HomeMy WebLinkAboutCOM 0736.001 2010-2012BRITTANY SMART
Councilmember
Hawai `i County Council
District 6
Upper Puna, Ka `u, South Kona
Hawai`i County Council
County of Hawai`i
25 Aupuni Street
Hilo, Hawai `i 96720
TO: Dominic Yagong, Chair
and Members of the Hawaii County Council
FROM: Vt' rfirittany Smart, Member
DATE: May 31, 2012
Phone: (808) 961 -8263
Fax: (808) 961 -8912
bsmart@co.hawaii.hi.us
a
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SUBJECT: MATERIAL FOR CONSIDERATION REGARDING THE RESOLUTION TO ENROLL
THE COUNTY INTO THE NATIONAL ASSOCIATION OF COUNTIES
PRESCRIPTION DISCOUNT CARD MARKETING FEE REIMBURSEMENT
PROGRAM.
Please find attached three items pertaining to the resolution to enroll the County into the NACo
marketing fee reimbursement program.
Please put this on the appropriate Committee agenda for the scheduled June 18, 2012 meeting.
BS:nh
Attach.
Serving the Interests oldie People of Our Island
Hawaii County is an Equal Opportunity Provider and Employer
Comm. No. G R G
Ref. To:
Ref. Dote JUN 4 2012
734.1
Dear County Officials:
The NACo Prescription Discount Card Program checklist and contract documents are attached. Please
fill out the checklist to include with your contract documents. Incorrect checklists, contracts or
missing documents will result in a delayed implementation of the program.
Please follow these directions carefully:
1. Counties, Parishes, Boroughs sign exhibit B of the contract which attaches the county to the
overall NACo contract (IMPORTANT: this is on page 14). If your county chooses to receive the optional
transaction revenue sharing fee, you will need to also submit your signed Rider 1 and your county's W -9
along with the Exhibit B.
2. All documents need to be mailed to:
Andrew Goldschmidt
Director, Membership Marketing
National Association of Counties -NACo
25 Massachusetts Ave, NW 5t' Floor
Washington, DC 20001
3. Once the contract is received, our Executive Director will sign it and pass it on to Caremark for final
signature. You may start your intemal planning process to promote the program.
4. While the final signatures are being completed, please forward your logo or seal via email to
Ralph.Frissore @caremark.com (if you prefer, you may have the materials simply read XYZ County or XYZ
CountyRx). Proceed to completing the NACo Prescription Discount Card Program Checklist.
Caremark will create proofs for your approval. Once approved by your county, Caremark will help determine
the amount of materials needed for your initial rollout of the program.
You may estimate 10 weeks from the date the contract is returned until you can distribute the cards to
your county residents. A key note, any non pre- approved press releases or other information to be
distributed on the program must come to NACo and Caremark's attention for approval prior to use.
Please contact me at agoldschmidt(a?naco.org or 1- 888 - 407 -6226 (NACo) ext. 221 if you have any
questions or need further information. NACo looks forward to working with you on this exciting program
and thank you for being a member county!
Sincerely,
Andrew S. Goldschmidt, CAE, MBA
Director, Membership Marketing
P.S. - If you need to access the collateral materials on the program, you can access those by logging in
to the NACo's members only portion of the website at www.naco.org. Please contact Ilene Manster,
Membership Coordinator at 1- 888 - 407 -6226 ext.291 or imanster @naco.org if you need assistance
with the NACo website.
The above message and enclosed attachments are confidential and should not be shared outside of
the county officials considering the program without specific permission from NACo.
NACo Prescription Discount Card Program Checklist
County Name /State: Date contract returned to NACo:
1. Who is the ONE contact person in the county with whom we may communicate about this program?
Name and title
Address (w/ City, State, Zip)
Phone Fax
E -mail (We must have your email address!)
2. What is your county's anticipated start-up date for the program? CURRENT START UP TIME IS
10 WEEKS FROM THE TIME THE CONTRACT IS RETURNED TO NACo. Please plan your county's
roll out of the program accordingly.
