This provision defines several terms used in the chapter, including “commissioner,” “formulary,” “pharmacy benefits manager,” and certain fees and rebate-related percentages.
As used in this chapter unless the context otherwise requires: 1. “Administrative fees” means a fee or payment, other than a rebate, under a contract between a pharmacy benefits manager and a pharmaceutical drug manufacturer in connection with the pharmacy benefits manager’s management of a third-party payor’s prescription drug benefit, that is paid by a pharmaceutical drug manufacturer to a pharmacy benefits manager or is retained by the pharmacy benefits manager. 2. “Aggregate retained rebate percentage” means the percentage of all rebates received by a pharmacy benefits manager that is not passed on to the pharmacy benefits manager’s third-party payor clients. 3. “Commissioner” means the commissioner of insurance. 4. “Covered person” means the same as defined in section 510B.1. 5. “Formulary” means a complete list of prescription drugs eligible for coverage under a health benefit plan. 6. “Health benefit plan” means the same as defined in section 510B.1. 7. “Health carrier” means the same as defined in section 510B.1. 8. “Pharmacy benefits manager” means the same as defined in section 510B.1. 9. “Prescription drug benefit” means the same as defined in section 510B.1. 10. “Rebate” means the same as defined in section 510B.1. 11. “Third-party payor” means the same as defined in section 510B.1. 12. “Third-party payor administrative service fee” means a fee or payment under a contract between a pharmacy benefits manager and a third-party payor in connection with the pharmacy benefits manager’s administration of the third-party payor’s prescription drug benefit that is paid by a third-party payor to a pharmacy benefits manager or is otherwise retained by a pharmacy benefits manager. 2019 Acts, ch 88, §1; 2020 Acts, ch 1063, §279 – 281; 2022 Acts, ch 1113, §17, 23