Page 350

House Bill No. 5506

Public Act No. 22-118 350 of 739

costs of paying bills, advertising, sales commissions, and other administrative costs, net additions or subtractions from reserves, rate credits and dividends, premium taxes and profits or losses; (7) "Office" means the Office of Health Strategy established under section 19a-754a of the general statutes; (8) "Other entity" means a drug manufacturer, pharmacy benefits manager or other health care provider that is not considered a provider entity; (9) "Payer" means a payer, including Medicaid, Medicare and governmental and nongovernment health plans, and includes any organization acting as payer that is a subsidiary, affiliate or business owned or controlled by a payer that, during a given calendar year, pays health care providers for health care services or pharmacies or provider entities for prescription drugs designated by the executive director; (10) "Performance year" means the most recent calendar year for which data were submitted for the applicable health care cost growth benchmark, primary care spending target or health care quality benchmark; (11) "Pharmacy benefits manager" has the same meaning as provided in subdivision (10) of section 38a-479ooo of the general statutes; (12) "Primary care spending target" means the annual target established pursuant to section 219 of this act; (13) "Provider entity" means an organized group of clinicians that come together for the purposes of contracting, or are an established billing unit that, at a minimum, includes primary care providers, and that collectively, during any given calendar year, has enough attributed lives to participate in total cost of care contracts, even if they are not engaged in a total cost of care contract;