Terms Used In South Carolina Code > Title 40 > Chapter 81 - State Athletic Commission

• Accident and health insurance: means insurance of human beings against death or personal injury by accident, and each insurance of human beings against sickness, ailment, and any type of physical disability resulting from accident or disease, and prepaid dental service, but not including coverages required by the Workers' Compensation Law of this State. See South Carolina Code 38-1-20
• Administrator: means the individual to whom the director has delegated authority to administer the programs of a specific board or of a professional or occupational group for which the department has regulatory authority or has delegated authority to administer the programs of a specific board;
  
  (2) "Authorization to practice" or "Practice authorization" means the approval to practice the specified profession, engage in the specified occupation, or use a title protected under this article, which has been granted by the applicable board. See South Carolina Code 40-1-20
• Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
• Affirmed: In the practice of the appellate courts, the decree or order is declared valid and will stand as rendered in the lower court.
• Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
• 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.
• Casualty insurance: means each insurance against legal liability of the insured for bodily injury to or death of another person, including workers' compensation insurance, and for damages to or loss or destruction of the property of another person; medical payments insurance when written in conjunction with insurance covering liability for the deaths or bodily injuries of another person; guaranteeing the fidelity of a person holding a position of public or private trust; loss of or damage to property caused by burglary, theft, larceny, robbery, fraud, or unlawful taking or secretion of property owned by or entrusted to the insured; loss of or damage to property of the insured resulting from the explosion of or damage to a fired or unfired boiler or other pressure vessel, engine, turbine, compressor, pump, wheel, or an apparatus generating, transmitting, or using electric power, and machinery or equipment connected with any of them; loss resulting from nonpayment of debts owed to merchants or another person extending credit. See South Carolina Code 38-1-20
• Claim: means a request from a pharmacy or pharmacist to be reimbursed for the cost of administering, filling, or refilling a prescription for a drug or for providing a medical supply or device. See South Carolina Code 38-71-2200
• Claim: means a request from a pharmacy or pharmacist to be reimbursed for the cost of administering, filling, or refilling a prescription for a drug or for providing a medical supply or device. See South Carolina Code 38-71-2200 v2
• Claims processing services: means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include:
  
  (a) receiving payments for pharmacist services;
  
  (b) making payments to pharmacists or pharmacies for pharmacist services; or
  
  (c) both receiving and making payments. See South Carolina Code 38-71-2200
• Claims processing services: means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include:
  
  (a) receiving payments for pharmacist services;
  
  (b) making payments to pharmacists or pharmacies for pharmacist services; or
  
  (c) both receiving and making payments. See South Carolina Code 38-71-2200 v2
• 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.
• Conviction: A judgement of guilt against a criminal defendant.
• 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.
• Department: means the Department of Insurance of South Carolina. See South Carolina Code 38-1-20
• Department: means the Department of Labor, Licensing and Regulation;
  
  (5) "Director" means the Director of the Department of Labor, Licensing and Regulation or the director's official designee;
  
  (6) "Licensee" means a person granted an authorization to practice pursuant to this article and refers to a person holding a license, permit, certification, or registration granted pursuant to this article;
  
  (7) "Licensing act" means the individual statute or regulations, or both, of each regulated profession or occupation which include, but are not limited to, board governance, the qualifications and requirements for authorization to practice, prohibitions, and disciplinary procedures;
  
  (8) "Person" means an individual, partnership, or corporation;
  
  (9) "Profession" or "occupation" means a profession or occupation regulated or administered, or both, by the department pursuant to this article. See South Carolina Code 40-1-20
• Director: means the person who is appointed by the Governor upon the advice and consent of the Senate and who is responsible for the operation and management of the department. See South Carolina Code 38-1-20
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Fiduciary: A trustee, executor, or administrator.
• Fraud: Intentional deception resulting in injury to another.
• Freedom of Information Act: A federal law that mandates that all the records created and kept by federal agencies in the executive branch of government must be open for public inspection and copying. The only exceptions are those records that fall into one of nine exempted categories listed in the statute. ^{Source: OCC}
• Health benefit plan: means any individual, blanket, or group plan, policy, or contract for health care services issued or delivered by a health care insurer in this State as defined in § 38-71-670(6) and 38-71-840(14), including the state health plan as defined in § 1-11-710. See South Carolina Code 38-71-2200
• Health benefit plan: means any individual, blanket, or group plan, policy, or contract for health care services issued or delivered by a health care insurer in this State as defined in § 38-71-670(6) and 38-71-840(14), including the state health plan as defined in § 1-11-710. See South Carolina Code 38-71-2200 v2
• insurance: includes annuities. See South Carolina Code 38-1-20
• Insurance company: means an "insurer". See South Carolina Code 38-1-20
• Insurer: includes a corporation, fraternal organization, burial association, other association, partnership, society, order, individual, or aggregation of individuals engaging or proposing or attempting to engage as principals in any kind of insurance or surety business, including the exchanging of reciprocal or interinsurance contracts between individuals, partnerships, and corporations. See South Carolina Code 38-1-20
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• License: means a document issued by the state's director or his designee authorizing a person to act as an insurance producer for the lines of authority specified in the document. See South Carolina Code 38-1-20
• Life insurance: means a contract of insurance upon the lives of human beings. See South Carolina Code 38-1-20
• Maximum Allowable Cost List: means a listing of generic drugs used by a pharmacy benefits manager to set the maximum allowable cost at which reimbursement to a pharmacy or pharmacist may be made. See South Carolina Code 38-71-2200
• Maximum Allowable Cost List: means a listing of generic drugs used by a pharmacy benefits manager to set the maximum allowable cost at which reimbursement to a pharmacy or pharmacist may be made. See South Carolina Code 38-71-2200 v2
• Negotiate: means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance concerning substantive benefits, terms, or conditions of the contract, provided that the person engaged in that act either sells insurance or obtains insurance from insurers for purchasers. See South Carolina Code 38-1-20
• Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
• Oath: A promise to tell the truth.
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Other prescription drug or device services: means services other than claims processing services, provided directly or indirectly by a pharmacy benefits manager, whether in connection with or separate from claims processing services, including without limitation:
  
