2012 New York Consolidated Laws
PBH - Public Health
Article 2-A - PRESCRIPTION DRUGS
Title 1 - (270 - 277) PREFERRED DRUG AND CLINICAL DRUG REVIEW PROGRAMS
270 - Definitions.

 
    §  270.  Definitions.  As  used  in  this  article, unless the context
  clearly requires otherwise:
    1.  "Administrator"  means  an  entity  with  which  the  commissioner
  contracts  for  the  purpose  of administering elements of the preferred
  drug program, as established under section two  hundred  seventy-two  of
  this  article  or  the  clinical  drug  review program established under
  section two hundred seventy-four of this article.
    2. "Clinical drug review  program"  means  the  clinical  drug  review
  program created by section two hundred seventy-four of this article.
    3.  "Committee"  or  "pharmacy  and  therapeutics committee" means the
  pharmacy and therapeutics  committee  created  by  section  two  hundred
  seventy-one of this article.
    4.  "Emergency  condition"  means a medical or behavioral condition as
  determined by the prescriber or  pharmacists,  the  onset  of  which  is
  sudden,  that  manifests  itself  by  symptoms  of  sufficient severity,
  including severe pain,  and  for  which  delay  in  beginning  treatment
  prescribed by the patient's health care practitioner would result in:
    (a)  placing  the  health  or safety of the person afflicted with such
  condition or other person or persons in serious jeopardy;
    (b) serious impairment to such person's bodily functions;
    (c) serious dysfunction of any bodily organ or part of such person;
    (d) serious disfigurement of such person; or
    (e) severe discomfort.
    5. "Non preferred drug" means a prescription drug that is included  in
  the  preferred drug program and is not one of the drugs on the preferred
  drug list because it is either: (a)  in  a  therapeutic  class  that  is
  included  in  the  preferred drug program and is not one of the drugs on
  the preferred  drug  list  in  that  class  or  (b)  manufactured  by  a
  pharmaceutical manufacturer with whom the commissioner is negotiating or
  has  negotiated  a  manufacturer  agreement  and is not a preferred drug
  under a manufacturer agreement.
    6. "Panel" means the elderly pharmaceutical insurance  coverage  panel
  established pursuant to section two hundred forty-four of the elder law.
    7.  "Preferred drug" means a prescription drug that is either (a) in a
  therapeutic class that is included in the preferred drug program and  is
  one  of  the  drugs  on  the  preferred drug list in that class or (b) a
  preferred drug under a manufacturer agreement.
    8.  "Preferred  drug  program"  means  the  preferred   drug   program
  established under section two hundred seventy-two of this article.
    9.  "Prescription  drug" or "drug" means a drug defined in subdivision
  seven of section sixty-eight hundred two of the education law, for which
  a prescription is required under the federal  food,  drug  and  cosmetic
  act.  Any  drug that does not require a prescription under such act, but
  which would otherwise meet the criteria under this article for inclusion
  on the preferred drug list may be added to the preferred drug list under
  this article;  and,  if  so  included,  shall  be  considered  to  be  a
  prescription  drug  for purposes of this article; provided that it shall
  be eligible for reimbursement under a  state  public  health  plan  when
  ordered  by  a prescriber authorized to prescribe under the state public
  health plan and the prescription is subject to the applicable provisions
  of this article and paragraph (a) of subdivision four of  section  three
  hundred sixty-five-a of the social services law.
    10.  "Prior authorization" means a process requiring the prescriber or
  the dispenser to verify with the applicable state public health plan  or
  its  authorized  agent that the drug is appropriate for the needs of the
  specific patient.
    11. "State public health plan" means the  medical  assistance  program
  established  by  title eleven of article five of the social services law

  (referred to in this article as "Medicaid"), the elderly  pharmaceutical
  insurance  coverage program established by title three of article two of
  the elder law (referred to in this article as "EPIC"),  and  the  family
  health  plus  program established by section three hundred sixty-nine-ee
  of the social services law to the extent that section provides that  the
  program shall be subject to this article.
    12.   "Supplemental   rebate"   means   a  supplemental  rebate  under
  subdivision ten of section two hundred seventy-two of this article.
    13. "Therapeutic class" means  a  group  of  prescription  drugs  that
  produce  a particular intended clinical outcome and are grouped together
  as a therapeutic class by the pharmacy and therapeutics committee.
    14.  "Manufacturer  agreement"  means   an   agreement   between   the
  commissioner  and  a  pharmaceutical manufacturer under paragraph (b) of
  subdivision eleven of section two hundred seventy-two of this article.