3. Please choose a design for the discount cards: (YOU MUST CIRCLE ONE)
a. "County Name" or "County NameRx"
b. Logo /seal on cards
a. Be sure to e-mail a black and white logo /seal to Ralph.frissore@caremark.com in a .jpg
or .tifformat
b. Put "(COUNTY NAME) LOGO" in the subject line of your e-mail
c. Other. You must contact NACo if you do not choose either a or b.
4. What is your county's population?
Do you need cards /posters in Spanish?
5. Please provide a street address for delivery of cards. Cards will be sent via UPS Ground.
NO P.O. BOXES!
6. What is your county's web address (if available)?
Will this program have its own page? (Please provide)
What number would county residents call to pick up a card?
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IN_0 National Association of Counties
CAREMARKPCS HEALTH, L.L.C.
AMENDED AND RESTATED MANAGED PHARMACY BENEFIT SERVICES AGREEMENT
CONSUMER CARD PROGRAM
THIS AMENDED AND RESTATED AGREEMENT (the "Agreement ") is effective beginning January 1, 2012
(the "Effective Date ") among National Association of Counties ( "Customer "), counties that are members of the National
Association of Counties ( "Member County ") and CaremarkPCS Health, L.L.C., ( "Caremark "), for the purpose of
delineating the terms and conditions under which Caremark will provide certain managed pharmacy benefit services to
Member County and Customer. This Agreement amends the existing Member County Agreements consistent with the
terms thereof. Customer agrees that it will require each Member County added after the Effective Date to execute an
individual agreement with Caremark in the form attached hereto as Exhibit B (the "Member County Agreement ") prior
to Caremark's providing Services to such Member County. Caremark will not provide Services to Member County prior
to the 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 any attachment, addendum or amendment hereto (collectively the "Services "). Caremark may
make changes to the Services from time to time so long as such changes do not materially alter any of the provisions of
this Agreement.
1.2 Participating Pharmacies. Caremark has created a network of Participating Pharmacies, which will
perform pharmacy services for Participants.
1.3 Pharmacy Help Desk and Voice Response Unit. Caremark will provide Participating Pharmacies
with help desk assistance and access to Caremark's voice response unit during Caremark's hours of operation.
1.4 Claims Processing.
a. Submission of Claims. Caremark will adjudicate Claims submitted by Participating Pharmacies to
Caremark in accordance with the Participating Pharmacy's agreement with Caremark and the Consumer Card
Program.
b. Collection at Point of Sale. Customer and Member County acknowledge that Participating
Pharmacies will collect from the Participant one hundred percent (100 %) of the applicable prescription price,
discounted at the rates set forth on Exhibit A as applicable, plus a transaction fee from the Participant.
1.5 Customer Service. Caremark will make available to Customer, Member County and Participants a
toll free number during those hours of operation maintained by Caremark. Staff will be available to answer questions
on the Consumer Card Program and Consumer Card Program guidelines.
1.6 Identification 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 distribution method
for identification cards; provided, however if Member County requests that Caremark mail the identification cards to
Participants, 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 Utilization 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 of cost - effective medications.
These programs may include mailings to Participants with active prescriptions for targeted drug products or
drug classes or to let Participants know that they may qualify for participation in a clinical trial program. Such
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mailings may include Participant and drug specific information and/or general educational material.
Participants, by notifying Caremark, may opt -out of such programs.
b. DUR Services. Caremark will provide its automated concurrent DUR Services for Claims. The
information generated in connection with DUR Services is intended as an economical supplement to, and not
as a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists, or other health
care providers in providing patient care. Providers are individually responsible for acting or not acting upon
information generated and transmitted through the DUR Services, and for performing services in each
jurisdiction consistent with the scope of their licenses. Notwithstanding anything set forth in this Agreement,
Caremark will have no obligation to acquire information concerning any Participant beyond the information
that is included in Caremark's eligibility records or the Claims submitted by Participating Pharmacies in
connection with the Consumer Card Program.
