- (a) The office may provide a prescription drug benefit to a Medicaid recipient in a Medicaid risk based managed care program.
(b) If the office provides a prescription drug benefit to a Medicaid recipient in a Medicaid risk based managed care program:
- (1) the office shall develop a procedure and provide the recipient's risk based managed care provider with information concerning the recipient's prescription drug utilization for the risk based managed care provider's case management program; and
- (2) the provisions of IC 12-15-35.5 apply.
- (c) If the office does not provide a prescription drug benefit to a Medicaid recipient in a Medicaid risk based managed care program, a managed care organization shall provide coverage and reimbursement for outpatient single source legend drugs subject to IC 12-15-35-46 , IC 12-15-35-47 , and IC 12-15-35.5 .
As added by P.L.231-1999, SEC.1. Amended by P.L.101-2005, SEC.1; P.L.152-2017, SEC.5.