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A-3.2. Definitions

  1. Board Member: A person who is appointed to the Texas Drug Utilization Review Board, either as a voting or non-voting member.
  2. Conflict of Interest: A situation that arises wherein a board member or any family member or relative has a financial relationship with an entity, ownership or financial interest with an entity, or any other interest where the member is in a position to derive a personal benefit from action or decisions made in their professional capacity, with an entity.
  3. Direct Payment or Other Transfer of Value: A payment or other transfer of value made by an applicable manufacturer/labeler directly to a Board member and/or their family member or relative.
  4. DUR Board: Drug Utilization Review Board
  5. Entity: Includes an individual, a corporation, organization, business trust, estate, trust, partnership, association, and any other legal entity that may have business come before the DUR Board or before the Medicaid Vendor Drug program. The term includes: (A) a pharmaceutical manufacturer or labeler with a product on the Texas Drug Code Index and any other entity HHSC has engaged to assist in developing the preferred drug list or in administering of the DUR Program; and (B) an "affiliate" or ""associate," as defined in Texas Business Organizations Code §1.002, of an entity.
  6. Family Member or relative: An individual who is related within the third degree by consanguinity or within the second degree by affinity, as defined by the Government Code, Chapter 573, Subchapter B (concerning Relationships by Consanguinity or by Affinity).
  7. Financial Relationship: A written or oral agreement between a board member and an entity that results in the payment of federally reportable income to the board member (i.e., income reported on IRS Form 1099 or Form W-2).
  8. High Level of Integrity: Behaving in an honest and morally upright way, at a level above a normal or average level, such that the public's trust in the member is warranted.
  9. Honoraria: Monetary or non-monetary compensation for services a public servant would not have been asked to provide but for the person's status as a public servant.
  10. Indirect Payment or Other Transfer of Value:& A payment or other transfer of value made by an applicable manufacturer/labeler to a Board member and/or their family member or relative through an intermediary, where the applicable manufacturer/labeler requires, instructs, directs, or otherwise causes the intermediary to provide the payment or transfer of value, in whole or in part, to a Board member and/or their family member or relative.
  11. Interested Party: A manufacturer/labeler with a covered outpatient drug or product on the Texas Drug Code Index (Formulary) and any other entity engaged by HHSC to assist in the administration of the Board.
  12. Manufacturer/Labeler: A manufacturer of prescription drugs as defined by §1927(k)(5) of the Social Security Act (42 U.S.C. §1396r-8(k)(5)), including a subsidiary or affiliate of a manufacturer or an entity that has a labeler code from the United State Food and Drug Administration under 21 C.F.R. Section 207.33 and receives prescription drugs from a manufacturer or wholesaler and repackages those drugs for later retail sale.
  13. Other Interest: Involvement in the affairs of an entity that impairs or may be perceived as impairing a Board member's independence of judgment regarding the board member's performance of duties for the DUR Board.
  14. Ownership or Financial Interest: An equity interest in where a Board member exercises control over the selection of investments and any other financial interest whose value cannot be readily determined through reference to public records.
  15. Personal Benefit: Anything reasonably regarded as economic gain or advantage, including a benefit to a family member or relative.
  16. Personal Financial Interest: Having a direct monetary interest in a matter or owing loyalty to an involved entity. Personal financial interest does not include the Board member's engagement in a profession, trade, or occupation when the Board member's interest is all others similarly engaged in the profession, trade, or occupation.