§ 22:1863 As used in this Subpart, the following definitions apply:
§ 22:1864 A. Before a pharmacy benefit manager places or continues a particular NDC or Maximum Allowable Cost List, the following requirements shall be met:
§ 22:1865 A. The pharmacy benefit manager shall provide a reasonable administrative appeal procedure to allow pharmacies to challenge maximum allowable costs for a specific NDC or NDCs as not
§ 22:1866 A. The commissioner may promulgate rules and regulations in accordance with the Administrative Procedure Act that are necessary or proper to carry out the provisions of this Subpart.
§ 22:1867 A. A pharmacy benefit manager is prohibited from conducting or participating in spread pricing in this state unless the pharmacy benefit manager provides written notice as provided i

Terms Used In Louisiana Revised Statutes > Title 22 > Chapter 6 > Part II > Subpart C-1 - Pharmacy Benefit Manager's Maintenance and Use of Maximum Allowable Cost Lists for Prescription Drugs

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Drug Shortage List: means a list of drug products posted on the United States Food and Drug Administration drug shortage website. See Louisiana Revised Statutes 22:1863
  • expansion project: means a project or projects for the acquisition, construction, installation, and equipping of additions or improvements to the Ernest N. See Louisiana Revised Statutes 33:4710.24
  • Fiduciary: A trustee, executor, or administrator.
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Maximum Allowable Cost List: means a listing of the National Drug Code used by a pharmacy benefit manager setting the maximum allowable cost on which reimbursement to a pharmacy or pharmacist may be based. See Louisiana Revised Statutes 22:1863
  • NDC: means the National Drug Code, a numerical identifier assigned to all prescription drugs. See Louisiana Revised Statutes 22:1863
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Person: as used in this Chapter shall have the same definition as that contained in La. See Louisiana Revised Statutes 33:4710.15
  • Pharmacist: means a licensed pharmacist as defined in La. See Louisiana Revised Statutes 22:1863
  • Pharmacist services: means products, goods, or services provided as a part of the practice of pharmacy as defined in La. See Louisiana Revised Statutes 22:1863
  • Pharmacy: means any appropriately licensed place where prescription drugs are dispensed as defined in La. See Louisiana Revised Statutes 22:1863
  • Pharmacy benefit manager: means an entity that administers or manages a pharmacy benefits plan or program. See Louisiana Revised Statutes 22:1863
  • Spread pricing: means any amount a pharmacy benefit manager charges or claims from a health plan provider or managed care organization for payment of a prescription or for pharmacy services that is different than the amount the pharmacy benefit manager paid to the pharmacist or pharmacy who filled the prescription or provided the pharmacy services. See Louisiana Revised Statutes 22:1863
  • Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.