As used in KRS § 205.5510 to KRS § 205.5520, unless the context otherwise requires: (1) “Department” means the Department for Medicaid Services;
(2) “Managed care organization” has the same meaning as in KRS § 205.532; (3) “Pharmacy benefit manager” has the same meaning as in KRS § 304.9-020;
(4) “Spread pricing” means any technique by which a pharmacy benefit manager or other administrator of pharmacy benefits charges or claims an amount from an insurer or managed care organization for pharmacy or pharmacist services, including payment for a prescription drug, that is different than the amount the pharmacy benefit manager or other administrator pays to the pharmacy or pharmacist that provided the services; and
(5) “State pharmacy benefit manager” means the pharmacy benefit manager contracted by the department, pursuant to KRS § 205.5512, to administer pharmacy benefits for all Medicaid recipients enrolled in a managed care organization in the Commonwealth.
Effective: March 27, 2020
History: Created 2020 Ky. Acts ch. 70, sec. 1, effective March 27, 2020.