  (a) negotiating rebates, discounts, or other financial incentives and arrangements with drug companies;
  
  (b) disbursing or distributing rebates;
  
  (c) managing or participating in incentive programs or arrangements for pharmacist services;
  
  (d) negotiating or entering into contractual arrangements with pharmacists or pharmacies, or both;
  
  (e) developing formularies;
  
  (f) designing prescription benefit programs; or
  
  (g) advertising or promoting services. See South Carolina Code 38-71-2200
• Other prescription drug or device services: means services other than claims processing services, provided directly or indirectly by a pharmacy benefits manager, whether in connection with or separate from claims processing services, including without limitation:
  
  (a) negotiating rebates, discounts, or other financial incentives and arrangements with drug companies;
  
  (b) disbursing or distributing rebates;
  
  (c) managing or participating in incentive programs or arrangements for pharmacist services;
  
  (d) negotiating or entering into contractual arrangements with pharmacists or pharmacies, or both;
  
  (e) developing formularies;
  
  (f) designing prescription benefit programs; or
  
  (g) advertising or promoting services. See South Carolina Code 38-71-2200 v2
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Person: means a corporation, agency, partnership, association, voluntary organization, individual, or another entity, organization, or aggregation of individuals. See South Carolina Code 38-1-20
• Pharmacist services: means products, goods, and services, or any combination of products, goods, and services, provided as a part of the practice of pharmacy. See South Carolina Code 38-71-2200
• Pharmacist services: means products, goods, and services, or any combination of products, goods, and services, provided as a part of the practice of pharmacy. See South Carolina Code 38-71-2200 v2
• Pharmacy benefits manager: means an entity that contracts with pharmacists or pharmacies on behalf of an insurer, third party administrator, or the South Carolina Public Employee Benefit Authority to:
  
  (a) process claims for prescription drugs or medical supplies or provide retail network management for pharmacies or pharmacists;
  
  (b) pay pharmacies or pharmacists for prescription drugs or medical supplies; or
  
  (c) negotiate rebates with manufacturers for drugs paid for or procured as described in this article. See South Carolina Code 38-71-2200
• Pharmacy benefits manager: means an entity that contracts with pharmacists or pharmacies on behalf of an insurer, third party administrator, or the South Carolina Public Employee Benefit Authority to:
  
  (a) process claims for prescription drugs or medical supplies or provide retail network management for pharmacies or pharmacists;
  
  (b) pay pharmacies or pharmacists for prescription drugs or medical supplies; or
  
  (c) negotiate rebates with manufacturers for drugs paid for or procured as described in this article. See South Carolina Code 38-71-2200 v2
• Pharmacy benefits manager affiliate: means a pharmacy or pharmacist that directly or indirectly, through one or more intermediaries, owns or controls, is owned or controlled by, or is under common ownership or control with a pharmacy benefits manager. See South Carolina Code 38-71-2200
• Pharmacy benefits manager affiliate: means a pharmacy or pharmacist that directly or indirectly, through one or more intermediaries, owns or controls, is owned or controlled by, or is under common ownership or control with a pharmacy benefits manager. See South Carolina Code 38-71-2200 v2
• Policy: means a contract of insurance. See South Carolina Code 38-1-20
• Premium: means payment given in consideration of a contract of insurance. See South Carolina Code 38-1-20
• PSAO-pharmacy contract: means a contractual agreement between a PSAO and a pharmacy by which a PSAO agrees to negotiate with third-party payers or pharmacy benefits managers on behalf of a pharmacy. See South Carolina Code 38-71-2310
• Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
• Service of process: The service of writs or summonses to the appropriate party.
• Surety: includes insurance or a bond that covers obligations to pay the debts, or answer for the default, of another, including faithlessness in a position of public or private trust. See South Carolina Code 38-1-20
• Terminate: means the cancellation of the relationship between an insurance producer and the insurer or the termination of a producer's authority to transact insurance. See South Carolina Code 38-1-20
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• Uphold: The decision of an appellate court not to reverse a lower court decision.