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2019 Delaware Code
Title 18 - Insurance Code
Chapter 33A. Pharmacy Benefits Managers [For application of this chapter, see 80 Del. Laws, c. 245, §  2]
Subchapter V Registration of Pharmacy Benefits Managers [Effective June 1, 2020]
§ 3351A Definitions [Effective June 1, 2020].

Universal Citation:
18 DE Code § 3351A (2019)
Learn more This media-neutral citation is based on the American Association of Law Libraries Universal Citation Guide and is not necessarily the official citation.

For purposes of this subchapter:

(1) “Pharmacy benefits management services” means all of the following:

a. The procurement of prescription drugs at a negotiated rate for dispensation within this State to beneficiaries.

b. The administration or management of prescription drug coverage provided by a purchaser for beneficiaries.

c. Any of the following services provided with regard to the administration of prescription drug coverage:

1. Mail service pharmacy.

2. Claims processing, retail network management, and payment of claims to pharmacies for prescription drugs dispensed to beneficiaries.

3. Clinical formulary development and management services.

4. Rebate contracting and administration.

5. Patient compliance, therapeutic intervention, and generic substitution programs.

6. Disease management programs.

(2) “Pharmacy benefits manager” means as defined under § 3302A of this title.

(3) “Purchaser” means an insurance company, health service corporation, health maintenance organization, managed care organization, and any other entity that does all of the following:

a. Provides prescription drug coverage or benefits in this State.

b. Enters into agreement with a pharmacy benefits manager for the provision of pharmacy benefits management services.

82 Del. Laws, c. 115, § 4.

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