Section He-C 5010.02 - Definitions(a) "Commissioner" means the commissioner of the New Hampshire department of health and human services, or his or her designee.(b) "Department" means the New Hampshire department of health and human services (DHHS) .(c) "Drug use review (DUR) " means a program designed to ensure that prescriptions are appropriate, medically necessary, and not likely to result in adverse medical results.(d) "DUR board" means an advisory board to the state's medicaid pharmacy program as required by the Omnibus Budget Reconciliation Act of 1990.(e) "Medicaid" means the Title XIX and Title XXI programs administered by the department which makes medical assistance available to eligible individuals.(f) "Pharmacy benefit manager (PBM) " means the vendor representative designated by the department to administer the medicaid pharmacy benefit for medicaid recipients.(g) "Prescriber" means any professional whose licensure and scope of practice permits prescribing medications.(h) "Provider" means an entity or individual who furnishes health care services or supplies to medicaid recipients under a provider enrollment agreement with the department, and is licensed or certified pursuant to applicable state law and rules to provide such services and supplies.(i) "Recipient" means any individual who is eligible for and receiving medical assistance under medicaid.(j) "Surveillance and utilization review subsystem (SURS) " means the function within the department to assess the quality of care, services, or supplies received by medicaid recipients and to ensure that accurate billing and proper reimbursement has been made for the care, services, or supplies.(k) "Title XIX program" means the joint federal-state program described in Title XIX of the Social Security Act and administered in New Hampshire by the department, under the medicaid program.(l) "Title XXI program" means the joint federal-state program described in Title XXI of the Social Security Act and administered in New Hampshire by the department under the medicaid program.N.H. Admin. Code § He-C 5010.02
#5529, eff 12-16-92; ss by #6907, eff 12-9-98; ss by #8743, eff 10-24-06; ss by #9587, eff 11-4-09
Amended by Volume XXXVIII Number 06, Filed February 8, 2018, Proposed by #12460, Effective 1/13/2018, Expires 1/13/2028.