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2007-401A
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2007-401A
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Last modified
6/28/2016 12:34:33 PM
Creation date
10/1/2015 4:11:59 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
11/20/2007
Control Number
2007-401A
Agenda Item Number
11.D.1
Entity Name
Caremark PCS Health
Subject
Pharmacy Benefit Services Agreement
Consumer Card Program
Alternate Name
Advance PCS Health NACo
Supplemental fields
SmeadsoftID
10989
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medications . These programs may include mailings to Participants with active prescriptions for targeted drug <br /> products or drug classes or to let Participants know that they may qualify for participation in a clinical <br /> trial <br /> program . Such mailings may include Participant and drug specific information and/or general educational <br /> material . Participants , by notifying Caremark , may opt- out of such programs . <br /> b . DUR Services . Caremark will provide its automated concurrent DUR Services for Claims . <br /> The information generated in connection with DUR Services is intended as an economical supplement to , and <br /> not as a substitute for, the knowledge, expertise, skill , and judgment of physicians , pharmacists , or other health <br /> care providers in providing patient care . Providers are individually responsible for acting or not acting upon <br /> information generated and transmitted through the DUR Services , and for performing services in <br /> each <br /> jurisdiction consistent with the scope of their licenses. Notwithstanding anything set forth in this Agreement, <br /> Caremark will have no obligation to acquire information concerning any Participant beyond the information <br /> that is included in Caremark ' s eligibility records or the Claims submitted by Participating Pharmacies <br /> in <br /> connection with the Consumer Card Program . <br /> 1 .8 Formulary Services . Caremark will administer an open formulary for the Member County and will <br /> provide certain Services that are designed to provide useful clinical information to physicians <br />(the " Formulary <br /> Services" ) . Caremark may snake changes to the Formulary Services described in this Agreement from time to time , and <br /> will notify Member County and Customer of any material changes to any formulary management programs . In all <br /> cases , the prescribing physician shall have final authority over the drug that is prescribed to the Participant . <br /> a. Rebate Contracts, Caremark contracts with certain Manufacturers for Rebate programs . <br /> b. Disclosure of Manufacturer Fees. Caremark may receive fees or other compensation from <br /> Manufacturers , including, without limitation , administrative fees not exceeding three percent of the aggregate <br /> cost of the pharmaceutical products dispensed to participants , and fees for property provided or <br /> services <br /> rendered to a Manufacturer ( which may include providing physicians clinical messages consistent with the <br /> Performance Drug List, as defined below ) . Caremark ' s specialty pharmacies may also receive fees <br /> from <br /> Manufacturers for products and services provided . In addition, Caremark ' s mail order and <br /> specialty <br /> pharmacies may negotiate on their own behalf directly with Manufacturers for discounts, including rebated <br /> discounts based on market share or other factors . The term Rebates as used in this Agreement does not include <br /> these fees and discounts which belong exclusively to Caremark or Caremark ' s mail order or <br /> specialty <br /> pharmacies , respectively . <br /> c. Participant Authorizations and Disclosures. Customer and Member County shall comply <br /> with all Laws applicable to it as a sponsor of the Services or as otherwise consistent with its obligations under <br /> this Agreement. <br /> d . Additional Participant Discounts. Caremark may provide a program that will provide <br /> Participants with additional manufacturer discounts on certain drugs at the point of sale. From time to time, <br /> Caremark may revise the list of drugs that have additional participant discounts . The current list of drugs on <br /> which Participants may receive additional discounts is available upon request . Caremark will timely notify <br /> Member County and Customer of any revisions to this list of drugs . <br /> 1 . 9 Management Reports . Caremark will provide Member County and Customer with Caremark ' s <br /> standard management reports in connection with the Services , which reports may change from time <br /> to time at <br /> Caremark ' s discretion . Member County and Customer may elect to receive a reasonable number of the standard <br /> management reports made available by Caremark . <br /> 1 . 10 Mail Service Program . Caremark may provide to Member County mail order pharmacy services <br /> through its mail order pharmacy facilities . For the duration of this Agreement, Member County agrees that it will <br /> offer <br /> only Caremark mail order pharmacy services for its Participants covered under this Agreement, as further described <br /> below . <br /> Caremark shall fill prescriptions for Participants and shall mail such drugs or medications to such Participants subject <br /> to <br /> the following terms and conditions : <br /> NACo k3 - v2 .doc ( 02/_14,12006 ) IR % Claiml Pace 2 of' 29 <br /> This document contains proprictary information of Caremark , and may not be used for any purpose other than to evaluate enterin _= <br /> into a relationship <br /> with Caremark. nor may it be duplicated or disclosed to others for any purpose . <br />
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