Title 12, TITLE 12. HUMAN SERVICES

Sec. 23. In making the physician appointments, the governor shall provide for geographic balance. As added by P.L.75-1992, SEC.19.

Sec. 24. An individual appointed to the board may be reappointed upon the completion of the individual's term. As added by P.L.75-1992, SEC.19.

Sec. 25. (a) The board shall annually elect a chairman from the members of the board. (b) The chairman may be re-elected to serve consecutive terms as chairman. (c) A member of the board who is not a state employee is entitled to the minimum salary per diem as provided by IC 4-10…

Sec. 26. (a) The secretary shall provide additional staff to the board. (b) The secretary shall provide staff for the therapeutics committee. As added by P.L.75-1992, SEC.19. Amended by P.L.291-2001, SEC.162; P.L.107-2002, SEC.16.

Sec. 27. The board is responsible for the oversight of the retrospective and prospective DUR program. As added by P.L.75-1992, SEC.19.

Sec. 28. (a) The board has the following duties: (1) The implementation of a Medicaid retrospective and prospective DUR program as outlined in this chapter, including the approval of software programs to be used by the pharmacist for prospective DUR and recommendations concerning…

Sec. 28.5. The therapeutics committee established under section 20.5 of this chapter shall do the following: (1) Advise and make recommendations to the board in the board's development and maintenance of a preferred drug list under section 28 of this chapter. (2) Submit to the bo…

restrictions; advance notice to providers; implementation; prior authorization limitation; rules Sec. 28.7. (a) The board shall submit the initial approved preferred drug list to the office not later than August 1, 2002. (b) Except as permitted under subsection (g), the office ma…

prescribing Sec. 29. (a) A quorum consists of six (6) voting members of the board. (b) DUR criteria and standards for appropriate prescribing may only be implemented with the approval of a majority of the quorum of the board. The majority vote must include at least three (3) of t…

Sec. 3. As used in this chapter, "compendia" means those resources widely accepted by the medical profession in the efficacious use of drugs, including the following sources: (1) The American Hospital Formulary Services Drug Information. (2) The U.S. Pharmacopeia-Drug Information…

Sec. 30. The criteria and standards developed under section 28(a)(3) of this chapter for appropriate prescribing that are implemented must reflect the local practices of physicians to monitor the following: (1) Therapeutic appropriateness. (2) Overutilization or underutilization.…

Sec. 31. (a) An intervention developed under section 28(a)(4) of this chapter that involves a physician must be approved by at least three (3) of the four (4) physician members of the board before implementation. (b) An intervention that involves a pharmacist must be approved by …

As added by P.L.75-1992, SEC.19. Repealed by P.L.76-1994, SEC.7.

Sec. 32.1. The annual report under section 28 of this chapter shall include information on the following: (1) A description of the nature and scope of the prospective drug review program. (2) A description of how pharmacies performing prospective DUR without computers are expecte…

As added by P.L.75-1992, SEC.19. Repealed by P.L.1-1993, SEC.132.

nonidentifying information Sec. 34. (a) Information that identifies an individual collected under this chapter is confidential and may not be disclosed by the board. (b) The board may have access to identifying information for purposes of carrying out intervention activities. The…

Sec. 35. (a) Except as provided in IC 12-15-35.5-9, before the board develops a program to place a single source drug on prior approval, restrict the drug in its use, or establish a drug monitoring process or program to measure or restrict utilization of single source drugs other…

Sec. 36. The board may establish advisory committees to assist the board in carrying out the board's duties under this chapter. As added by P.L.75-1992, SEC.19.

DUR program Sec. 37. The board shall, in cooperation with the secretary, include in the Medicaid state plan the creation and implementation of a retrospective and prospective DUR program for Medicaid outpatient drugs to ensure that the prescriptions are appropriate, medically nec…

Sec. 38. The retrospective and prospective DUR program shall be operated under the guidelines and procedures established by the board under section 29 of this chapter. As added by P.L.75-1992, SEC.19.

Sec. 39. Retrospective DUR must: (1) be based on the guidelines established by the board; and (2) use the mechanized drug claims processing and information retrieval system to analyze claims data to do the following: (A) Identify patterns of fraud, abuse, gross overuse, and inapp…

Sec. 4. As used in this chapter, "counseling" means the activities conducted by a pharmacist to inform Medicaid recipients about the proper use of drugs as required by the board under this chapter. As added by P.L.75-1992, SEC.19.

Sec. 4.5. As used in this chapter, "covered outpatient drug" has the meaning set forth in 42 U.S.C. 1396r-8(k)(2). As added by P.L.107-2002, SEC.12.

Sec. 40. Prospective DUR must be based on the guidelines established by the board and must provide that prior to the prescription being filled or delivered a review will be conducted by the pharmacist at the point of sale to screen for potential drug therapy problems resulting fr…

Sec. 41. The activities of the board in carrying out this chapter are covered under IC 34-30-15. As added by P.L.75-1992, SEC.19. Amended by P.L.1-1998, SEC.103.

