North Dakota Code 26.1-36.10-01 – Definitions
1. “Board” means the state board of pharmacy.
Terms Used In North Dakota Code 26.1-36.10-01
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Individual: means a human being. See North Dakota Code 1-01-49
- Organization: includes a foreign or domestic association, business trust, corporation, enterprise, estate, joint venture, limited liability company, limited liability partnership, limited partnership, partnership, trust, or any legal or commercial entity. See North Dakota Code 1-01-49
- Person: means an individual, organization, government, political subdivision, or government agency or instrumentality. See North Dakota Code 1-01-49
- State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See North Dakota Code 1-01-49
- United States: includes the District of Columbia and the territories. See North Dakota Code 1-01-49
2. “Commissioner” means the insurance commissioner.
3. “Concession” includes a free good, delayed billing, and billing forgiveness.
4. “Drug” has the same meaning as provided under section 19-02.1-01.
5. “Drug manufacturer” means the entity that holds the national drug code for a drug which is engaged in the production, preparation, propagation, compounding, conversion, or processing of the drug or which is engaged in the packaging, repackaging, labeling, relabeling, or distribution of the drug. The term does not include a wholesale drug distributor or retail pharmacy licensed in this state.
6. “Health care plan” means an individual, blanket, or group plan, policy, or contract for health care services issued or delivered in this state by a health insurer.
7. “Health insurer” means an insurance company, nonprofit health service corporation, health maintenance organization, third-party payer, health program administered by a state agency other than the department of health and human services or other person engaged as principal in the business of insurance which issues or delivers a health care plan in this state.
8. “Manufacturer-packaged drug container” means a drug manufacturer-prepared supply of medication packaged in a container with a unique product-identifying national drug code number.
9. “Net spending” means the cost of drugs minus any discounts that lower the price of the drugs, including a rebate, fee, retained price protection, retail pharmacy network spread, and dispensing fee.
10. “Pharmacy benefits manager” has the same meaning as provided under section 19-03.6-01. The term does not include the department of health and human services.
11. “Prescription drug” has the same meaning as under section 43-15-01.
12. “Rebate” includes any discount, financial incentive, or concession that affects the price of a drug to a pharmacy benefits manager or health insurer for a drug manufactured by the drug manufacturer.
13. “Specialty drug” has the same meaning as provided under section 19-02.1-16.2.
14. “Utilization management” means a set of formal techniques designed to monitor the use of, or evaluate the medical necessity, appropriateness, efficacy, or efficiency of, health care services, procedures, or settings.
15. “Wholesale acquisition cost” means, with respect to a prescription drug, the drug manufacturer’s list price for the prescription drug to wholesalers or direct purchasers in the United States for the most recent month for which the information is available, as reported in wholesale price guides or other publications of drug pricing data, such as Medi-Span Price Rx, Gold Standard Drug Database, or First Databank drug data. The term does not include a rebate, prompt pay, or other discount or other reduction in price.