{"data":{"id":"us-ky/krs-304.17a-161","jurisdiction":"us-ky","citation":"KRS 304.17A-161","heading":"Definitions for KRS 304.17A -161, 304.17A -162, 304.17A -163, and","body":"304.17A-165.\nAs used in this section and KRS 304.17A-162, 304.17A-163, and 304.17A-165 unless the\ncontext requires otherwise:\n(1) \"Contracted pharmacy\" or \"pharmacy\" means a pharmacy  located in Kentucky\nparticipating in the network of a pharmacy benefit manager through a direct contract\nor through a contract with a pharmacy services administration organization or group\npurchasing organization;\n(2) \"Drug product reimbursement\" means th e amount paid by a pharmacy benefit\nmanager to a contracted pharmacy for the cost of the drug dispensed to a patient and\ndoes not include a dispensing or professional fee;\n(3) \"Maximum allowable cost\" means the maximum amount that a pharmacy benefit\nmanager will reimburse a pharmacy for the cost of a generic drug and does not\ninclude a dispensing or professional fee; and\n(4) \"Pharmacy benefit manager\" means an entity that, on behalf of a health benefit plan,\nstate agency, insurer, managed care organization providing services under KRS\nChapter 205, or other third-party payor:\n(a) Contracts directly or indirectly with pharmacies to provide prescription drugs\nto individuals;\n(b) Administers a prescription drug benefit;\n(c) Processes or pays pharmacy claims;\n(d) Creates or updates prescription drug formularies;\n(e) Makes or assists in making prior authorization determinations on prescription\ndrugs;\n(f) Administers rebates on prescription drugs; or\n(g) Establishes a pharmacy network.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=45113","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:46Z","sha256":"741653d1420f9784fc0bdb4f3f2aa0a66cc3fae44b03a05f057770f6195e228e","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-160","next":"us-ky/krs-304.17a-162"},"notice":"GroundRules: Original legal text. Not legal advice."}