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2025-126D
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2025-126D
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Last modified
9/18/2025 10:43:54 AM
Creation date
9/8/2025 1:42:16 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
06/03/2025
Control Number
2025-126D
Agenda Item Number
13.D.1.
Entity Name
Rightway Healthcare, Inc.
Subject
Pharmacy Benefit Management Services Agreement
Document Relationships
2025-126
(Cover Page)
Path:
\Official Documents\2020's\2025
2025-126A
(Cover Page)
Path:
\Official Documents\2020's\2025
2025-126B
(Cover Page)
Path:
\Official Documents\2020's\2025
2025-126C
(Cover Page)
Path:
\Official Documents\2020's\2025
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Docusign Envelope ID: 921 F7A24-D5CE-4BCC-9F3C-5E7844661266 <br />EXHIBIT 1 <br />DEFINITIONS <br />340B Claim means a Claim f'or a Covered Product (i) dispensed pursuant to the dispensing Participating <br />Pharmacy's participation under Section 340B of the Public Health Service Act, 42 U.S.C. §256b, as <br />amended, superseded or replaced, and the regulations promulgated thereunder ("PHS Act"). <br />ACA means the Patient Protection and Affordable Care Act, as amended, and the regulations promulgated <br />thereunder. <br />Additional Fees means those service fees identified in Exhibit 3 (Administrative Services Fee Schedule), <br />payable to RIGHTWAY for the performance of those specified services when selected by Client. <br />Administrative Fees means the amount Per Eligible Person per Month (PMPM) or Per Eligible Employee <br />per Month (PEPM) fee as set forth in Exhibit 3 (Administrative Services Fee Schedule, payable to <br />RIGHTWAY for the performance of this Agreement and certain specified Services under this Agreement. <br />This does not include amounts paid for Covered Products (e.g., Ingredient Cost, Dispensing Fees, and <br />taxes), Additional Fees, or Ancillary Service Fees. <br />Ancillary Service Fees means those service fees identified in Exhibit 3 (Administrative Services Fee <br />Schedule), or otherwise in the Agreement and/or agreed to by the parties in writing, and not including any <br />Administrative Fee. <br />Authorized Users means each of Client's active employees "Eligible Employee" and dependents, and <br />retired employees and dependents, who satisfy all the eligibility criteria necessary to receive Care <br />Navigation Services under Client's plan. <br />Average Wholesale Price or AWP means the average wholesale price of a Covered Product, based on the <br />11 -digit NDC for the actual package size of the Covered Product as submitted by the Participating <br />Pharmacy, as published and updated by the Pricing Source. AWP does not represent a true wholesale price, <br />but rather is a fluctuijting henclunark provided by third -party pricing sources. <br />AWP Discount means the result of a Claim's total ingredient cost, before Cost -Sharing Amount deducted. <br />subtracted from the Claim's AWP divided by the AWP. <br />AWP Discount Guarantee means the minimum aggregate AWP discount guarantee as set forth in Exhibit <br />4 (Pharmacy Pricing and Rebates) for all Claims for each Pricing Category, as calculated, reported and <br />reconciled in accordance with Exhibit 4 Pharmacy Pricing and Rebates). <br />Brand Covered Product or Brand Drug means a single source or multi -source Covered Product <br />designated by RIGHTWAY using indicators from the Pricing Source and reporting services and <br />RIGHTWAY's standard policies, including where the Pricing Source multi -source indicator for the <br />Covered Product contains an "M" (co -branded product), "O" (originator brand) or an "N" (single source <br />brand) for the Covered Product on the date dispensed (except where the Claim is submitted with both an <br />O and a DAW code of "Y', "5", "6", or "9" in which case it shall be considered a Generic Covered Product). <br />Business Day means all days except Saturdays, Sundays, and RIGHTWAY designated holidays. All <br />references to "day" or "days" in this Agreement are to calendar days unless "Business Day" is specified. <br />22 <br />This document is CONFIDENTIAL AND PROPRIETARY to RIGHTWAY Healthcare, Inc. and may not be reproduced, <br />transmitted, published, or disclosed to others without the prior written authorization of RIGHTWAY Healthcare, Inc. <br />
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