1.8 Formulary Services. Caremark will administer an open formulary for the Member County and will
provide certain Services that are designed to provide useful clinical information to physicians (the "Formulary
Services "). Caremark may make changes to the Formulary Services described in this Agreement from time to time, and
will notify Member County and Customer of any material changes to any formulary management programs. In all
cases, the prescribing physician shall have final authority over the drug that is prescribed to the Participant.
a. Customer's Authorization. Customer authorizes Caremark to contract as a group
purchasing organization for Customer with pharmaceutical companies for Rebates. Customer acknowledges
that whether and to what extent pharmaceutical companies are willing to provide Rebates to Customer may
depend upon a variety of factors, including the content of any drug list adopted by Customer, the plan's design
features and participating in Caremark's drug list management programs, as well as Caremark receiving
sufficient information regarding each Claim that is submitted to pharmaceutical companies for Rebates.
b. Disclosure of Manufacturer Fees. In accordance with Section 1.8(a) of this Agreement,
Caremark or its affiliates may hold contracts with certain pharmaceutical companies relating to products
covered under this Agreement. The parties agree that Caremark shall retain one hundred percent (100 %) of the
Rebates as reasonable compensation for its services under this Agreement. In connection with such contracts,
Caremark or its affiliates may have a financial relationship with such pharmaceutical companies and may
receive and retain fees or other compensation from pharmaceutical companies for services rendered and
property provided to pharmaceutical companies, including, without limitation, administrative fees that range
between one percent (1 %) and four percent (4 %) of the Wholesale Acquisition Cost ( "WAC ") of the products
dispensed across Caremark's book of business. In addition, Caremark or its affiliates may receive concurrent
or retrospective discounts or Rebates from pharmaceutical companies which are attributable to or based on
products purchased by Caremark affiliated dispensing pharmacies. The term "Rebates" as used in this
Agreement does not include the fees, compensation, and concurrent or retrospective discounts associated with
the purchase price of products described in this Section 1.3, which belong exclusively to Caremark or its
affiliates.
c. Participant Authorizations and Disclosures. Customer and Member County shall comply
with all Laws applicable to it as a sponsor of the Services or as otherwise consistent with its obligations under
this Agreement.
d. Additional Participant Discounts. Caremark may provide a program that will provide
Participants with additional manufacturer discounts on certain drugs at the point of sale. From time to time,
Caremark may revise the list of drugs that have additional participant discounts. The current list of drugs on
which Participants may receive additional discounts is available upon request. Caremark will timely notify
Member County and Customer of any revisions to this list of drugs.
1.9 Management Reports. Caremark will provide Member County and Customer with Caremark's
standard management reports in connection with the Services, which reports may change from time to time at
Caremark's discretion. Member County and Customer may elect to receive a reasonable number of the standard
management reports made available by Caremark.
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1.10 Mail Service Program. Caremark may provide to Member County mail order pharmacy services
through its mail order pharmacy facilities. For the duration of this Agreement, Member County agrees that it will offer
only Caremark mail order pharmacy services for its Participants covered under this Agreement, as further described
below.
Caremark shall fill prescriptions for Participants and shall mail such drugs or medications to such Participants subject to
the following terms and conditions:
a. Distribution of Information. Caremark shall provide Participants with its standard
informational material explaining the mail service and the forms necessary for Participants to utilize mail
service. Participants will have toll -free telephone access to a pharmacist and customer service representative.
Access to a pharmacist will be available 24 hours per day, seven days per week.
b. Delivery and Dispensing. Caremark shall dispense through its mail service pharmacy new
or refill prescription orders upon receipt from a Participant of (i) a valid prescription order or a completed refill
order form and (ii) the applicable payment. Caremark shall cause the filled prescriptions to be mailed to each
Participant via common carrier at the address appearing on the face of the prescription so long as such
addresses are in the United States. Caremark shall not be liable to Member County, Customer or Participant
for any delay in delivery resulting from circumstances beyond Caremark's control as set forth in Section 6.2.
