§ 1395w-151. Definitions; treatment of references to provisions in part C
(a)
Definitions
For purposes of this part:
(7)
Insurance risk
The term “insurance risk” means, with respect to a participating pharmacy, risk of the type commonly assumed only by insurers licensed by a State and does not include payment variations designed to reflect performance-based measures of activities within the control of the pharmacy, such as formulary compliance and generic drug substitution.
(13)
PDP sponsor
The term “PDP sponsor” means a nongovernmental entity that is certified under this part as meeting the requirements and standards of this part for such a sponsor.
(14)
Prescription drug plan
The term “prescription drug plan” means prescription drug coverage that is offered—
(b)
Application of part C provisions under this part
For purposes of applying provisions of part C of this subchapter under this part with respect to a prescription drug plan and a PDP sponsor, unless otherwise provided in this part such provisions shall be applied as if—
(2)
any reference to an MA organization or a provider-sponsored organization included a reference to a PDP sponsor;
[1] See References in Text note below.