program - Sec. 50. (a) IC 12-15-13-6 does not apply to this...

12-15-35-51. Advisory Committee; Duties; Report - Sec. 51. (a) As used in this section, "advisory committee"...