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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 />Generic — 1 87.50% 87.60% 87.70% 1 $0.10 <br />Specialty Pharmacy (All Days' Supple): <br />(tCialtytiscount <br />Guarantee <br />Claim <br />Year One t Ncal 1111tt All Three Years <br />Brand (Excludes <br />21.00% 21.10% <br />21.20% $0.00 <br />LDD <br />Generic - <br />8000% 80.10% <br />80.20% $0.00 <br />Excludes LDD <br />LDD <br />18.25% 18.25% <br />18.25% $0.00 <br />100% of the Participating Pharmacy negotiated pricing will be passed through to Client from RIGHTWAY <br />on a Claim by Claim basis even if a Claim is excluded from an AWP Discount Guarantee or Dispensing <br />Fee Guarantee hereunder. Under the RIGHTWAY transparent, full Pass -Through model, Client pays the <br />actual reimbursement rate (discounts and dispense fees) paid by RIGHTWAY to the Participating Pharmacy <br />from which the Claim originates, less the Eligible Person Cost -Sharing Amount. RIGHTWAY agrees to <br />negotiate to achieve or exceed the AWP Discount Guarantees and Dispensing Fee Guarantees on an <br />aggregated basis (i.e. not Claim by Claim). It is acknowledged by both parties that Participating Pharmacy <br />contracts may vary from the AWP Discount Guarantees and Dispensing Fee Guarantees, causing the actual <br />reimbursement paid to each Participating Pharmacy to be greater or less than the guarantees, and that the <br />AWP Discount Guarantees and Dispensing Fee Guarantees are representative pharmacy reimbursement <br />amounts. <br />The AWP Discount Guarantee performance for a Claim is calculated by subtracting the applicable AWP <br />Discount Guarantee from the actual AWP Discount achieved and multiplying the result by the AWP. The <br />total AWP Discount Guarantee shortfall is calculated by summing this result for all Claims within a Pricing <br />Category, with a net negative result illustrating an AWP Discount Guarantee shortall for that Pricing <br />Category. Should a pharmacy be contracted on a cost-plus basis, all claim costs (e.g. Dispensing Fees, <br />professional fees, etc.) shall be included in the total ingredient cost used to calculate the AWP Discount. <br />Should a Claim price at a discount card price, all claim costs (e.g. Dispensing Fees, professional fees, etc.) <br />shall be included in the total ingredient cost used to calculate the AWP Discount. The Dispensing Fee <br />Guarantee performance is calculated by multiplying the applicable Dispensing Fee Guarantee by the total <br />number of net Claims dispensed for each Pricing Category and subtracting it from the sum of the Dispensing <br />Fees paid for all Claims dispensed for each Pricing Category. Shipping for Covered Products dispensed <br />from Mail Service Pharmacies and Specialty Pharmacies is included in the applicable AWP Discount <br />45 <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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