Delaware Code Title 18. Insurance Code § 3335A. Definitions

(1) “Emergency” means a situation that will result in loss of life, limb or organ function.

(2) “Pharmacy benefit manager” has the meaning given in § 3302A of this title.

(3) “Prior authorization” means a requirement by a carrier or health-insurance plan that providers submit a request or other prior notification to the carrier for evaluation of appropriateness of the request or if the prescription is medically necessary before treatment is rendered.  Prior authorization lets the insured and provider know in advance which pharmaceuticals are considered by the insurer to be medically necessary.