What are the guidelines for coverage of drugs for Indiana Medicaid?
Indiana Medicaid covers drugs in accordance with the IHCP rule 405 IAC 5-24-3, which is as follows: 405 IAC 5-24-3 Coverage of legend drugs Authority: IC 12-8-6-5; IC 12-15-1-10; IC 12-15-21-2 Affected: IC 12-13-7-3; IC 12-15 Sec. 3. (a) A legend drug is covered by Indiana Medicaid if the drug is: approved by the United States Food and Drug Administration; not designated by the Health Care Financing Administration (HCFA) as less than effective, or identical, related, or similar to a less than effective drug; subject to the terms of a rebate agreement between the drug’s manufacturer and the HCFA; and not specifically excluded from coverage by Indiana Medicaid. (b) The following are not covered by Indiana Medicaid: Anorectics or any agent used to promote weight loss. Topical minoxidil preparations. Fertility enhancement drugs. Drugs when prescribed solely or primarily for cosmetic purposes.
