Sec. 18. (a) The definitions in section 17 of this chapter apply throughout this section.

     (b) This section applies to a state employee health plan that uses a formulary, cost sharing, or utilization review for prescription drug coverage.

Terms Used In Indiana Code 5-10-8-18

     (c) A state employee health plan shall not remove a prescription drug from the state employee health plan’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 state employee health plan 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 covered individual for whom the prescription drug has been prescribed during the preceding twelve (12) month period.

(2) At the time a covered individual 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 covered individual:

(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.2.

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