Current through P.L. 171-2024
Section 27-1-24.5-12 - "Pharmacy benefit manager"(a) As used in this chapter, "pharmacy benefit manager" means an entity that, on behalf of a health plan, state agency, insurer, managed care organization, or other third party payor:(1) contracts directly or indirectly with pharmacies to provide prescription drugs to individuals;(2) administers a prescription drug benefit;(3) processes or pays pharmacy claims;(4) creates or updates prescription drug formularies;(5) makes or assists in making prior authorization determinations on prescription drugs;(6) administers rebates on prescription drugs; or(7) establishes a pharmacy network.(b) The term does not include the following:(1) A person licensed under IC 16.(2) A health provider who is:(A) described in IC 25-0.5-1; and(B) licensed or registered under IC 25.(3) A consultant who only provides advice concerning the selection or performance of a pharmacy benefit manager.Amended by P.L. 32-2021,SEC. 77, eff. 7/1/2021.Added by P.L. 68-2020,SEC. 1, eff. 7/1/2020.