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Docusign Envelope ID: 921 F7A24-D5CE-4BCC-9F3C-5E7844661266
<br />Formulary means the list of FDA -approved Covered Products developed by RIGHTWAY's Pharmacy
<br />and Therapeutics Committee, approved and adopted by Client and subject to Client's Plan Documents and
<br />coverage decisions.
<br />Generic Covered Product or Generic Drug is a Covered Product for which there is an approved
<br />application under § 5050) of the Federal Food Drug and Cosmetic Act (21 USC 3550)) and the Pricing
<br />Source multi -source indicator for the Covered Product is a "Y" on the date dispensed. Claims submitted
<br />with the Pricing Source multi -source indicator of "O" and also submitted with a DAW code of "3", "5",
<br />"611, "9" shall also be considered a Generic Covered Product.
<br />Government Agency(ies) means government agencies, including but not limited to state Medicaid
<br />agencies, Veteran's Administration ("VA") facilities, Indian Health Services and Bureau of Indian Affairs
<br />("IHS"), and Department of Defense ("DOD") military treatment facilities (or other similar facilities)
<br />("MTF"), or the agencies' or facilities' third -party representatives.
<br />HIPAA means the Health Insurance Portability and Accountability Act of 1996, and regulations
<br />promulgated thereunder, as amended from time to time.
<br />HIPAA Privacy Rule means the federal regulations related to the use and disclosure of patients' Protected
<br />Health Information under 45 CFR Parts 160, 162 and 164, as amended from time to time.
<br />Initial Term means the initial term of this Agreement as defined in Section 5.01 (Term of Agreement;
<br />Automatic Renewal) of this Agreement.
<br />Law means any federal, state or local constitution, act, statute, code, rule, regulation, or standard, including
<br />any such rule, regulation, or standard issued by the Centers for Medicare and Medicaid Services, the Office
<br />of the Inspector General, the Department of Labor, a state department of insurance, or any other government
<br />or quasi -governmental entity; any objective criteria contained in any applicable permit or approval; any
<br />legislative or administrative action of the United States of America or of any state or agency, department,
<br />authority, political subdivision or other instrumentality thereof, and any decree, judgment or order of a
<br />court.
<br />Mail Service Pharmacy or Mail Service or Mail Order means a pharmacy where prescriptions are filled
<br />and delivered to Eligible Persons via the United States Postal Service, United Parcel Service or other
<br />delivery service, and which has entered into an agreement with RIGHTWAY to dispense Covered Products.
<br />Manufacturer means a pharmaceutical, biotech, medical equipment, or medical device manufacturer,
<br />and/or any other entity that performs sales, distribution, and/or marketing functions (including wholesalers
<br />and distributors) with respect to any such manufacturer's products.
<br />Material Breach means a breach such that a reasonable person in the position of the non -breaching party
<br />would wish to terminate this Agreement because of that breach.
<br />Maximum Allowable Cost ("MAC") means the maximum allowable cost determined by RIGHTWAY
<br />and updated at least quarterly, or more frequently as required by Law, based upon review and analysis of
<br />current pricing in the marketplace. Upon request, RIGHTWAY will provide Client or its designee with a
<br />current MAC list.
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<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.
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