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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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a . Distribution of Information . Caremark shall provide Participants with its standard <br /> informational material explaining the mail service and the forms necessary for Participants to utilize <br /> mail <br /> service . Participants will have toll - free telephone access to a pharmacist and customer service representative. <br /> Access to a pharmacist will be available 24 hours per day , seven days per week . <br /> b. Delivery and Dispensing. Caremark shall dispense through its mail service pharmacy new <br /> or refill prescription orders upon receipt from a Participant of ( i ) a valid prescription order or a completed refill <br /> order form and ( ii ) the applicable payment. Caremark shall cause the filled prescriptions to be mailed to each <br /> Participant via common carrier at the address appearing on the face of the prescription so long <br /> as such <br /> addresses are in the United States . Caremark shall not be liable to Member County , Customer or Participant <br /> for any delay in delivery resulting from circumstances beyond Caremark ' s control as set forth in Section 6 . 2 . <br /> Caremark ' s mail order pharmacies may dispense drugs even if the prescription is not accompanied by <br /> the <br /> correct amount however, Member County and Customer acknowledge and agree that Caremark may refuse to <br /> fill any prescription that is either not accompanied by the correct amount and/or for any Participant who has an <br /> unpaid balance with Caremark. <br /> 1 . 11 Preferred Drug Program . Caremark and the retail Participating Pharmacies will work together to <br /> encourage the use of Preferred Drugs by ( i ) identifying appropriate opportunities for converting a prescription from <br /> a <br /> non - Preferred Drug to a Preferred Drug, and ( ii ) contacting the Participant and the prescriber to <br /> request that the <br /> prescription be changed to the Preferred Drug . A Preferred Drug is one on the Performance Drug List, which has <br /> been <br /> developed by Caremark as a clinically appropriate and economically advantageous subset of the Caremark Formulary , <br /> as revised by Caremark from time to time . <br /> 1 . 12 Specialty Pharmacy . Caremark ' s specialty pharmacy service will be provided by a Caremark <br /> specialty pharmacy entity or its affiliate ( "Caremark SpecialtyRx" ), and offers a distribution channel for <br /> certain <br /> pharmaceutical products that are generally biotechnological in nature, are given by injection, or otherwise <br /> require <br /> special handling ("Specialty Medications" ). <br /> Caremark SpecialtyRx shall provide prescription fulfillment and distribution of Specialty Medications and supplies, <br /> pharmaceutical care management services, as well as the types of Service that Member County receives under <br /> this <br /> Agreement, including but not limited to customer services , utilization and clinical management, integrated reporting and <br /> Claims processing ( "SpecialtyRx Services" ) . <br /> Caremark SpecialtyRx may receive prescriptions from Participants through an affiliated Caremark mail facility <br /> or <br /> directly via the U . S . Mail or commercial carrier at the address specified by Caremark from time to time and <br /> may also <br /> receive prescriptions from physicians by fax or by U . S . Mail/commercial carrier. In accordance with the Consumer <br /> Card Program , Caremark SpecialtyRx shall dispense Covered Items in accordance with those prescriptions and mail the <br /> Covered Items to Participants at the designated address , so long as such address is located within the United <br /> States . <br /> Caremark SpecialtyRx may not dispense drugs to Participants who fail to submit the correct payment <br /> with their <br /> prescription . <br /> Caremark SpecialtyRx pharmaceutical care management services include but may not be limited to : ( 1 ) patient profiling <br /> focusing on the appropriateness of Specialty Medication therapy and care and the prevention of drug-drug interactions ; <br /> ( 2 ) patient education materials ; and (3 ) disease management and compliance programs with respect <br /> to Specialty <br /> Medications . As part of these services , Participants will be asked to participate in various surveys . <br /> Caremark will provide Member County and Customer with a list of the Specialty Medications and their corresponding <br /> rates ( which may vary from Network Rates ) upon request . Routine supplies ( needles , syringes , alcohol swabs ) <br /> in a <br /> sufficient quantity will be included at no additional expense . <br /> 2 . FEES AND PAYMENT, <br /> N .ACn k3 V2 doc ( 02 /24/2006 ) IRcClaiml Pagc 3 of 29 <br /> This document contains proprietary information of Caremark, and may not he used for any purpose other than to evaluate entering into <br /> a relationship <br /> with Caremark , nor may it he duplicated or disclosed to others for any purpose . <br />
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