(a) As used in this chapter, 'pharmacy benefit manager' means an entity that, on behalf of a health plan, state agency, insurer, managed care organization, or other third party payor:(1) contracts directly or indirectly with pharmacies to provide prescription drugs to individuals;(2) administers a prescription drug benefit;(3) processes or pays pharmacy claims;(4) creates or updates prescription drug formularies;(5) makes or assists in making prior authorization determinations on prescription drugs;(6) administers rebates on prescription drugs; or(7) establishes a pharmacy network.(b) The term does not include the following:(1) A person licensed under IC 16.(2) A health provider who is:(A) described in IC 25-0.5-1; and(B) licensed or registered under IC 25.(3) A consultant who only provides advice concerning the selection or performance of a pharmacy benefit manager.As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.77.
Indiana Legal Code