Specialty Pharmacy. The City’s Pharmacy Benefits Manager (PBM) will determine which drugs are included in any or all of these clinical programs and the applicable quantity level limits subject to the restrictions noted above.
Specialty Pharmacy. A pharmacy which dispenses biotech drugs for rare and chronic diseases via scheduled drug delivery either to the Member’s home or to a Physician’s office. These pharmacies also provide telephonic therapy management to ensure safety and compliance. Spinal Manipulation Correction of subluxations in the body to remove nerve interference or its effects. Interference must be the result of or related to distortion, misalignment or subluxation of or in the vertebral column.
Specialty Pharmacy. Claim Administrator and Prime have contracted with Specialty Pharmacies and/or vendors to provide Members with access to in-network benefits for covered Specialty Drugs.
Specialty Pharmacy. (f) Notwithstanding the foregoing, the clinical programs described herein shall not impair a member’s right to appeal any adverse decision in accordance with the appeals rights described in the SPD. Further, a member or the member’s physician may seek an exception to one or more otherwise applicable clinical programs listed above. The City’s Pharmacy Benefits Manager (PBM) will determine which drugs are included in any or all of these clinical programs and the applicable quantity level limits subject to the restrictions noted above.
Specialty Pharmacy. AdvancePCS’ specialty pharmacy service will be provided by an AdvancePCS specialty pharmacy entity or its affiliate (“AdvancePCS SpecialtyRx”), and offers a distribution channel for certain pharmaceutical products that are generally biotechnological in nature, are given by injection, or otherwise require special handling (“Specialty Medications”). AdvancePCS SpecialtyRx shall provide prescription fulfillment and distribution of Specialty Medications and supplies, pharmaceutical care management services, as well as the types of Service that Member County receives under this Agreement, including but not limited to customer services, utilization and clinical management, integrated reporting and Claims processing (“SpecialtyRx Services”). AdvancePCS SpecialtyRx may receive prescriptions from Participants through an affiliated AdvancePCS mail facility or directly via the U.S. Mail or commercial carrier at the address specified by AdvancePCS from time to time and may also receive prescriptions from physicians by fax or by U.S. Mail/commercial NAOC_k2_v2.doc (07/06/2005) [RxClaim] Page 3 of 16 carrier. In accordance with the Consumer Card Program, AdvancePCS SpecialtyRx shall dispense Covered Items in accordance with those prescriptions and mail the Covered Items to Participants at the designated address, so long as such address is located within the United States. AdvancePCS SpecialtyRx may not dispense drugs to Participants who fail to submit the correct payment with their prescription. AdvancePCS SpecialtyRx pharmaceutical care management services include but may not be limited to:
Specialty Pharmacy. A pharmacy that dispenses generally low volume and high cost medications to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. Require patient counseling/ support/compliance management.
Specialty Pharmacy. A pharmacy that has a contract with Us and is designated by Us as a Specialty Pharmacy who provides certain Covered Drugs, including, but not limited to, Prescription Drugs and Self- Administered Injectable and Specialty Drugs Orders or Refills.
Specialty Pharmacy. PBM shall provide the following services from its specialty pharmacy:
Specialty Pharmacy. Pricing proposal assumes an exclusive specialty arrangement with If a Participating Group requires other specialty pharmacy arrangements, the parties will discuss separate contractual terms and conditions on a case-by-case basis. Under an exclusive arrangement, grace fills at retail will not be allowed. New drugs are added as soon as they hit Medi-Span which is usually on the day or within a few days of product launch. Pricing is available around the same timeline. Newly FDA- approved products will be billed and reimbursed at the Default Rate of AWP 14%.
Specialty Pharmacy. Upon Client’s request, Navitus will provide Client a Specialty Pharmaceutical program which provides a distribution channel for certain Covered Products that are generally biotechnological in nature, are given by injection, or otherwise require special handling. The Specialty Pharmacy will dispense Specialty Pharmaceuticals to Eligible Persons subject to the terms set forth in Exhibit 2.
