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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 />Prior Authorization means a prospective review to verify that certain criteria required by Client are <br />satisfied for specific Covered Products prior to processing the Claim for such Covered Products. <br />Protected Health Information (PHI) has the meaning set forth in Exhibit 7 (Business Associate <br />Agreement). <br />Rebates means all rebates, discounts, or other financial incentives, including Manufacturer administrative <br />fees, received by RIGHTWAY that are paid by a Manufacturer in connection with Covered Products <br />dispensed to Eligible Persons under the Plan, and do not include any other Manufacturer monies received <br />by RIGHTWAY and not directly attributable to Covered Product utilization of Eligible Persons. <br />Rebate Aggregator means any party engaged by RIGHTWAY for the purpose of obtaining Rebates. Client <br />acknowledges that reasonable formulary management fees and costs may be retained by the Rebate <br />Aggregator. <br />Renewal Term means the time period as defined in Section 5.01 (Term of Agreement; Automatic Renewal) <br />of this Agreement. <br />Retail Pharmacy means a resident licensed pharmacy that primarily dispenses Covered Products via a <br />retail, storefront location that accepts walk-in customers, and such other criteria set forth on RIGHTWAY's <br />enrollment and/or credentialing forms, as may be amended from time to time. <br />Retail 30 Claim means any Paid Claim, other than Specialty Drug Claims, filled through a Retail Pharmacy <br />for a days' supply less than or equal to 83 days. <br />Retail 90 Claim means any Paid Claim, other than Specialty Drug Claims, filled through a Retail Pharmacy <br />for a days' supply 84 days or greater. <br />Services means the services provided by RIGHTWAY pursuant to this Agreement. <br />Specialty Pharmaceuticals or Specialty Drug means those biotech and other Covered Products identified <br />by RIGHTWAY as specialty pharmaceuticals from time to time, which typically include pharmaceutical <br />products that are generally biotechnological in nature, including but not limited to those that are injected, <br />infused, or orally administered, and are typically used for complex, life threatening, or chronic conditions <br />and that may have special shipping, administration, or handling requirements. A then -current list of <br />Specialty Pharmaceuticals may be obtained at any time by contacting RIGHTWAY. RIGHTWAY reserves <br />the right to modify the Specialty Drug list from time to time. <br />Specialty Pharmacy means a pharmacy that has entered into an agreement with RIGHTWAY to dispense <br />Covered Products including Specialty Pharmaceuticals to Eligible Persons and is designated by <br />RIGHTWAY as a preferred specialty provider. <br />Tax or Taxes means a charge imposed, assessed, or levied by any federal, state, local, or other <br />governmental entity in connection with Services provided hereunder. <br />F <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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