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Indiana General Assembly
House Bill 1857


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House Bill 1857

ARCHIVE (2001)

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DIGEST OF HB 1857 (Updated February 27, 2001 6:56 PM - DI 77)

Medicaid. Provides that rulemaking concerning Medicaid waivers for adult foster care, assisted living, or adult day care must comply with certain procedures. Requires a pharmacist who fills a prescription that is covered under the children's health insurance program (CHIP) to fill the prescription with a generically equivalent drug product and inform the customer of the substitution if the substitution results in a lower price, unless the prescribing practitioner indicates that the prescription must be filled with a brand name drug. Provides that reimbursement for legend drugs under Medicaid will be limited to the lowest of: (1) the federal supply schedule price; (2) the maximum allowable cost (MAC) of the drug as determined by the Health Care Financing Administration; or (3) the provider's submitted charge, representing the provider's usual and customary charge for the drug. Requires the office of Medicaid policy and planning (OMPP) to establish an automated phone system for practitioners to obtain prior approval before writing a prescription for a Medicaid patient. Requires a pharmacist to use the system to confirm the patient has been approved for the drug. Makes changes to the conditions the drug utilization review (DUR) board must meet to place a single source drug on prior approval, restrict the drug in its use, or establish a drug monitoring process. Provides that an outpatient formulary established by OMPP must comply with federal law. Requires a practitioner to obtain prior approval from OMPP before writing a prescription to a Medicaid patient for a brand name drug. Requires OMPP to require Marion County Hoosier Healthwise enrollees to enroll in the risk-based managed care program. Requires OMPP to conduct an annual evaluation on a data analysis of certain information that can be used to determine possible cost containment measures for the state's Medicaid program. Requires the attorney general to submit an annual report to the select joint committee on Medicaid oversight on the state medicaid fraud control unit's activities during the preceding year. Requires the division of family and children to establish a fraud control unit to investigate and prosecute claims of any violation, abuse, or fraud by recipients of Medicaid, temporary assistance for needy families (TANF), and food stamps and to submit an annual report to the select joint committee on Medicaid oversight on the fraud control unit's activities during the preceding year. Provides certain procedures for the office of the secretary of family and social services to follow to implement certain Medicaid waivers. Makes other changes regarding Medicaid.
Current Status:
 In Committee - 2nd House
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