Section 23-79-2502 - DefinitionsAs used in this subchapter:
(1) "Defined cost sharing" means a deductible payment or coinsurance amount imposed on an enrollee for a covered prescription drug under the enrollee's health benefit plan;(2) "Enrollee" means an individual entitled to coverage of healthcare services from a healthcare insurer;(3)(A) "Health benefit plan" means any individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by a healthcare insurer in this state.(B) "Health benefit plan" does not include:(ii) Specified disease plans;(iii) Disability income plans;(iv) Plans that provide only for indemnity for hospital confinement;(v) Long-term-care-only plans that do not include pharmacy benefits;(vi) Other limited-benefit health insurance policies or plans;(vii) Health benefit plans provided under Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, § 11-9-101 et seq., or the Public Employee Workers' Compensation Act, § 21-5-601 et seq.; or(viii) Any state or local governmental employee plan;(4)(A) "Healthcare insurer" means a:(i) Health insurance issuer that:(a) Is subject to state law regulating insurance; and(b) Offers health insurance coverage under 42 U.S.C. § 300gg-91, as it existed on January 1, 2023;(ii) Health maintenance organization; or(iii) Hospital and medical service corporation.(B) "Healthcare insurer" does not include an entity that provides only dental benefits or eye and vision care benefits;(5) "Price protection rebate" means a negotiated price concession that accrues directly or indirectly to a healthcare insurer, or other party on behalf of the healthcare insurer, if there is an increase in the wholesale acquisition cost of a prescription drug above a specified threshold; and(6) "Rebate" means:(A) A negotiated price concession, including without limitation base price concessions, whether described as a rebate or not, reasonable estimates of any price protection rebates, and performance-based price concessions that may accrue, directly or indirectly, to the healthcare insurer during the coverage year from a manufacturer or other party in connection with the dispensing or administration of a prescription drug; and(B) Any reasonable estimate of a negotiated price concession, fee, and other administrative cost that is passed through, or is reasonably anticipated to be passed through, to the healthcare insurer and serves to reduce the healthcare insurer's liabilities for a prescription drug.Added by Act 2023, No. 333,§ 1, eff. 8/1/2023.