Insurance Risk Law and Legal Definition
According to 42 USCS § 1395w-151 [Title 42. The Public Health and Welfare; Chapter 7. Social Security Act], insurance risk means, “with respect to a participating pharmacy, risk of the type commonly assumed only by insurers licensed by a State and does not include payment variations designed to reflect performance-based measures of activities within the control of the pharmacy, such as formulary compliance and generic drug substitution.”
