Common use of Drug Coverage Clause in Contracts

Drug Coverage. Prescription drugs and certain over-the-counter drugs are benefits under the Hoosier Care Connect program to be covered by the Contractor. Members are responsible for a copayment for covered drugs in the amount outlined in Section 12.2. The Contractor shall support FSSA in promptly responding to public and legislative inquiries involving the design and management of the Contractor’s pharmacy benefit. If the Contractor elects to subcontract with a pharmacy benefit manager (PBM), the Contractor must ensure compliance with all subcontracting requirements outlined in Section 2.3, including but not limited to conducting regular audits and monitoring of the subcontractor’s data and performance, as well as requiring their PBM to conduct regular audits of their pharmacy provider networks.