maximum fair price eligible individual
Defined in 1 place of the United States Code.
The term "maximum fair price eligible individual" means, with respect to a selected drug—
(A) in the case such drug is dispensed to the individual at a pharmacy, by a mail order service, or by another dispenser, an individual who is enrolled in a prescription drug plan under part D of subchapter XVIII or an MA–PD plan under part C of such subchapter if coverage is provided under such plan for such selected drug; and
(B) in the case such drug is furnished or administered to the individual by a hospital, physician, or other provider of services or supplier, an individual who is enrolled under part B of subchapter XVIII, including an individual who is enrolled in an MA plan under part C of such subchapter, if payment may be made under part B for such selected drug.
Source
- 2022–present42 U.S.C. § 1320fThe Public Health and Welfare · Establishment of program · for purposes of this part