As used in this part:(1) 'Health benefit plan' has the same meaning as defined in § 56-61-102;(2) 'Health carrier' has the same meaning as defined in § 56-61-102;(3) 'Healthcare provider' has the same meaning as defined in § 56-61-102;(4) 'Interchangeable biological product' means a biological product licensed by the federal food and drug administration and determined to meet the safety standards for determining interchangeability pursuant to 42 U.S.C. § 262(k)(4);(5) 'Pharmaceutical sample' means a unit of a prescription drug that is not intended to be sold;(6) 'Prescription drug' means a drug that under federal or state law is required to be dispensed only pursuant to a prescription order or is restricted to use by individuals authorized by law to prescribe drugs;(7) 'Required prescription drug' means a medication that is required as part of a step therapy protocol;(8) 'Step therapy exception' occurs when a step therapy protocol is overridden in favor of immediate coverage of the healthcare provider's selected prescription drug;(9) 'Step therapy protocol' means a protocol, policy, or program that establishes a specific sequence in which prescription drugs for a specified medical lthcare provider's selected prescription drug;(9) 'Step therapy protocol' means a protocol, policy, or program that establishes a specific sequence in which prescription drugs for a specified medical condition, and medically appropriate for a particular patient, are covered by a health carrier or health benefit plan; and(10) 'Utilization review organization' means an entity that conducts utilization review, as defined in § 56-6-703, other than a health carrier or health benefit plan performing utilization review for its own health plans.Added by 2022 Tenn. Acts, ch. 1020, s 1, eff. 1/1/2023.
Tennessee Legal Code