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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 />IDAHO PBM REGULATORY ADDENDUM <br />With respect to the following provisions required by the State of Idaho, "PBM" shall mean RIGHTWAY, <br />and "Insurer" shall mean Client. <br />Notwithstanding anything in the Agreement to the contrary, PBM and Insurer agree as follows: <br />1. Applicability. This Addendum is required by Idaho Code § 41-349 in order to include the requirements <br />thereof to the extent such requirements are applicable to the Services provided by PBM under the <br />Agreement, such requirements are applicable to the Services provided by PBM under the Agreement, <br />and such requirements are not already addressed in the Agreement. This Addendum applies to the <br />extent Eligible Person(s) reside in the State of Idaho and Insurer operates a "pharmacy benefits plan or <br />program" as contemplated by Idaho Code § 41-349. <br />2. General. In the event of a direct conflict between this Addendum and the Agreement, the applica- <br />ble provisions of this Addendum shall control if required. Absent such direct conflict, the terms and con- <br />ditions of the Agreement shall remain in full force and effect. Capitalized terms not defined in this Adden- <br />dum shall have the same meaning as set forth in the Agreement. This Addendum may be modified from <br />time to time pursuant to the Agreement. <br />3. Pass-through Pricing Model. PBM shall use a pass-through pricing model. Idaho Code § 41- <br />349(1 ])(a). <br />4. Funds for Services. PBM shall use funds received in relation to providing the Services only pur- <br />suant to this Agreement or as otherwise required by applicable law. Idaho Code § 41-349(11)(c). <br />5. Manufacturer Rebates. PBM shall pass 100 percent of all Rebates received to the Insurer for the <br />sole purpose of offsetting defined cost-sharing and reducing premiums of covered persons. Rebates include <br />any payment, discount, incentive, fee, price concession, or other remuneration. Idaho Code § 41-349(11)(d). <br />6. Network Adequacy Standards. <br />6.1 Medicare Part D Program Standards. PBM shall meet Medicare Part D program network <br />adequacy standards set forth in 42 C.F.R. § 423.120(a)(1). Idaho Code § 41-349(11)(e). <br />6.2 Affiliated Pharmacies. PBM shall not exclude unaffiliated Participating Pharmacies from <br />any of its networks. Idaho Code § 41-349(11)(e)(i). <br />;1 <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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