Arizona Laws 20-3341. Definitions
In this article, unless the context otherwise requires:
Terms Used In Arizona Laws 20-3341
- Insurer: means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital and medical service corporation. See Arizona Laws 20-3321
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
- Pharmacy benefit manager: means a person, business or other entity that, pursuant to a contract or under an employment relationship with an insurer or other third-party payor, either directly or through an intermediary manages the prescription drug coverage provided by the insurer or other third-party payor, including the processing and payment of claims for prescription drugs, the performance of drug utilization review, the processing of drug prior authorization requests, the adjudication of appeals or grievances related to prescription drug coverage, contracting with network pharmacies and controlling the cost of covered prescription drugs. See Arizona Laws 20-3321
- United States: includes the District of Columbia and the territories. See Arizona Laws 1-215
1. "Drug coverage":
(a) Means any form of compensation paid to a pharmacy that dispenses prescription drugs for a patient under a contractual or other legal obligation with a health insurer or pharmacy benefit manager.
(b) Does not include either of the following:
(i) Coverage provided pursuant to Title 36, Chapter 29, Article 1.
(ii) Any amounts paid by an individual on his or her own behalf or on behalf of another individual without a contractual or legal obligation to do so.
2. "Health care plan" has the same meaning prescribed in section 20-3151.
3. "Health insurer" has the same meaning prescribed in section 20-242.
4. "Third party" means a health insurer or pharmacy benefit manager that provides or manages drug coverage under a health care plan.
5. "340B covered entity" means an entity that participates in the 340B drug discount program authorized by 42 United States Code § 256b.
6. "340B drug" means a drug that is purchased by a 340B covered entity through the 340B drug discount program authorized by 42 United States Code § 256b and that is dispensed by a pharmacy.