Pharmacy. 4.6.6.1 The Contractor shall provide pharmacy services either directly or through a Pharmacy Benefits Manager (PBM). The Contractor or its PBM may establish a drug formulary if the following minimum requirements are met: 4.6.6.1.1 Drugs from each specific therapeutic drug class are included and are sufficient in amount, duration, and scope to meet Members’ medical needs; 4.6.6.1.2 The only excluded drug categories are those permitted under section 1927(d) of the Social Security Act; 4.6.6.1.3 A Pharmacy & Therapeutics Committee that advises and/or recommends formulary decisions; and 4.6.6.1.4 Over-the-counter medications specified in the Georgia State Medicaid Plan are included in the formulary. 4.6.6.2 The Contractor shall provide the formulary to DCH upon the request of DCH. 4.6.6.3 If the Contractor chooses to implement a mail-order pharmacy program, any such program must be accordance with State and federal law.
Appears in 2 contracts
Sources: Contract for Provision of Services (Amerigroup Corp), Contract (Centene Corp)
Pharmacy. 4.6.6.1 The Contractor shall provide pharmacy services either directly or through a Pharmacy Benefits Manager (PBM). The Contractor or its PBM may establish a drug formulary if the following minimum requirements are met:
4.6.6.1.1 : · Drugs from each specific therapeutic drug class are included and are sufficient in amount, duration, and scope to meet Members’ medical needs;
4.6.6.1.2 ; · The only excluded drug categories are those permitted under section 1927(d) of the Social Security Act;
4.6.6.1.3 ; · A Pharmacy & Therapeutics Committee that advises and/or recommends formulary decisions; and
4.6.6.1.4 and · Over-the-counter medications specified in the Georgia State Medicaid Plan are included in the formulary.
4.6.6.2 The Contractor shall provide the formulary to DCH upon the request of DCH.
4.6.6.3 If the Contractor chooses to implement a mail-order pharmacy program, any such program must be accordance with State and federal law.
Appears in 2 contracts
Sources: Contract for Provision of Services (Centene Corp), Contract (Wellcare Health Plans, Inc.)
Pharmacy. 4.6.6.1 The Contractor shall provide pharmacy services either directly or through a Pharmacy Benefits Manager (PBM). The Contractor or its PBM may establish a drug formulary if the following minimum requirements are met:
4.6.6.1.1 : · Drugs from each specific therapeutic drug class are included and are sufficient in amount, duration, and scope to meet Members’ medical needs;
4.6.6.1.2 ; · The only excluded drug categories are those permitted under section 1927(d) of the Social Security Act;
4.6.6.1.3 ; · A Pharmacy & Therapeutics Committee that advises and/or recommends formulary decisions; and
4.6.6.1.4 and · Over-the-counter medications specified in the Georgia State Medicaid Plan are included in the formulary.
4.6.6.1.1 The Contractor shall provide covered pharmacy services either directly or through a Pharmacy Benefits Manager (PBM) to P4HB Participants.
4.6.6.1.2 The Contractor shall make available to P4HB Participants folic acid and/or a multivitamin with folic acid.
4.6.6.2 The Contractor shall provide the formulary to DCH upon the request of DCH.
4.6.6.3 If the Contractor chooses to implement a mail-order pharmacy program, any such program must be accordance with State and federal law.
Appears in 1 contract
Sources: Contract (Centene Corp)
Pharmacy. 4.6.6.1 The Contractor shall provide pharmacy services either directly or through a Pharmacy Benefits Manager (PBM). The Contractor or its PBM may establish a drug formulary if the following minimum requirements are met:
4.6.6.1.1 : • Drugs from each specific therapeutic drug class are included and are sufficient in amount, duration, and scope to meet Members’ medical needs;
4.6.6.1.2 ; • The only excluded drug categories are those permitted under section 1927(d) of the Social Security Act;
4.6.6.1.3 ; • A Pharmacy & Therapeutics Committee that advises and/or recommends formulary decisions; and
4.6.6.1.4 and • Over-the-counter medications specified in the Georgia State Medicaid Plan are included in the formulary.
