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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 />9. Accreditation Standards for Participating Pharmacies. Except for specialty networks, PBM <br />shall not institute a network that requires a Participating Pharmacy to meet accreditation standards incon- <br />sistent with or more stringent than applicable federal and state requirements for licensure and operation as <br />a pharmacy in Florida. Florida Stat. Ann. § 626.8825(2)(g). <br />9.1 Specialty Network. For participation in a specialty network, PBM shall not require a Par- <br />ticipating Pharmacy to meet requirements for participation beyond those necessary to demonstrate the phar- <br />macy's ability to dispense the drug in accordance with the United States Food and Drug Administration's <br />approved manufacturer labeling. Florida Stat. Ann. § 626.8825(2)(g). <br />10. Formulary. When a formulary managed by the PBM is utilized, PBM shall, at a minimum, upon <br />revising the formulary or Covered Benefits during a plan year, provide a 60 -day continuity -of -care period <br />in which the modified or deleted Covered Benefit continues to be provided at the same cost for Eligible <br />Person for a period of 60 days. When a formulary managed by the Insurer is utilized, Insurer shall, at a <br />minimum, upon revising the formulary or Covered Benefits during a plan year, provide a 60 -day continuity - <br />of -care period in which the modified or deleted Covered Benefit continues to be provided at the same cost <br />for Eligible Person for a period of 60 days. The applicable 60 -day continuity -of -care period commences <br />upon notification to Eligible Person and Insurer shall pay such Claim amounts consistent with the terms of <br />the Agreement. This requirement does not apply if the Covered Benefit is a prescription drug that (a) has <br />been approved and made available over the counter by the United States Food and Drug Administration <br />and has entered the commercial market as such; (b) has been removed or withdrawn from the commercial <br />market by the manufacturer; or (c) is subject to an involuntary recall by state or federal authorities and is <br />no longer available on the commercial market. PBM shall ensure the 60 -day continuity -of -care period Flor- <br />ida Stat. Ann. § 626.8825(h). <br />79 <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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