PBM Services definition

PBM Services means any drug benefit management services, including, without limitation, management of retail pharmacy networks, payment of claims to pharmacies for prescription drugs, drug utilization review and formulary management services.

PBM Services means those services provided by 25 Contractor in accordance with this Contract and any other documents or correspondence provided by the 26 MSN Program relating to Benefit Plan design, formulary changes, or any other changes to the MSN 27 Program and communicated to Contractor which impact how or which pharmaceuticals are provided.

PBM Services means, services associated with the prescription benefit management business, including but not limited to: (i) claims administration, (ii) establishment and administration of a pharmacy network and benefits, (iii) mail order pharmacy services (by phone, fax or internet), (iv) drug utilization review, (v) disease state management and delivery of specialty pharmacy benefits, (vi) formulary creation and administration, (vii) rebate negotiation and administration, and (viii) therapeutic substitution programs.

Examples of PBM Services in a sentence

• County will continue to pay Contractor in accordance with this Agreement for any Fees for PBM Services provided during the term and any run-off period.

• In consideration of the PBM Services provided by ESI, Sponsor will pay the applicable claims reimbursement amounts (“Claims Reimbursements”) and other administrative fees (“Administrative Fees”) pursuant to the terms set forth on Exhibit A (“Claims Reimbursements,” “Administrative Fees” and any other charge or fee that is the responsibility of Sponsor as may be described elsewhere in this Agreement are hereinafter referred to collectively as “Fees”).

• Upon reasonable notice, ESI will have the right to terminate PBM Services to any Plan (or, if applicable, Members) located in a state requiring a pharmacy benefit manager to be a fiduciary to Sponsor, a Plan, or a Member in any capacity.

• Sponsor will continue to pay ESI in accordance with this Agreement for any Fees for PBM Services provided during the term and any run-off period.

• Client shall have the right to audit, at its expense, the books and records of CastiaRx once annually to verify the performance of PBM Services, and the accuracy of Claims Reimbursements and Rebates during the previous 12-month period and will be limited to the actual number of Claims (by pharmacy channel) to verify Rebates, and a representative sample of Claims Reimbursements and Fees to verify Client charges.

More Definitions of PBM Services

PBM Services means PBM claims processing services for commercial health plans, self-insured employer plans, Medicaid, Medicare Advantage, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.

PBM Services means any one or more services typically provided by a PBM, including, without limitation, design, management or administration of pharmacy benefits, pharmaceutical claims adjudication, retail pharmacy network management, mail order pharmacy operations, rebate management, and formulary design and/or management.

PBM Services means those services provided by Contractor in accordance with this Contract and any other documents or correspondence provided by the BHS Program relating to Benefit Plan design, formulary changes, or any other changes to the BHS Program and communicated to Contractor which impact how or which pharmaceuticals are provided.

PBM Services shall have the meaning set forth in Section 9.1(d).

PBM Services means any one or more services typically provided by a PBM, including, without limitation, design, management or administration of pharmacy benefits, pharmaceutical claims adjudication, retail pharmacy network management, mail order pharmacy operations, rebate management, and formulary design and/or management. "Proprietary Information" means all proprietary and non-public information and data that concerns the business, technology, systems, finances, personnel, operations, or other assets and activities of a Party, including, but not limited to, trade secrets, ideas, processes, formulas, systems, source codes, data programs, other original works of authorship, know-how, improvements, discoveries, developments, designs, inventions, techniques, marketing plans, information systems, strategies forecasts, new products, unpublished financial statements, budgets, projections, licenses, rates, prices (including the fees charged under this Agreement), costs, customer lists, and supplier lists not available to the public. Proprietary Information does not include information generally available to the public other than as a result of improper disclosure by a Party or its agents or employees receiving such information under this Agreement.

PBM Services means services associated with the prescription benefit management and Specialty Pharmacy business, including but not limited to: (i) claims administration, (ii) establishment and administration of a pharmacy network and benefits, (iii) mail order pharmacy services (by phone, fax or internet), (iv) drug utilization review, (v) disease state management and delivery of specialty pharmacy benefits, including growth hormones, transplants, mental health, women's health, men's health, and certain respiratory ailments, (vi) formulary creation al1d administration, (vii) rebate negotiation and administration, (viii) therapeutic substitution programs and (ix) specialty compounding of pharmaceutical products.

PBM Services means pharmacy benefit management services as defined in the Preliminary Statements.