North Carolina § 58-56A-1 - Definitions.

§ 58-56A-1. Definitions.

The following definitions apply in this Article: Health benefit plan. - As defined in G.S. 58-50-110(11). This definition specifically excludes the State Health Plan for Teachers and State Employees. Insured. - An individual covered by a health benefit plan. Insurer. - Any entity that provides or offers a health benefit plan. Maximum allowable cost price. - The maximum per unit reimbursement for multiple source prescription drugs, medical products, or devices. Pharmacist. - A person licensed to practice pharmacy under Article 4A of Chapter 90 of the General Statutes. Pharmacy. - A pharmacy registered with the North Carolina Board of Pharmacy. Pharmacy benefits manager. - An entity who contracts with a pharmacy on behalf of an insurer or third-party administrator to administer or manage prescription drug benefits. Third-party administrator. - As defined in G.S. 58-56-2. History (2014-120, s. 20(a); 2017-116, s. 1.) Editor's Note. - The designation of subsections (1a) and (3a) were assigned at the direction of the Revisor of Statutes. Session Laws 2014-120, s. 20(c), made this article effective January 1, 2015, and applicable to contracts entered into, renewed, or amended on or after that date. Session Laws 2014-120, s. 20(b), provides: "The Department of Insurance, in collaboration with the Department of Commerce and the North Carolina Board of Pharmacy, shall study the issue of pharmacy benefits management company regulation. Specifically, the study shall include: (i) frequency of disclosure of and methodology for calculating maximum allowable cost prices by the pharmacy benefits management companies; (ii) appeals procedures for pharmacies relating to maximum allowable cost pricing; (iii) consumer protections and the disclosure of consumer health information by pharmacy benefits managers; (iv) regulation of the various forms of incentives offered to a consumer by pharmacy benefits managers and its effects on choice of pharmacy; and (v) any further industry regulation deemed necessary to study. The Department of Insurance shall report the collective findings and recommendations, including any proposed legislation, to the 2015 General Assembly on or before January 20, 2015." Session Laws 2014-120, s. 60, is a severability clause. Session Laws 2017-116, s. 3, provides: "The Commissioner of Insurance may adopt rules to implement this act." Session Laws 2017-116, s. 4, made the addition of subsections (1a) and (3a) by Session Laws 2017-116, s. 1, effective October 1, 2017, and applicable to all contracts entered into, renewed, or amended on or after that date. Effect of Amendments. - Session Laws 2017-116, s. 1, added (1a) and (3a). For effective date and applicability, see editor's note.