§ 56-7-3501 — Part definitions

Tennessee § 56-7-3501

• Jurisdiction: Tennessee
• Title: 56

Text

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 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.

Legislative History

Added by 2022 Tenn. Acts, ch. 1020, s 1, eff. 1/1/2023.