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: · Drugs from each specific therapeutic drug class are included and are sufficient in amount, duration, and scope to meet Members’ medical needs; · The only excluded drug categories are those permitted under section 1927(d) of the Social Security Act; · A Pharmacy & Therapeutics Committee that advises and/or recommends formulary decisions; 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
Samples: 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 · 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
Samples: 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; · Revised 5/19/2008
4.6.6.1.3 A Pharmacy & Therapeutics Committee that advises and/or recommends formulary decisions; and · 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
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 · 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
