Section 19.340.020. Definitions applicable to RCW 19.340.040 through 19.340.090.  


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  • As used in this section and RCW 19.340.040 through 19.340.090:
    (1) "Audit" means an on-site or remote review of the records of a pharmacy by or on behalf of an entity.
    (2) "Clerical error" means a minor error:
    (a) In the keeping, recording, or transcribing of records or documents or in the handling of electronic or hard copies of correspondence;
    (b) That does not result in financial harm to an entity; and
    (c) That does not involve dispensing an incorrect dose, amount or type of medication, or dispensing a prescription drug to the wrong person.
    (3) "Entity" includes:
    (a) A pharmacy benefit manager;
    (b) An insurer;
    (c) A third-party payor;
    (d) A state agency; or
    (e) A person that represents or is employed by one of the entities described in this subsection.
    (4) "Fraud" means knowingly and willfully executing or attempting to execute a scheme, in connection with the delivery of or payment for health care benefits, items, or services, that uses false or misleading pretenses, representations, or promises to obtain any money or property owned by or under the custody or control of any person.