This RSA section is an unofficial mirror, is not legal advice, and may be incomplete, outdated, or incorrectly processed.
RSA 402-N:1 · Definitions
402-N:1 Definitions. – In this chapter:
Copy link"Claims processing services" means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include:
Copy link"Pharmacist services" means products, goods, and services, or any combination of products, goods, and services, provided as a part of the practice of pharmacy.
Copy link"Pharmacy" means the place licensed by the pharmacy board in which drugs, chemicals, medicines, prescriptions, and poisons are compounded, dispensed, or sold at retail.
Copy link(a) "Pharmacy benefits manager" means a person, business, or other entity, including a wholly or partially owned or controlled subsidiary of a pharmacy benefits manager, that, pursuant to a contract with a health carrier, manages the prescription drug coverage provided by the health carrier, including, but not limited to, providing claims processing services for prescription drugs, performing drug utilization review, processing drug prior authorization requests, adjudication of grievances or appeals related to prescription drug coverage, contracting with network pharmacies, and controlling the cost of covered prescription drugs.
Copy linkConsultant who only provides advice as to the selection or performance of a pharmacy benefits manager;
Copy linkHealth insurer licensed in this state if the health insurer or its subsidiary is providing pharmacy benefits management services exclusively to its own insureds.
Copy link"Rebate" means a discount or price concession attributable to the utilization of a prescription drug that is paid by the pharmaceutical manufacturer of the drug directly to a pharmacy benefits manager or health carrier after the pharmacy benefits manager or health carrier processes a claim from a pharmacy for a prescription drug manufactured by such pharmaceutical manufacturer. "Rebate" shall not include bona fide service fees, administrative fees, or any other amount which does not qualify as a rebate under this paragraph. Source. 2019, 320:2, eff. Jan. 1, 2020.
Copy linkSource note
Source. 2019, 320:2, eff. Jan. 1, 2020.
Source history
- 2019, 320:2, eff. Jan. 1, 2020
Related materials
Bill relationships
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2026 HB1268
amend · effective 2027-01-01
s: (a) [For each separate violation, a penalty in the amount of $2,500] An administrative fine not to exceed $5,000 per violation. 13 New Section; Written Agreements. Amend RSA 402-N by inserting after section 2 the following new section: 402-N:2-a. Written Agreement. I. No pharmacy benefits manager shall act as such without a written agreement between the pharmacy benefits manager and the h
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2026 HB1268
amend · effective 2027-01-01
council. III. RSA 193-A:11, relative to the authority of school district officials in governance of home education programs. 11 Pharmacy Benefits Managers; Definitions. Amend RSA 402-N:1, VIII to read as follows: VIII.(a) "Pharmacy benefits manager" means a person, business, or other entity, including a wholly or partially owned or controlled subsidiary of a pharmacy benefits manager or of a license
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2026 SB478
amend · effective 2027-01-01
rules, pursuant to RSA 541-A, to implement this act, including standardized reporting formats, confidentiality protections, audit standards, and enforcement. II. Penalties under RSA 402-N shall remain administrative and proportionate. No private right of action is created. 4 New Section; Employer Choice and State Plan Alignment. Amend RSA 402-N by inserting after section 2 the following new section:
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2026 SB478
repeal · effective 2027-01-01
expand access to biosimilars and other lower-net-cost therapies, and offer consumers optional monthly out-of-pocket smoothing. 2 Pharmacy Benefits Managers; Definitions. Amend RSA 402-N:1 is repealed and reenacted to read as follows: 402-N:1 Definitions. In this chapter: I. "Claims processing services" means the administrative services performed in connection with the processing and adjudicati
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2026 SB478-FN
amend · effective 2027-01-01
rules, pursuant to RSA 541-A, to implement this act, including standardized reporting formats, confidentiality protections, audit standards, and enforcement. II. Penalties under RSA 402-N shall remain administrative and proportionate. No private right of action is created. 4 New Section; Employer Choice and State Plan Alignment. Amend RSA 402-N by inserting after section 2 the following new section:
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2026 SB478-FN
repeal · effective 2027-01-01
expand access to biosimilars and other lower-net-cost therapies, and offer consumers optional monthly out-of-pocket smoothing. 2 Pharmacy Benefits Managers; Definitions. Amend RSA 402-N:1 is repealed and reenacted to read as follows: 402-N:1 Definitions. In this chapter: I. "Claims processing services" means the administrative services performed in connection with the processing and adjudicati
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2026 SB547
amend · effective 2026-10-01
hat is in excess of the amount the pharmacy benefit manager paid to the pharmacy that filled the prescription. 3 New Section; Pharmacy Benefit Manager Business Practices. Amend RSA 402-N by inserting after section 4-a the following new section: 4-b Pharmacy Benefit Manager Business Practices. I. A pharmacy benefit manager has a fiduciary duty to a health carrier client or affiliate and shall dischar
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2026 SB547
amend · effective 2026-10-01
III. More than 25 percent of residents skip doses, cut pills in half, or do not fill prescriptions at all due to cost concerns. 2 Pharmacy Benefit Managers; Definitions. Amend RSA 402-N:1 to read as follows: 402-N:1 Definitions. In this chapter: I. “Affiliate” of, or “affiliated” with, a specific person or other corporate entity means a person or other corporate entity that directly, or indire
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2026 SB547-FN
amend · effective 2026-10-01
III. More than 25 percent of residents skip doses, cut pills in half, or do not fill prescriptions at all due to cost concerns. 2 Pharmacy Benefit Managers; Definitions. Amend RSA 402-N:1 to read as follows: 402-N:1 Definitions. In this chapter: I. “Affiliate” of, or “affiliated” with, a specific person or other corporate entity means a person or other corporate entity that directly, or indire
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2026 SB547-FN
amend · effective 2026-10-01
hat is in excess of the amount the pharmacy benefit manager paid to the pharmacy that filled the prescription. 3 New Section; Pharmacy Benefit Manager Business Practices. Amend RSA 402-N by inserting after section 4-a the following new section: 4-b Pharmacy Benefit Manager Business Practices. I. A pharmacy benefit manager has a fiduciary duty to a health carrier client or affiliate and shall dischar
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2026 SB665
amend · effective 2027-01-01
-compliance shall be considered a separate violation. (b) Revocation or suspension of the pharmacy benefits manager registration. 3 New Section; Written Agreements. Amend RSA 402-N by inserting after section 2 the following new section: 402-N:2-a. Written Agreement. I. No pharmacy benefits manager shall act as such without a written agreement between the pharmacy benefits manager and the h
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2026 SB665
amend · effective 2027-01-01
and notice of drug pricing options. Be it Enacted by the Senate and House of Representatives in General Court convened: 1 Pharmacy Benefits Managers; Definitions. Amend RSA 402-N:1, VIII to read as follows: VIII.(a) "Pharmacy benefits manager" means a person, business, or other entity, including a wholly or partially owned or controlled subsidiary of a pharmacy benefits manager or licensed hea