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27-8-5-31. Prescription drug coverage

IN Code § 27-8-5-31 (2019) (N/A)
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Sec. 31. (a) The definitions in section 30 of this chapter apply throughout this section.

(b) This section applies to an insurer that uses a formulary, cost sharing, or utilization review for prescription drug coverage.

(c) An insurer shall not remove a prescription drug from the insurer's formulary, change the cost sharing requirements that apply to a prescription drug, or change the utilization review requirements that apply to a prescription drug unless the insurer does at least one (1) of the following:

(1) At least sixty (60) days before the removal or change is effective, send written notice of the removal or change to each insured for whom the prescription drug has been prescribed during the preceding twelve (12) month period.

(2) At the time an insured for whom the prescription drug has been prescribed during the preceding twelve (12) month period requests a refill of the prescription drug, provide to the insured:

(A) written notice of the removal or change; and

(B) a sixty (60) day supply of the prescription drug under the terms that applied before the removal or change.

As added by P.L.19-2016, SEC.4.

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