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North Carolina · Through S.L. 2026-30

N.C. Gen. Stat. § 58-50-400: Definitions.

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Where this section sits in the code
  1. Chapter 58. Insurance.
  2. Article 50. General Accident and Health Insurance Regulations.
  3. Part 8. Pharmacy Audit Rights.

The following definitions apply in this Part:

(1) Auditing entity. - The responsible party conducting an audit of a pharmacy or the entity conducting an audit of a pharmacy on behalf of a responsible party.

(2) Claim. - A request for reimbursement submitted by a pharmacy or pharmacist to a pharmacy benefits manager for a single fill or refill of any drug, product, or medication for which a prescription is written by a licensed prescriber under applicable State or federal law, or pharmacist-provided service, that has been adjudicated and processed by the pharmacy benefits manager. Each fill or refill shall constitute a separate and distinct claim, regardless of the number of days' supply or quantity dispensed.

(3) Reserved for future codification purposes.

(4) Medication error. - The dispensing of the wrong prescription drug, the dispensing of a prescription to the wrong patient, or the dispensing of a prescription with the wrong directions or patient instructions.

(5) Pharmacist. - An individual licensed to practice pharmacy under Article 4A of Chapter 90 of the General Statutes.

(6) Pharmacy. - An individual or entity holding a valid pharmacy permit pursuant to G.S. 90-85.21 or G.S. 90-85.21A.

(7) Reserved for future codification purposes.

(8) Responsible party. - An insurer offering a health benefit plan or any other entity regulated under this Chapter responsible for payment of claims for healthcare services. (2011-375, s. 1; 2013-379, s. 3; recodified from N.C. Gen. Stat. 90-85.50(a) by 2025-69, s. 5.1(a), (b).)

Collected 2026-08-27T18:06:53Z. Source file · JSON

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