405 IAC 5-24-5 - Reimbursement for nonlegend drugs
Authority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-21-2
Affected: IC 12-13-7-3; IC 12-15
Sec. 5.
(a) The
office shall reimburse pharmacy providers for nonlegend (over-the-counter or
OTC) drugs at the lower of the following:
(1)
the state over-the-counter maximum allowable cost plus professional dispensing
fee; or
(2) the provider's
submitted charge, representing the provider's usual and customary charge for
the drug, as of the date of dispensing.
(b) Only those nonlegend drugs that are
included on the OTC drug formulary are covered by Indiana health coverage
programs (IHCP).
Notes
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Authority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-21-2
Affected: IC 12-13-7-3; IC 12-15
Sec. 5.
(a) The office shall reimburse pharmacy providers for nonlegend (over-the-counter or OTC) drugs at the lower of the following:
(1) the state over-the-counter maximum allowable cost plus professional dispensing fee; or
(2) the provider's submitted charge, representing the provider's usual and customary charge for the drug, as of the date of dispensing.
(b) Only those nonlegend drugs that are included on the OTC drug formulary are covered by Indiana health coverage programs (IHCP).