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Delaware Code Title 18. Insurance Code § 3351A. Definitions

Current as of January 01, 2022 | Updated by FindLaw Staff

For purposes of this subchapter:

(1) “Pharmacy benefits management services” means all of the following:

a. The procurement of prescription drugs at a negotiated rate for dispensation within this State to beneficiaries.

b. The administration or management of prescription drug coverage provided by a purchaser for beneficiaries.

c. Any of the following services provided with regard to the administration of prescription drug coverage:

1. Mail service pharmacy.

2. Claims processing, retail network management, and payment of claims to pharmacies for prescription drugs dispensed to beneficiaries.

3. Clinical formulary development and management services.

4. Rebate contracting and administration. For purposes of this paragraph (1)c.4., “rebate” means as defined in § 3361A of this title.

5. Patient compliance, therapeutic intervention, and generic substitution programs.

6. Disease management programs.

(2) “Pharmacy benefits manager” means as defined under § 3302A of this title.

(3) “Purchaser” means a person that does all of the following:

a. Provides prescription drug coverage or benefits in this State.

b. Enters into agreement with a pharmacy benefits manager for the provision of pharmacy benefits management services.

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Cite this article: FindLaw.com - Delaware Code Title 18. Insurance Code § 3351A. Definitions - last updated January 01, 2022 | https://codes.findlaw.com/de/title-18-insurance-code/de-code-sect-18-3351a/

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