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Code · North Carolina · Chapter 58 — Insurance

Article 56B.

286 words·~1 min read·/nc/chapter-58/56b

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Article 56B.
Pharmacy Services Administrative Organizations.
§ 58-56B-1. (Effective October 1, 2026) Definitions.
The following definitions apply in this Article:
(1)Reserved for future codification purposes.
(2)Independent pharmacy. - As defined in G.S. 58-51-37.
(3)Insured. - An individual covered by a health benefit plan.
(4)Pharmacy. - As defined in G.S. 58-51-37.
(5)Pharmacy benefits manager or PBM. - As defined in G.S. 58-56A-1.
(6)Pharmacy services administrative organization or PSAO. - An entity operating within this State that contracts with one or more independent pharmacies to conduct business with third-party payers on behalf of the independent pharmacy or pharmacies to provide administrative services to the independent pharmacy or pharmacies and to negotiate and enter into contracts with third-party payers or PBMs on behalf of the independent pharmacy or pharmacies. Administrative services provided on behalf of one or more independent pharmacies may include one or more of the following:
a. Assistance with claims.
b. Assistance with audits.
c. Centralized payment.
d. Certification in specialized care programs.
e. Compliance support.
f. Setting flat fees for generic drugs.
g. Assistance with store layout.
h. Inventory management.
i. Marketing support.
j. Management and analysis of payment and drug dispensing data.
k. Provision of services for retail cash cards.
(7)PSAO-pharmacy contract. - A contractual agreement between a PSAO and an independent pharmacy under which a PSAO agrees to negotiate with PBMs or third-party payers or both on behalf of an independent pharmacy. A PSAO-pharmacy contract may contain an agreement that the PSAO will provide other services to the independent pharmacy in addition to negotiation with PBMs or third-party payers.
(8)Reserved for future codification purposes.
(9)Wholesale distributor. - As defined in G.S. 106-145.2. (2025-69, s. 2.1.)
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