§ 357. Definitions
Oklahoma Statutes AnnotatedTitle 59. Professions and Occupations
59 Okl.St.Ann. § 357
§ 357. Definitions
As used in this act:
1. “Covered entity” means a nonprofit hospital or medical service organization, insurer, health coverage plan or health maintenance organization; a health program administered by the state in the capacity of provider of health coverage; or an employer, labor union, or other entity organized in the state that provides health coverage to covered individuals who are employed or reside in the state. This term does not include a health plan that provides coverage only for accidental injury, specified disease, hospital indemnity, disability income, or other limited benefit health insurance policies and contracts that do not include prescription drug coverage;
2. “Covered individual” means a member, participant, enrollee, contract holder or policy holder or beneficiary of a covered entity who is provided health coverage by the covered entity. A covered individual includes any dependent or other person provided health coverage through a policy, contract or plan for a covered individual;
6. “Pharmacy benefits management” means a service provided to covered entities to facilitate the provision of prescription drug benefits to covered individuals within the state, including negotiating pricing and other terms with drug manufacturers and providers. Pharmacy benefits management may include any or all of the following services:
7. “Pharmacy benefits manager” or “PBM” means a person, business or other entity that performs pharmacy benefits management. The term includes a person or entity acting for a PBM in a contractual or employment relationship in the performance of pharmacy benefits management for a managed care company, nonprofit hospital, medical service organization, insurance company, third-party payor, or a health program administered by an agency of this state;
Credits
Laws 2014, c. 263, § 1, eff. July 1, 2014; Laws 2016, c. 285, § 7, eff. Nov. 1, 2016.
59 Okl. St. Ann. § 357, OK ST T. 59 § 357
Current with emergency effective legislation through Chapter 295 of the Second Regular Session of the 59th Legislature (2024). Some sections may be more current, see credits for details.
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