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Indiana Code Title 27. Insurance § 27-13-38-7

Current as of January 02, 2024 | Updated by Findlaw Staff

Sec. 7. (a) The definitions in IC 27-13-7-23 apply throughout this section.

(b) A health maintenance organization shall not remove a prescription drug from the health maintenance organization's formulary, change the cost sharing requirements that apply to a prescription drug, or change the utilization review program requirements that apply to a prescription drug unless that health maintenance organization 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 enrollee for whom the prescription drug has been prescribed during the preceding twelve (12) month period.

(2) At the time an enrollee 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 enrollee:

(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.

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Cite this article: FindLaw.com - Indiana Code Title 27. Insurance § 27-13-38-7 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-27-insurance/in-code-sect-27-13-38-7/

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