Caremark's mail order pharmacies may dispense drugs even if the prescription is not accompanied by the
correct amount however, Member County and Customer acknowledge and agree that Caremark may refuse to
fill any prescription that is either not accompanied by the correct amount and/or for any Participant who has an
unpaid balance with Caremark.
1.11 Preferred Drug Program. Caremark and the retail Participating Pharmacies will work together to
encourage the use of Preferred Drugs by (i) identifying appropriate opportunities for converting a prescription from a
non - Preferred Drug to a Preferred Drug, and (ii) contacting the Participant and the prescriber to request that the
prescription be changed to the Preferred Drug. A Preferred Drug is one on the Performance Drug List, which has been
developed by Caremark as a clinically appropriate and economically advantageous subset of the Caremark Formulary,
as revised by Caremark from time to time.
1.12 Specialty Pharmacy. Caremark's specialty pharmacy service will be provided by a Caremark
specialty pharmacy entity or its affiliate ( "Caremark 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 ").
Caremark 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 ").
Caremark SpecialtyRx may receive prescriptions from Participants through an affiliated Caremark mail facility or
directly via the U.S. Mail or commercial carrier at the address specified by Caremark from time to time and may also
receive prescriptions from physicians by fax or by U.S. Mail/commercial carrier. In accordance with the Consumer
Card Program, Caremark 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.
Caremark SpecialtyRx may not dispense drugs to Participants who fail to submit the correct payment with their
prescription.
Caremark SpecialtyRx pharmaceutical care management services include but may not be limited to: (1) patient profiling
focusing on the appropriateness of Specialty Medication therapy and care and the prevention of drug -drug interactions;
(2) patient education materials; and (3) disease management and compliance programs with respect to Specialty
Medications. As part of these services, Participants will be asked to participate in various surveys.
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Caremark will provide Member County and Customer with a list of the Specialty Medications and their corresponding
rates (which may vary from Network Rates) upon request. Routine supplies (needles, syringes, alcohol swabs) in a
sufficient quantity will be included at no additional expense.
2. FEES AND PAYMENT.
a. Fees. The parties agree that, in lieu of billing Member County a "per Claim" fee for Services,
Caremark shall retain 1 00% of the Rebates as reasonable compensation for the Services. Customer and Member
County understand and agree that neither they nor any Participant will share in the Rebate monies collected from
Manufacturers by Caremark.
b. Remedies. Additional services may be mutually agreed -upon by the parties, and the associated fees
for such services, if any. will be identified in Exhibit A as reasonable compensation. In the event any such fees apply
and Member County or Customer fails to pay Caremark by the due date any amount owing, Caremark, after making a
reasonable effort to collect and upon notice to such Member County or Customer may, in addition to its remedies under
this Agreement, at Law or in equity, do any or all of the following: (i) suspend performance of any or all of Caremark's
obligations under or in connection with this Agreement with respect to such Member County or Customer, including
Caremark's obligation to process Claims or (ii) set off against any amounts payable to such Member County or
Customer by any amounts due Caremark from such Member County or Customer.
c. Pricing Changes. After the Initial Term of this Agreement, as set forth in Section 7.a, Caremark may
change the fees applicable to the Consumer Card Program. Caremark will give Customer sixty days' written notice of
any change, and such change will take effect on the first day of the month following the sixty-day notice period.
Customer may object to an increase in fees by providing written notice to Caremark at least thirty days before the
expiration of the sixty-day notice period. If the parties cannot agree on an appropriate fee, this Agreement will
terminate at the end of the sixty-day notice period. If Customer does not timely object, Customer will have no right to
terminate this Agreement based on the pricing change.
3. CUSTOMER AND MEMBER COUNTY OBLIGATIONS.
a. Marketing Materials. The parties agree to use only those marketing brochures and other advertising
materials pertaining to Customer's Consumer Card Program (in any medium, including, but not limited to, written
communications, verbal communications and web based marketing) that have been approved by the other. Member
County and Customer further agree that they will communicate such requirements to its clients or groups and will
ensure that such clients or groups comply with the requirements of this Section 3.a. Caremark may terminate this
Agreement immediately in the event Member County or Customer fails to comply with the provisions of this Section
3.a.
