Note: This version of section effective until 1-1-2026. See also following version of this section, effective 1-1-2026. Sec. 12. (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. IC 27-1-24.5-12 "Pharmacy benefit manager" Note: This version of section effective 1-1-2026. See also preceding version of this section, effective until 1-1-2026. Sec. 12. (a) As used in this chapter, "pharmacy benefit manager" means: (1) a person who, under a written agreement with an insurer, health plan, state agency, managed care organization, or other third party payor, directly or indirectly provides one (1) or more pharmacy benefit management services on behalf of the insurer, health plan, state agency, managed care organization, or other third party payor; and (2) an agent, a contractor, an intermediary, an affiliate, a subsidiary, or a related entity of a person described in subdivision (1) who facilitates, provides, directs, or oversees the provision of the pharmacy benefit management services. (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.
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