26-52-102. Definitions. (a) As used in this article: (i) 'Claim' means a request from a pharmacy or pharmacist to be reimbursed for the cost of filling or refilling a prescription for a drug or for providing a medical supply or device; (ii) 'Insurer' means the entity defined in W.S. 26-1-102(a)(xvi) and who provides health insurance coverage in this state; (iii) 'List' means the list of drugs for which a pharmacy benefit manager has established a maximum allowable cost; (iv) 'Maximum allowable cost' means the maximum amount that a pharmacy benefit manager will reimburse a pharmacist or pharmacy for the cost of a generic drug; (v) 'Network providers' means those pharmacies that provide covered health care services or supplies to an insured or a member pursuant to a contract with a network plan to act as a participating provider; (vi) 'Pharmacy' means an entity through which pharmacists or other persons practice pharmacy as specified in W.S. 33-24-124; (vii) 'Pharmacy benefit manager' means an entity that contracts with a pharmacy or the pharmacy's designee who holds a contract with the pharmacy benefit manager on behalf of an insurer or third party administrator to administer or means an entity that contracts with a pharmacy or the pharmacy's designee who holds a contract with the pharmacy benefit manager on behalf of an insurer or third party administrator to administer or manage prescription drug benefits; (ix) 'Pharmacy services' means any product, good or service, or any combination of products, goods or services, provided as part of the practice of pharmacy; (x) 'Pharmacy services administrative organization' means an organization that evaluates and executes pharmacy benefit manager contracts on behalf of pharmacies and provides administrative, clerical, audit and data analytics support services.
Wyoming Legal Code