Indiana Code 22-3-7-17.4. Repackaged drugs; maximum reimbursement amount
(b) As used in this section, “repackage” has the meaning set forth in IC 25-26-14-9.3.
Terms Used In Indiana Code 22-3-7-17.4
- disablement: means the event of becoming disabled from earning full wages at the work in which the employee was engaged when last exposed to the hazards of the occupational disease by the employer from whom the employee claims compensation or equal wages in other suitable employment, and "disability" means the state of being so incapacitated. See Indiana Code 22-3-7-9
- medical service provider: refers to a person or an entity that provides services or products to an employee under this chapter. See Indiana Code 22-3-7-9
(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.