Caremark will provide its standard marketing brochures, advertising materials and mail order forms, as applicable, to
Member County at no cost. Caremark will work with and support each Member County in marketing the Consumer
Card Program at no cost. If the cost associated with providing such materials is determined by Caremark to be
unreasonable or excessive, Member County shall pay for the costs of the materials at a rate to be mutually agreed to by
the parties in writing. If Member County elects to use customized brochures or advertising materials (in any medium,
including but not limited to written communications, verbal communications and web based marketing), Member
County will (i) obtain Caremark's approval on such forms, and (ii) pay a reasonable charge, as established by Caremark,
for such materials if created or provided by Caremark.
3.2 Support of Consumer Card Program. Customer will recommend and support the Consumer Card
Program in accordance with the terms of this Agreement.
4. USE OF AND ACCESS TO INFORMATION.
a. Use of Deidentified Data. Claims, as well as eligibility information which is deidentified in
accordance with HIPAA and other applicable law, and which is not identifiable on a Customer or Plan Participant basis,
may be used, disclosed, reproduced, adapted or sold by Caremark. Such deidentified data may be provided to nationally
recognized data integration firms to support appropriate administration of Caremark's drug management programs.
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This benchmarking data enables Caremark to compare against other drug population sets and improve programs and
Services for clients.
b. Right to Audit Rebates. Customer, at its sole expense, may audit a reasonable sample of records
directly related to Customer's Rebates once in each twelve -month period (following sixty (60) days written notice to
Caremark). Such records shall be limited to information necessary for validating the accuracy of the Rebate amounts
distributed to Member County by Caremark. The parties agree that an independent third -party auditor agreeable to
Customer and Caremark shall conduct such audit, and that such firm will sign a Caremark confidentiality agreement
ensuring that all details and terms of all Manufacturer Rebate contracts with Caremark (except the total aggregate
amount due to Customer) will be treated as confidential to Caremark and will not be revealed in any manner or form by
or to any person or entity. Furthermore, such audit shall be conducted at Caremark's office where such records are
located, during normal business hours, without undue interference with business activities, and in accordance with
reasonable audit procedures.
5. CONFIDENTIALITY AND INTELLECTUAL PROPERTY.
a. Confidential and Proprietary Information. In connection with this Agreement, each party may
disclose to the other party certain proprietary or confidential technical and business information, databases, trade
secrets, and innovations belonging to the disclosing party ("Confidential Information "), the value of which might be
lost if the proprietary nature or confidentiality of such Confidential Information is not maintained. For the purposes of
this Section, the contents of this Agreement and of any exhibits, amendments, or addenda attached hereto are deemed
Confidential Information. Furthermore. any work, compilation, processes or inventions developed by Caremark,
Member County or Customer, or their respective agents, employees or contractors, is deemed Confidential Information
of such party under this Agreement. Notwithstanding the foregoing, Confidential Information may be disclosed by
Member County in response to a request made pursuant to the Member County's applicable state Public Records Law,
insofar as disclosure is required by that Law. Member County shall provide Caremark with (i) notice of its intent to
disclose Confidential Information and (ii) an opportunity for Caremark to object to such disclosure in accordance with
Law.
b. Non- Disclosure of Confidential Information. The parties will not (except to the extent expressly
authorized by this Agreement) disclose Confidential Information of any other to anyone outside of Caremark, Member
County or Customer, nor will they copy or reproduce any Confidential Information of another unless expressly
authorized to do so by such party in writing. Each party will disclose Confidential Information of another only to its
employees who have a need to know the Confidential Information in order to accomplish the purpose of this Agreement
and who (i) have been informed of the confidential and proprietary nature of the Confidential Information, and (ii) have
agreed not to disclose it to others. In order to preserve and protect the confidential or proprietary nature of any
Confidential Information and to prevent it from falling into the public domain or into the possession of persons not
bound to maintain its confidentiality, each party will handle the Confidential Information of any other party with the
same degree of care that it applies with respect to its own information that it considers as confidential and proprietary,
but in no event with less than reasonable care.