Sec. 42. (a) The board may meet in an executive session for purposes of reviewing DUR data or to conduct or to discuss activity as provided for in IC 5-14-1.5-6.1. (b) The board shall also conduct regular public meetings to gather input from the public on the operation of the DUR…

Sec. 43. Confidential data or information obtained by pharmacists as part of prospective DUR are confidential but may be released to prescribers or others according to procedures established by the board. As added by P.L.75-1992, SEC.19.

information obtained under certain circumstances Sec. 43.5. (a) The board, the therapeutics committee, or the office may not release proprietary or confidential information obtained as part of the development, implementation, or maintenance of a preferred drug list under this cha…

Sec. 44. A person who does not comply with the confidentiality provisions under section 34 of this chapter commits a Class A misdemeanor. As added by P.L.75-1992, SEC.19. Amended by P.L.1-1993, SEC.133.

Sec. 45. (a) The chairman of the board, subject to the approval of the board members, may appoint an advisory committee to make recommendations to the board on the development of a Medicaid outpatient drug formulary. (b) If the office decides to establish a Medicaid outpatient dr…

Sec. 46. (a) This section applies to a managed care organization that enters into an initial contract with the office to be a managed care organization after May 13, 1999. (b) Before a managed care organization described in subsection (a) implements a formulary, the managed care …

Sec. 47. (a) This section applies to the following changes to a formulary used by a managed care organization for Medicaid recipients: (1) Removing one (1) or more drugs from the formulary. (2) Placing new restrictions on one (1) or more drugs on the formulary. (b) Before a manag…

program Sec. 48. (a) The board shall review the prescription drug program of a managed care organization that participates in a risk based managed care program at least one (1) time per year. The board's review of a prescription drug program must include the following: (1) An ana…

Sec. 49. (a) The office shall provide the board with information necessary for the board to carry out its duties under this chapter. (b) The office shall provide the information required under subsection (a): (1) when requested by the board; and (2) in a timely manner. As added b…

Sec. 5. As used in this chapter, "criteria" means the predetermined and explicitly accepted elements that are used to measure drug use on an ongoing basis to determine if the use is appropriate, medically necessary, and not likely to result in adverse medical outcomes. As added b…

participation in Medicaid program Sec. 50. (a) IC 12-15-13-6 does not apply to this section. (b) The office shall maintain an Internet web site and post on the web site any changes concerning the office's maximum allowable cost schedule for drugs. (c) A change in the office's max…

Sec. 51. (a) As used in this section, "advisory committee" refers to the mental health Medicaid quality advisory committee established by subsection (b). (b) The mental health Medicaid quality advisory committee is established. The advisory committee consists of the following mem…

Sec. 6. As used in this chapter, "drug-disease contraindication" means an occurrence in which the therapeutic effect of a drug is adversely altered by the presence of another disease condition. As added by P.L.75-1992, SEC.19.

Sec. 7. As used in this chapter, "drug-drug interaction" means an occurrence in which at least two (2) drugs taken by a recipient leads to clinically significant toxicity that: (1) is characteristic of one (1) or any of the drugs present; or (2) leads to the interference with the…

Sec. 8. As used in this chapter, "drug utilization review" or "DUR" means the program designed to measure and assess on a retrospective and a prospective basis the proper use of outpatient drugs in the Medicaid program. As added by P.L.75-1992, SEC.19.

Sec. 9. As used in this chapter, "intervention" means an action taken by the board with a prescriber or pharmacist to inform about or to influence prescribing or dispensing practices or utilization of drugs. As added by P.L.75-1992, SEC.19.

Sec. 1. (a) An Indiana resident who meets the income and resource standards established by the division under section 3 of this chapter is eligible for assistance to satisfy the resident's financial obligation for care provided to the resident in a hospital in Indiana that was ne…

qualifications Sec. 2. (a) An individual who is not an Indiana resident is eligible for assistance to satisfy the individual's financial obligation for the care provided to the individual in a hospital in Indiana that was necessitated after the onset of a medical condition that w…

adoption; conditions Sec. 3. (a) The division shall adopt rules under IC 4-22-2 to establish income and resource eligibility standards for patients whose care is to be paid under the hospital care for the indigent program. (b) To the extent possible and subject to this article, r…

Sec. 4. A provider may provide a patient, and if the patient is not able to understand the statement, the patient's representative, with a statement of the eligibility and benefit standards adopted by the division if at least one (1) of the following occurs: (1) The provider has …

As added by P.L.120-2002, SEC.19. Repealed by P.L.255-2003, SEC.55.

Sec. 1. (a) This chapter applies to all child care providers regardless of whether a provider is required to be licensed or registered under this article. However, except as provided in section 4(b) of this chapter, a child care provider that is licensed under IC 12-17.2-4 or IC …

Sec. 1.2. As used in this chapter, "child care program" refers to the activities provided for children during the time that children are in the care of a provider. As added by P.L.18-2003, SEC.9. IC 12-17.2-3.5-1.3 "Employed"; "employee"; "employment"; "employs" Sec. 1.3. As used…

Sec. 10. (a) A facility where a provider operates a child care program must have two (2) exits that: (1) do not require passage through a: (A) garage; or (B) storage area; where hazardous materials are stored; (2) are not windows; (3) are on different sides of the facility; (4) a…

Sec. 11. (a) A provider shall provide for a safe environment by ensuring that no conditions exist in or on the grounds of the facility where the provider operates a child care program that would endanger the health, safety, or welfare of the children, including ensuring that the …