Definitions.

(a) For the purposes of this section, the terms in this subdivision have the meanings given them.

(b) "Clinical practice guideline" means a systematically developed statement to assist health care providers and enrollees in making decisions about appropriate health care services for specific clinical circumstances and conditions developed independently of a health plan company, pharmaceutical manufacturer, or any entity with a conflict of interest. new text begin A clinical practice guideline also includes a preferred drug list developed in accordance with section 256B.0625. new text end

(c) "Clinical review criteria" means the written screening procedures, decision abstracts, clinical protocols, and clinical practice guidelines used by a health plan company to determine the medical necessity and appropriateness of health care services.

(d) "Health plan company" has the meaning given in section 62Q.01, subdivision 4 , but deleted text begin does not include a managed care organization or deleted text end new text begin also includes a new text end county-based purchasing plan participating in a public program under chapter 256B or 256L deleted text begin , or deleted text end new text begin and new text end an integrated health partnership under section 256B.0755 .

(e) "Step therapy protocol" means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition, including self-administered and physician-administered drugs, are medically appropriate for a particular enrollee and are covered under a health plan.