4.6.6.2 4.6.6.1.1 The Contractor shall provide the formulary covered pharmacy services either directly or through a Pharmacy Benefits Manager (PBM) to DCH upon the request of DCHP4HB Participants.
4.6.6.3 If the 4.6.6.1.2 The Contractor chooses shall make available to implement P4HB Participants folic acid and/or a mail-order pharmacy program, any such program must be accordance multivitamin with State and federal lawfolic acid.
Appears in 1 contract
Sources: Contract for Provision of Services (Wellcare Health Plans, Inc.)
Pharmacy.
4.6.6.1 The Contractor shall provide pharmacy services either directly or through a Pharmacy Benefits Manager (PBM). The Contractor or its PBM may establish a drug formulary if the following minimum requirements are met:
4.6.6.1.1 : • Drugs from each specific therapeutic drug class are included and are sufficient in amount, duration, and scope to meet Members’ medical needs;
4.6.6.1.2 ; • The only excluded drug categories are those permitted under section 1927(d) of the Social Security Act;
4.6.6.1.3 ; • A Pharmacy & Therapeutics Committee that advises and/or recommends formulary decisions; and
4.6.6.1.4 and • Over-the-counter medications specified in the Georgia State Medicaid Plan are included in the formulary.
4.6.6.2 4.6.6.1.1 The Contractor shall provide the formulary to DCH upon the request of DCH.
4.6.6.3 If the Contractor chooses to implement covered pharmacy services either directly or through a mail-order pharmacy program, any such program must be accordance with State and federal law.Pharmacy Benefits Manager (PBM)
Appears in 1 contract
Sources: Contract for Provision of Services
Pharmacy. 4.6.6.1 The Contractor shall provide pharmacy services either directly or through a Pharmacy Benefits Manager (PBM). The Contractor or its PBM may establish a drug formulary if the following minimum requirements are met:
4.6.6.1.1 : · Drugs from each specific therapeutic drug class are included and are sufficient in amount, duration, and scope to meet Members’ medical needs;
4.6.6.1.2 ; · The only excluded drug categories are those permitted under section 1927(d) of the Social Security Act;
4.6.6.1.3 ; · A Pharmacy & Therapeutics Committee that advises and/or recommends formulary decisions; and
4.6.6.1.4 and · Over-the-counter medications specified in the Georgia State Medicaid Plan are included in the formulary.
4.6.6.2 4.6.6.1.1 The Contractor shall provide the formulary to DCH upon the request of DCH.
4.6.6.3 If the Contractor chooses to implement covered pharmacy services either directly or through a mail-order pharmacy program, any such program must be accordance with State and federal law.Pharmacy Benefits Manager (PBM)
Appears in 1 contract
Sources: Contract for Provision of Services (Wellcare Health Plans, Inc.)
Pharmacy. 4.6.6.1 The Contractor shall provide pharmacy services either directly or through a Pharmacy Benefits Manager (PBM). The Contractor or its PBM may establish a drug formulary if the following minimum requirements are met:
4.6.6.1.1 Drugs from each specific therapeutic drug class are included and are sufficient in amount, duration, and scope to meet Members’ medical needs;
4.6.6.1.2 The only excluded drug categories are those permitted under section 1927(d) of the Social Security Act;
4.6.6.1.3 A Pharmacy & Therapeutics Committee that advises and/or recommends makes the formulary decisions; and
4.6.6.1.4 Over-the-counter medications specified in the Georgia State Medicaid Plan are included in the formulary.
4.6.6.2 The Contractor shall provide the formulary to DCH upon the request of DCH.
4.6.6.3 If the Contractor chooses to implement a mail-order pharmacy program, any such program must be accordance with State and federal law.
Appears in 1 contract