AG 2008 08 18 - Laserfiche WebLink

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CAREMARKPCS HEALTH, L.Y. AMENDED AND RESTATED MANAGED PHARMACY BENEFIT SERVICES AGREEMENT CONSUMER CARD PROGRAM THIS AMENDED AND RESTATED AGREEMENT (the "Agreement's ffi effective beginning May 15, 2008 (the "Effective Date") among National Association of Counties ("Customer"), counties that are members of the Natioml Association of Counties ("Member County's and CeremarkPCS Health, L.P., formerly known as AdvancePCS Health, L.P. ("Caremark', for the purpose of delineating the terms and conditions under which Caremark will provide certain managed pharmacy benefit services to Member Couny and Customer. 'Chia Agreement amends the existing Member County Agreements consistent with the terrrra thereof. Customr agrees that it will require each Member County added after the Effective Dak to execute an individual agreement with Caremark in the form attached hereto ss Exhibit C (the "Member County AgreemenY~ prior ro Carearark's providing Services to such Member County. Caremark will not provide Services to Member County prior ro tlu receipt of the Member County's execution of the Member County Agreement. 1. STATEMENT OF SERVICES /OBLIGATIONS. 1.1 Services. Caremark will provide Member County the services as set forth in this Section 1, and the services described in say attachment, addendum or amendment hereto (collectively the "Servicea'7. Caremark tray make changes to the Services from limo to time so long es such changes do not materially alter any of the provisions of this Agreement. 1.2 Pardcipadag Pharmacies. Caremark has created a network of Participating Phamtacies, which will perform pharmacy services for Participaaffi. 13 Pharmacy Help Dak sad Voice Response Unit. Caremark will provide Participating Pharmacies with help desk assistance and access to Caremark's voice response unit during Caremark's Lours of operation 1.4 Claims Processing. a. Submission of Claims. Caremark will adjudicate Claims submitted by Participating Pharrmcies to Caremark in accordance with the Participating Pharmacy's agreermnt with Caremark and Ore Consumer Card Program b. Collectlon at Point of Sale. Customer and Member County acknowledge that Participating Phtarrmcies will collect from the Participant one hundred percent (100°h) of the applicable prescription price, discounted at the rates set forth on Exhrbit B as applicable, plus a transaction fee from the Participant. 1.5 Customer Service. Caremark will make available to Customer, Member County and Participanffi a toll free number during those hours of operation maintained by Caremark. Staff wiB be available to answer questions on dre Consttmet Card Program and Consumer Card Program guidelines. 1.6 IdeadlhcaHan Cards. Caremark will, at its own cost, produce identification cards for Participants, which contain Member County's and Customer's logo(s). Identification cards will be available to any individual the Member County or Customer deem appropriate. Caremark will work with Member County on the dishibuHon method for identification cards; provided, however if Member County requesffi that Caremark mail the identification cards to Members, postage and handling charges will apply. The Participant shall be responsible for paying for any prescriptions obtained while using the identification card. 1.7 Clinical Services and Drug Utilizatlon Review ("DUR"). a. Clinical Services. Caremark may provide to Member County its member compliance programs and other programs designed to ensure proper drug utilization and encourage the use ofcost-effective medications. These programs may include mailings to Participants with active prescriptions for targeted drug This document conuins praprieury infotnution of Caremark, and may net Ix used for= ny purptae other Man to evamate enrenng with Caremark, nor may it be duplicated or disclosed soothers for any purpose.