205.5510 Definitions for KRS 205.5510 to 205.5520.
144 words·~1 min read·
/ky/chapter-205/205-5510A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
As used in KRS 205.5510 to 205.5520, unless the context otherwise requires:
(1)"Department" means the Department for Medicaid Services;
(2)"Managed care organization" has the same meaning as in KRS 205.532;
(3)"Pharmacy benefit manager" has the same meaning as in KRS 304.9-020;
(4)"Spread pricing" means any technique by which a pharmacy benefit manager or
other administrator of pharmacy benefits charges or claims an amount from an
insurer or managed care organization for pharmacy or pharmacist services,
including payment for a prescription drug, that is different than the amount the
pharmacy benefit manager or other administrator pays to the pharmacy or
pharmacist that provided the services; and
(5)"State pharmacy benefit manager" means the pharmacy benefit manager contracted
by the department, pursuant to KRS 205.5512, to administer pharmacy benefits for
all Medicaid recipients enrolled in a managed care organization in the
Commonwealth.