§ 15-1601. Definitions
West's Annotated Code of MarylandInsuranceEffective: January 1, 2022
Effective: January 1, 2022
MD Code, Insurance, § 15-1601
§ 15-1601. Definitions
(b) “Agent” means a pharmacy, a pharmacist, a mail order pharmacy, or a nonresident pharmacy acting on behalf or at the direction of a pharmacy benefits manager.
(c) “Beneficiary” means an individual who receives prescription drug coverage or benefits from a purchaser.
(d)(1) “Carrier” means the State Employee and Retiree Health and Welfare Benefits Program, an insurer, a nonprofit health service plan, or a health maintenance organization that:
(2) “Carrier” does not include a person that provides prescription drug coverage or benefits through plans subject to ERISA and does not provide prescription drug coverage or benefits through insurance, unless the person is a multiple employer welfare arrangement as defined in § 514(b)(6)(a)(ii) of ERISA.
(e) “Compensation program” means a program, policy, or process through which sources and pricing information are used by a pharmacy benefits manager to determine the terms of payment as stated in a participating pharmacy contract.
(f) “Contracted pharmacy” means a pharmacy that participates in the network of a pharmacy benefits manager through a contract with:
(i)(1) “Manufacturer payments” means any compensation or remuneration a pharmacy benefits manager receives from or on behalf of a pharmaceutical manufacturer.
(j) “Nonprofit health maintenance organization” has the meaning stated in § 6-121(a) of this article.
(k) “Nonresident pharmacy” has the meaning stated in § 12-403 of the Health Occupations Article.
(l) “Participating pharmacy contract” means a contract filed with the Commissioner in accordance with § 15-1628(b) of this subtitle.
(o) “Pharmacy and therapeutics committee” means a committee established by a pharmacy benefits manager to:
(p)(1) “Pharmacy benefits management services” means:
(q) “Pharmacy benefits manager” means a person that performs pharmacy benefits management services.
(r) “Proprietary information” means:
(s) “Purchaser” means a person that offers a plan or program in the State, including the State Employee and Retiree Health and Welfare Benefits Program, that:
(t) “Rebate sharing contract” means a contract between a pharmacy benefits manager and a purchaser under which the pharmacy benefits manager agrees to share manufacturer payments with the purchaser.
(u)(1) “Therapeutic interchange” means any change from one prescription drug to another.
(v) “Therapeutic interchange solicitation” means any communication by a pharmacy benefits manager for the purpose of requesting a therapeutic interchange.
Credits
Added by Acts 2008, c. 201, § 1, eff. Oct. 1, 2008; Acts 2008, c. 202, § 1, eff. Oct. 1, 2008; Acts 2008, c. 203, § 1, eff. Oct. 1, 2008; Acts 2008, c. 204, § 1, eff. Oct. 1, 2008; Acts 2008, c. 205, § 1, eff. Oct. 1, 2008; Acts 2008, c. 206, § 1, eff. Oct. 1, 2008; Acts 2008, c. 262, § 1, eff. Oct. 1, 2008; Acts 2008, c. 279, § 1, eff. Oct. 1, 2008. Amended by Acts 2019, c. 400, § 1, eff. May 13, 2019; Acts 2020, c. 434, § 1, eff. June 1, 2020; Acts 2021, c. 4, § 1, eff. March 13, 2021; Acts 2021, c. 28, § 1, eff. March 14, 2021; Acts 2021, c. 358, § 1, eff. Jan. 1, 2022.
MD Code, Insurance, § 15-1601, MD INSURANCE § 15-1601
Current through legislation effective through April 25, 2024, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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