Sec. 17.4. (a) As used in this section, "legend drug" has the meaning set forth in IC 25-26-14-7.
(b) As used in this section, "repackage" has the meaning set forth in IC 25-26-14-9.3.
(c) This subsection does not apply to a retail or mail order pharmacy. Except as provided in subsection (d), whenever a prescription covered by this chapter is filled using a repackaged legend drug:
(1) the maximum reimbursement amount for the repackaged legend drug must be computed using the average wholesale price set by the original manufacturer for the legend drug;
(2) the medical service provider may not be reimbursed for more than one (1) office visit for each repackaged legend drug prescribed; and
(3) the maximum period during which a medical service provider may receive reimbursement for a repackaged legend drug begins on the date of the disablement and ends at the beginning of the eighth day after the date of the disablement.
(d) If the National Drug Code (established under Section 510 of the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. 360) for a legend drug cannot be determined from the medical service provider's billing or statement, the maximum reimbursement amount for the repackaged legend drug under subsection (c) is the lowest cost generic for that legend drug.
As added by P.L.275-2013, SEC.16. Amended by P.L.99-2014, SEC.6.
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