There Is a Newer Version of the Utah Code
2011 Utah Code
Title 49 Utah State Retirement and Insurance Benefit Act
Chapter 20 Public Employees' Benefit and Insurance Program Act
Section 502 Definitions.
49-20-502. Definitions.As used in this part:
(1) "Health benefit plan" means:
(a) a health benefit plan as defined in Section 31A-1-301; or
(b) a health, dental, medical, Medicare supplement, or conversion program offered under Title 49, Chapter 20, Public Employees' Benefit and Insurance Program Act.
(2) "Pharmacist" is as defined in Section 58-17b-102.
(3) "Pharmacy" is as defined in Section 58-17b-102.
(4) "Pharmacy benefits management service" means any of the following services provided to a health benefit plan, or to a participant of the health benefit plan:
(a) negotiating the amount to be paid by a health benefit plan for a prescription drug; or
(b) administering or managing prescription drug benefits provided by the health benefit plan for the benefit of a participant of the health benefit plan, including:
(i) mail service pharmacy;
(ii) specialty pharmacy;
(iii) claims processing;
(iv) payment of a claim;
(v) retail network management;
(vi) clinical formulary development;
(vii) clinical formulary management services;
(viii) rebate contracting;
(ix) rebate administration;
(x) a participant compliance program;
(xi) a therapeutic intervention program;
(xii) a disease management program; or
(xiii) a service that is similar to, or related to, a service described in Subsection (4)(a) or (4)(b)(i) through (xii).
(5) "Pharmacy benefits manager" means a person that provides a pharmacy benefits management service to a health benefit plan.
(6) "Pharmacy service" means a product, good, or service provided by a pharmacy or
pharmacist to an individual.
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