§ 27-29.1-1 - Definitions. - Rhode Island Statutes

SECTION 27-29.1-1

   § 27-29.1-1  Definitions. – For purposes of this chapter, the following terms shall mean:

   (1) "Director" shall mean the director of the department ofbusiness regulation.

   (2) "Eligible bidder" shall mean a retail pharmacy, communitypharmacy or pharmacy department registered pursuant to chapter 19 of title 5,irrespective of corporate structure or number of locations at which it conductsbusiness, located within the geographical service area of a carrier and willingto bid for participation in a restricted pharmacy network contract.

   (3) "Insurer" shall mean an insurance carrier as defined inchapters 18, 19, 20 and 41 of title 27.

   (4) "Insured" shall mean any person who is entitled to havepharmacy services paid by an insurer pursuant to a policy, certificate,contract or agreement of insurance or coverage.

   (5) "Non-restricted pharmacy network" shall mean a networkthat permits any pharmacy to participate on substantially uniform terms andconditions established by an insurer or pharmacy benefits manager.

   (6) "Pharmacy benefits manager" shall mean any person orentity that is not licensed in Rhode Island as an insurer and that develops ormanages pharmacy benefits, pharmacy network contracts, or the pharmacy benefitbid process.

   (7) "Restricted pharmacy network" shall mean an arrangementfor the provision of pharmaceutical drug services to insureds which under theterms of an insurer's policy, certificate, contract or agreement of insuranceor coverage requires an insured or creates a financial incentive for an insuredto obtain prescription drug services from one or more participating pharmaciesthat have entered into a specific contractual relationship with the carrier.