For purposes of this chapter, the following words shall have the following meanings:
(1) CLAIMS PROCESSING SERVICES. The administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include any of the following:
a. Receiving payments for pharmacist services.
b. Making payments to pharmacists or pharmacies for pharmacist services.
c. Both paragraphs a. and b.
(2) OTHER PRESCRIPTION DRUG OR DEVICE SERVICES. Services, other than claims processing services, provided directly or indirectly, whether in connection with or separate from claims processing services, including without limitation any of the following:
a. Negotiating rebates, discounts, or other financial incentives and arrangements with drug companies.
b. Disbursing or distributing rebates.
c. Managing or participating in incentive programs or arrangements for pharmacist services.
d. Negotiating or entering into contractual arrangements with pharmacists or pharmacies, or both.
e. Developing formularies.
f. Designing prescription benefit programs.
g. Advertising or promoting services.
(3) PHARMACIST. An individual licensed as a pharmacist by the State Board of Pharmacy.
(4) PHARMACIST SERVICES. Products, goods, and services, or any combination of products, goods, and services, provided as a part of the practice of pharmacy.
(5) PHARMACY. The place licensed by the State Board of Pharmacy in which drugs, chemicals, medicines, prescriptions, and poisons are compounded, dispensed, or sold at retail.
(6) PHARMACY BENEFITS MANAGER. a. A person, business, or entity, including a wholly or partially owned or controlled subsidiary of a pharmacy benefits manager, that provides claims processing services or other prescription drug or device services, or both, for health benefit plans.
b. Pharmacy benefits manager does not include any of the following:
1. A healthcare facility licensed in Alabama.
2. A healthcare professional licensed in Alabama.
3. A consultant who only provides advice as to the selection or performance of a pharmacy benefits manager.
Last modified: May 3, 2021