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Terms Used In Arizona Laws 20-3652

  • Health care plan: means a policy, contract or evidence of coverage that a health care insurer issues to an insured, enrollee or subscriber. See Arizona Laws 20-3651
  • including: means not limited to and is not a term of exclusion. See Arizona Laws 1-215
  • Step therapy protocol: means a protocol or program that establishes the specific sequence in which prescription drugs that are for a specified medical condition and that are medically necessary for a particular patient are covered by a health care insurer under a health care plan. See Arizona Laws 20-3651

1. Any health care plan that is subject to state law regulating insurance, that provides prescription drug benefits and that includes coverage for a step therapy protocol regardless of how that coverage is described.

2. A contractor, agent or similar entity that implements coverage for a step therapy protocol on behalf of a health care plan, including a pharmacy benefit manager or utilization review agent.