§ 56-7-3101 Compliance – Promulgation of rules
§ 56-7-3102 Part definitions
§ 56-7-3103 Audit of records of pharmacist or pharmacy
§ 56-7-3104 Calculation of reimbursement of pharmacy benefits manager
§ 56-7-3105 Contract compliance
§ 56-7-3106 Placement of drug on maximum allowable cost list
§ 56-7-3107 Information to be provided regarding maximum allowable cost lists – Updating maximum allowable cost lists
§ 56-7-3108 Appeal by pharmacy of cost of particular drug or device on maximum allowable cost list – Procedure
§ 56-7-3109 Medical products and devices subject to requirements of part
§ 56-7-3110 Sanctions for violation of part
§ 56-7-3111 Disclosure of maximum allowable cost lists and related information
§ 56-7-3112 Fair Disclosure of State Funded Payments for Pharmacists’ Services Act
§ 56-7-3113 Licensure as pharmacy benefits manager
§ 56-7-3114 Right to provide information regarding amount of insured’s cost share of prescription drug
§ 56-7-3115 Prohibited charges
§ 56-7-3116 Prohibited terms or conditions in contracts
§ 56-7-3117 Disclosure of material changes to contract provisions
§ 56-7-3118 Mutual agreement on terms and conditions for provision of pharmacy services – Use of untrue, deceptive, or misleading advertisement, etc. prohibited – Effect of removal of pharmacist or pharmacy – Pattern or practice of reimbursing pharmacies or pharmacis
§ 56-7-3119 Dealings with 340B entities – Discrimination against 340B entity prohibited
§ 56-7-3120 Penalty for obtaining prescription drugs from contracted pharmacy prohibited – Interference with patient’s right to choose contracted pharmacy or contracted provider of choice prohibited
§ 56-7-3121 Utilization of any pharmacy in state – Preferred network of pharmacies and nonpreferred network of pharmacies
§ 56-7-3122 Applicability of part
§ 56-7-3123 Confidentiality of information obtained or produced pursuant to audit – Disclosure of audit findings
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Terms Used In Tennessee Code > Title 56 > Chapter 7 > Part 31 - Pharmacy Benefits Managers

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Code: includes the Tennessee Code and all amendments and revisions to the code and all additions and supplements to the code. See Tennessee Code 1-3-105
  • Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-1-102
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Department: means the department of commerce and insurance. See Tennessee Code 56-1-102
  • Fraud: Intentional deception resulting in injury to another.
  • Maximum allowable cost: means the maximum amount that a pharmacy benefits manager or covered entity will reimburse a pharmacy for the cost of a drug or a medical product or device. See Tennessee Code 56-7-3102
  • Maximum allowable cost list: means a list of drugs, medical products or devices, or both medical products and devices, for which a maximum allowable cost has been established by a pharmacy benefits manager or covered entity. See Tennessee Code 56-7-3102
  • Month: means a calendar month. See Tennessee Code 1-3-105
  • 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.
  • Person: means any association, aggregate of individuals, business, company, corporation, individual, joint-stock company, Lloyds-type organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Tennessee Code 56-16-102
  • Pharmacy benefits manager: includes , but is not limited to, a health insurance issuer, managed health insurance issuer as defined in §. See Tennessee Code 56-7-3102
  • Pharmacy services administrative organization: means an entity that provides contracting and other administrative services to pharmacies to assist them in their interaction with third-party payers, pharmacy benefits managers, drug wholesalers, and other entities. See Tennessee Code 56-7-3102
  • Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in a perceivable form. See Tennessee Code 1-3-105
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
  • United States: includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
  • written: includes printing, typewriting, engraving, lithography, and any other mode of representing words and letters. See Tennessee Code 1-3-105