South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:16 - Covered medical services › Chapter 67:16:14 - Prescription drugs › Section 67:16:14:01 - Definitions

Current through Register Vol. 51, page 10, July 15, 2024
Terms defined in SDCL 36-11-2 have the same meaning when used in this
	 chapter. In addition, terms used in this chapter mean:
(1) "Bioavailability," the degree to which a
  drug or other substance becomes available to the target tissue after
  administration;
(2) "Brand name,"
  an arbitrarily adopted name that is given by a manufacturer to a drug to
  distinguish it as produced or sold by the manufacturer and which may be used
  and protected as a trademark;
(3)
  "Compounded medication," a therapeutic product prescribed by a licensed
  practitioner requiring the mixing together of two or more substances by the
  pharmacist or prescriber;
(4)
  "Consolidated price," a replacement for average wholesale price calculated
  according to the guidelines provided in the South Dakota Medicaid State
  Plan;
(5) "Contractor," a vendor
  that has a contract with the department to provide a list of drugs that are
  widely and consistently available to South Dakota pharmacies at a price that is
  less than the consolidated price;
(6) "Cost," for all drugs and supplies, the
  actual amount paid by the dispensing provider to the supplier after all
  discounts are deducted;
(7)
  "Estimated acquisition cost," for all drugs not subject to the federal upper
  limit pricing covered under the provisions of subdivision 67:16:14:06(3) or the
  state maximum allowable cost covered under the provisions of subdivision
  67:16:14:06(4), the consolidated cost of the drug less 13 percent;
(8) "Generic drugs," drugs of similar
  chemical composition available from multiple sources and not protected by
  trademark registration;
(9) "Legend
  drugs," drugs which may be dispensed by prescription only;
(10) "Maintenance drugs," a medication that
  has been dispensed three times in the same strength, regardless of dosage
  schedule, in any combination of brand name or generic form, and used in the
  treatment of a chronic health condition;
(11) "Multiple-source drug," a drug that is
  sold in therapeutically equivalent forms under one or more brand names,
  available from two or more generic distributors, and available from one or more
  drug wholesale firms located in South Dakota;
(12) "Nonlegend drugs," drugs and supplies
  available without a prescription;
(13) "Over-the-counter" or "OTC," drugs
  available without a prescription which have been recommended by the P and T
  committee for coverage under the medical services program;
(14) "Pharmaceutical and therapeutics
  committee" or "P and T committee," the South Dakota medicaid pharmaceutical and
  therapeutics committee established under the provisions of Executive Order
  2005-09;
(15) "Pharmacist," a
  person licensed to practice pharmacy under SDCL chapter 36-11 or by the state
  in which the pharmacist is located;
(16) "Pharmacy," a facility defined as a
  pharmacy under SDCL chapter 36-11 or by the state in which it is
  located;
(17) "PHS provider," an
  entity which participates as a public health service provider under the
  provisions of 42 U.S.C.
  §
										256 b(a)(4), except §
  256b(a)(4)(C), as in effect on October 1, 1995, and provides covered drugs on
  an outpatient basis to an individual who is a patient of the PHS provider.
  Entities operated by state or local government are not considered PHS
  providers;
(18) "State MAC list" or
  "state maximum allowable cost," the maximum allowable cost established by the
  department, in consultation with the contractor, for drugs listed on the state
  MAC list and covered under the provisions of this chapter;
(19) "Therapeutically equivalent," drug
  products that contain the same active ingredients and are identical in strength
  or concentration, dosage form, and route of administration with comparable
  bioavailability; and
(20)
  "Trademark," a device or word which points distinctly to the origin or
  ownership of the drug to which it is applied and whose exclusive use is legally
  reserved to the owner.
General Authority:
SDCL 28-6-1,
		21 U.S.C.
		801,
		812.
Law Implemented:
SDCL 28-6-1,
		21 U.S.C.
		801,
		812.
South Dakota Medicaid State Plan
, Attachment 4.19-B,
		page 20. Copies may be obtained from the Department of Social Services,
		Division of Medical Services, 700 Governors Drive, Pierre, South Dakota
		57501.