Md. Code Regs. 31.10.49.02

Current through Register Vol. 51, No. 22, November 1, 2024

Section 31.10.49.02 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Appeal decision" means a written or electronic notice in response to an appeal under this chapter provided to a contracted pharmacy that includes a reason for the appeal denial.

(2) "Contracted pharmacy" means an independent pharmacy in a pharmacy services administrative contract.

(3) "Delivered by electronic means" includes:

(a) Delivery to an electronic mail address at which an independent pharmacy or contracted pharmacy has consented to receive notice; and

(b) Posting on an electronic network, together with separate notice to an independent pharmacy or contracted pharmacy directed to the electronic mail address at which the independent pharmacy or contracted pharmacy has consented to receive notice of the posting.

(4) "Independent pharmacy" has the meaning stated in Insurance Article, § 15-2001(b), Annotated Code of Maryland.

(5) "Material change" means a change in control or business operations of a pharmacy services administrative organization after a purchase, merger, or acquisition of a parent company, subsidiary, or other organization.

(6) Medical Device.

(a) "Medical device" means a device used in the diagnosis, treatment, or prevention of disease.

(b) "Medical device" does not include:

(i) Any surgical or dental instrument;

(ii) Physical therapy equipment;

(ii) Any x-ray apparatus; or

(iii) Any component or accessory of any of these items.

(7) "Pharmacy benefits manager (PBM)" has the meaning stated in Insurance Article, § 15-1601, Annotated Code of Maryland.

(8) "Pharmacy services administrative contract" has the meaning stated in Insurance Article, § 15-2001(d), Annotated Code of Maryland.

(9) "Pharmacy services administrative organization" or "PSAO" has the meaning stated in Insurance Article, § 15-2001(e), Annotated Code of Maryland.

(10) "Purchaser" has the meaning stated in Insurance Article, § 15-2001(f), Annotated Code of Maryland.

(11) "Working days" means any day that the Maryland Insurance Administration is open for business.

Md. Code Regs. 31.10.49.02

Regulation .02 adopted effective 49:26 Md. R. 1081, eff. 12/26/2022