{"data":{"id":"us-in/ic-27-1-24.5-11.5","jurisdiction":"us-in","citation":"IC 27-1-24.5-11.5","heading":"\"Pharmacy benefit management services\"","body":"Sec. 11.5. As used in this chapter, \"pharmacy benefit management services\" means:\n(1) negotiating the price of prescription drugs, including negotiating and contracting for direct or indirect rebates, discounts, or other price concessions;\n(2) managing any aspect of a prescription drug benefit, including:\n(A) the processing and payment of claims for prescription drugs;\n(B) arranging alternative access to or funding for prescription drugs;\n(C) the performance of drug utilization review;\n(D) the processing of drug prior authorization requests;\n(E) the adjudication of appeals or grievances related to the prescription drug benefit;\n(F) contracting with network pharmacies;\n(G) controlling the cost of covered prescription drugs;\n(H) managing or providing data relating to the prescription drug benefit;\n(I) the provision of services related to the prescription drug benefit; or\n(J) creating or updating prescription drug formularies;\n(3) the performance of any administrative, managerial, clinical, pricing, financial, reimbursement, data administration or reporting, or billing service; and\n(4) any other services specified in a rule adopted by the department.","path":["TITLE 27. INSURANCE","ARTICLE 1. DEPARTMENT OF INSURANCE","Chapter 24.5. Pharmacy Benefit Managers"],"source_url":"https://iga.in.gov/ic/2026/Title_27.html#27-1-24.5-11.5","current_through":"2026","vintage":"2026","retrieved_at":"2026-09-25T05:39:04Z","sha256":"5157d822deb5bb779415dd3e718ce0664a568124f2bf8c46fbb6f71c09f6d798","source_id":"us-in","stale":false,"prev":"us-in/ic-27-1-24.5-11","next":"us-in/ic-27-1-24.5-12"},"notice":"GroundRules: Original legal text. Not legal advice."}