There are two relevant AWP laws for the state: (l) No hospital, physician, pharmacist, or other provider willing to meet the terms and conditions of a health plan agreement may be denied the right to enter into such an agreement. When an insurer denies a provider the right to enter into an agreement on the grounds that the provider does not satisfy the terms and conditions established by the insurer for providers entering into the agreements with the insurer, the insurer shall provide the provider with a written notice that (1) explains the basis of the insurer’s denial, and (2) states the specific terms and conditions that the provider, in the opinion of the insurer, does not satisfy; (ll) A pharmacy benefit manager shall provide equal access and incentives to all pharmacies within the pharmacy benefit network; “equal access and incentives” means that a pharmacy benefit manager allows any willing pharmacy provider to participate as part of any of the pharmacy benefit manager’s networks as long as the pharmacy provider agrees to the terms and conditions of the relevant contract applicable to any other pharmacy provider within that network.

Link to Existing Law: IC 27-8-11-3

IC 27-1-24.5-19(a)

The first law is written broadly to apply to pharmacies and dispensing physicians, alike, and imposes requirements on health insurers to state a basis for any efforts to deny network access. The second law is within a Chapter that applies to PBMs, specifically, and applies to pharmacies, which are defined as a physical location licensed pursuant to statelaw and from where drugs are dispensed.