2018 Wyoming Statutes
TITLE 26 - INSURANCE CODE
CHAPTER 52 - PHARMACY BENEFIT MANAGERS
SECTION 26-52-102 - Definitions.
26-52-102. Definitions.
(a) As used in this article:
(i) "Claim" means a request from a pharmacy or pharmacist to be reimbursed for the cost of filling or refilling a prescription for a drug or for providing a medical supply or device;
(ii) "Insurer" means the entity defined in W.S. 26-1-102(a)(xvi) and who provides health insurance coverage in this state;
(iii) "List" means the list of drugs for which a pharmacy benefit manager has established a maximum allowable cost;
(iv) "Maximum allowable cost" means the maximum amount that a pharmacy benefit manager will reimburse a pharmacist or pharmacy for the cost of a generic drug;
(v) "Network providers" means those pharmacies that provide covered health care services or supplies to an insured or a member pursuant to a contract with a network plan to act as a participating provider;
(vi) "Pharmacy" means an entity through which pharmacists or other persons practice pharmacy as specified in W.S. 33-24-124;
(vii) "Pharmacy benefit manager" means an entity that contracts with a pharmacy on behalf of an insurer or third party administrator to administer or manage prescription drug benefits.