c. Exceptions and Permitted Disclosures. The receiving party of Confidential Information will not be
liable for any disclosure or use of Confidential Information which is publicly available or later becomes publicly
available other than through a breach of this Agreement, or if the Confidential Information is shown by written
documentation to be known to the receiving party on the date of execution of this Agreement, having been received
from a source (other than a party to this Agreement) that had the right to disclose the Confidential Information.
d. Subpoena. Confidential Information may be disclosed pursuant to a bona fide subpoena if the party
receiving the bona fide subpoena has given the other party prompt written notice of receipt of the subpoena so that the
other party can object or otherwise intervene as it deems proper.
e. Return or Destruction of Information. All Confidential Information will remain the property of the
disclosing party, and the receiving party will return all written or tangible materials, and all copies thereof, upon request
of the disclosing party. If and to the extent feasible, upon termination of this Agreement, Caremark will destroy or will
return to Member County or Customer all PHI obtained pursuant to this Agreement and shall retain no copies thereof;
provided however, that if such return or destruction is not reasonably feasible, the provisions of Section 4 of this
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Agreement shall continue to apply to such information after the termination hereof.
f. Proprietary to Caremark. Member County and Customer acknowledge that the Formulary is
proprietary to Caremark. Further, all Caremark databases, as well as the software, hard coding, and logic used to
generate the compilations of information contained in Caremark's Claims adjudication system and in all other databases
developed by Caremark or its designees in connection with performing Services including identifiers assigned by
Caremark, and the format of all reports, printouts, and copies there from, and any prior and future versions thereof by
any name, are the property of Caremark and are protected by copyright which shall be owned by Caremark.
g. Tradenames; Trademarks; and Service Marks. None of the parties hereto may use any
tradenames, trademarks or service marks of another, or any word or symbol likely to be confused with such tradenames,
trademarks or service marks, unless authorized in writing or as expressly permitted by this Agreement.
h. Remedies. Any unauthorized disclosure or use of Confidential Information would cause Caremark,
Member County or Customer immediate and irreparable injury or loss that cannot be adequately compensated with
money damages. Accordingly, if any party hereto fails to comply with this Section 5, the other(s) will be entitled to
specific performance including immediate issuance of a temporary restraining order or preliminary injunction enforcing
this Agreement, and to judgment for damages (including reasonable attorneys' fees) caused by the breach, and to any
other remedies provided by Law.
6. LIMITATION OF LIABILITY; COMPLIANCE WITH LAW.
a. Warranty. This Agreement is not a contract for the sale of goods. Caremark will perform the
Services in a good and workmanlike manner in accordance with the customs, practices, and standards of providers
skilled in the industry. EXCEPT AS WARRANTED IN THIS SECTION 6.a, CAREMARK DISCLAIMS ALL
EXPRESS AND ALL IMPLIED WARRANTIES OF ANY KIND, INCLUDING THE SUITABILITY FOR ANY
PARTICULAR PURPOSE OF THE DATA GENERATED THROUGH THE CAREMARK SYSTEM. CAREMARK
RELIES ON FIRST DATABANK, MEDI -SPAN, OR INDUSTRY COMPARABLE DATABASES IN PROVIDING
CUSTOMER, MEMBER COUNTY AND PARTICIPANTS WITH DRUG UTILIZATION REVIEW SERVICES.
