For purposes of this subchapter:

(1) “Claim” means as defined under § 3321A of this title.

(2) “Insured” means an individual covered by health insurance offered by an insurer.

(3) “Insurer” means as defined under § 3321A of this title.

(4) “Pharmacist” means as defined under § 2502 of Title 24.

(5) “Pharmacy” means as defined under § 2502 of Title 24.

(6) “Pharmacy benefits manager” means as defined under § 3302A of this title.

(7) “Pharmacy benefits manager network” means a network of pharmacists or pharmacies that are offered by an agreement or contract to provide pharmacy goods or services.

(8) “Pharmacy goods or services” means as defined under § 3325A of this title.

(9) a. “Rebate” means a discount or other price concession, or a payment that is both of the following:

1. Based on utilization of a prescription drug.

2. Paid by a manufacturer or third party, directly or indirectly, to the pharmacy benefits manager, pharmacy services administrative organization, or pharmacy after a claim has been processed and paid at a pharmacy.

b. “Rebate” includes incentives, disbursements, and reasonable estimates of a volume-based or category-based discount.

83 Del. Laws, c. 256, § 12; 

(a) A pharmacy benefits manager shall provide a reasonably adequate and accessible pharmacy benefits manager network for the provision of prescription drugs, which provides for convenient patient access to pharmacies within a reasonable distance from a patient’s residence.

(b) A pharmacy benefits manager may not deny a pharmacy the opportunity to participate in a pharmacy benefits manager network at preferred participation status if the pharmacy is willing to accept the terms and conditions that the pharmacy benefits manager has established for other pharmacies as a condition of preferred network participation status.

(c) A mail-order pharmacy may not be included in the calculations for determining pharmacy benefits manager network adequacy under this section.

83 Del. Laws, c. 256, § 12; 

(a) A pharmacy benefits manager shall provide a pharmacy benefits manager network adequacy report describing the pharmacy benefits manager network and the pharmacy benefits manager network’s accessibility in this State. The Commissioner shall adopt regulations setting the time and manner for providing the report.

(b) A pharmacy benefits manager shall report to the Commissioner on a quarterly basis all of the following information for each insurer:

(1) The itemized amount of pharmacy benefits manager revenue sources, including professional fees, administrative fees, processing fees, audits, direct and indirect renumeration fees, or any other fees.

(2) The aggregate amount of rebates distributed to the appropriate insurer.

(3) The aggregate amount of rebates passed on to insureds of each insurer at the point of sale that reduced the insureds’ applicable deductible, copayment, coinsurance, or other cost-sharing amount.

(4) The individual and aggregate amount the insurer paid to the pharmacy benefits manager for pharmacy goods or services itemized by all of the following:

a. Pharmacy.

b. Product.

c. Goods and services.

(5) The individual and aggregate amount a pharmacy benefits manager paid for pharmacy goods or services itemized by all of the following:

a. Pharmacy.

b. Product.

c. Goods and services.

(c) The information provided under subsection (b) of this section is confidential and not subject to subpoena or the Freedom of Information Act, Chapter 100 of Title 29.

83 Del. Laws, c. 256, § 12;