CAREMARK HAS UTILIZED DUE DILIGENCE IN COLLECTING AND REPORTING THE INFORMATION
CONTAINED IN THE DATABASES AND HAS OBTAINED SUCH INFORMATION FROM SOURCES
BELIEVED TO BE RELIABLE. CAREMARK, HOWEVER, DOES NOT WARRANT THE ACCURACY OF
REPORTS, ALERTS, CODES, PRICES, OR OTHER DATA CONTAINED IN THE DATABASES. THE CLINICAL
INFORMATION CONTAINED IN THE DATABASES AND THE FORMULARY IS INTENDED AS A
SUPPLEMENT TO, AND NOT A SUBSTITUTE FOR, THE KNOWLEDGE, EXPERTISE, SKILL, AND
JUDGMENT OF PHYSICIANS, PHARMACISTS, OR OTHER HEALTH -CARE PROFESSIONALS INVOLVED IN
PARTICIPANT'S CARE. THE ABSENCE OF A WARNING FOR A GIVEN DRUG OR DRUG COMBINATION
SHALL NOT BE CONSTRUED TO INDICATE THAT THE DRUG OR DRUG COMBINATION IS SAFE,
APPROPRIATE OR EFFECTIVE FOR ANY PARTICIPANT. CAREMARK DOES NOT WARRANT THAT ITS
SERVICES WILL BE UNINTERRUPTED OR ERROR FREE.
b. Force Majeure. Except for the payment obligations set forth in Section 2 of this Agreement, the
parties are excused from performance under this Agreement to the extent that a party is prevented from performing any
obligation, in whole or in part, as a result of causes beyond its reasonable control, including, acts of God, war, civil
disturbance, court order, governmental intervention, Change in Law, nonperformance by the other party or any third
party, failures or fluctuations in electrical power, heat, light, air conditioning, or telecommunications equipment. Any
nonperformance under this Section 6.b will not constitute a default or a ground for termination of this Agreement.`
c. Indemnity. To the extent permitted by applicable Law applicable to Customer and each Member
County, Customer and Member County shall indemnify and hold harmless Caremark and its officers, directors,
employees, agents, successors, and assigns ( "Caremark Indemnitees ") for, from and against any damages, costs, or
attomey's fees, actually incurred by Caremark or a Caremark Indemnitee, as the result of a third party claim that
Customer or Member County, its officers, directors, employees, agents, successors, or assigns acted with negligence,
willfully, and/or in violation of applicable standards of care, provided that the Caremark Indemnitee has acted in a
manner that is consistent with this Agreement, the Consumer Card Program and applicable standards of care. The
foregoing indemnification shall not apply and shall not be enforceable to the extent any applicable Law prohibits a
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Member County from providing such indemnification. To the extent permitted by applicable Law, Caremark shall
indemnify and hold harmless Member County, Customer and their officers, directors, employees, agents, successors,
and assigns (collectively "Customer Indemnitees ") for, from and against any damages, costs, or attorney's fees, actually
incurred by any Customer Indemnitee, as the result of a third party claim that Caremark, its officers, directors,
employees, agents, successors, or assigns acted with negligence, willfully, and/or in violation of applicable standards of
care, provided that the Customer Indemnitee has acted in a manner that is consistent with this Agreement, the Consumer
Card Program and applicable standards of care. However, nothing in this Agreement is to be construed as a waiver of
governmental immunity as offered by the court or state law.
d. Compliance with Law. Customer and Member County will comply with all Laws applicable to its
prescription drug benefit plan, including without limitation insurance licensing, antitrust, consumer protection, and any
other Laws that may apply. Caremark has no responsibility to advise Member County or Customer about the
applicability of or compliance with any applicable Law including, without limitation, HIPAA, the Employee Retirement
Income Security Act, or the Americans with Disabilities Act.
Caremark will comply with all Laws applicable to it and to the Services it provides under this Agreement. Member
County and Customer have no responsibility to advise Caremark regarding its compliance with any applicable Law.
Effective as of September 8, 2005, each party certifies that it shall not violate the federal anti - kickback statute, set forth
at 42 U.S.C. § 1320a -7b(b) ( "Anti- Kickback Statute "), or the federal "Stark Law," set forth at 42 U.S.C. § 1395nn
( "Stark Law "), with respect to the performance of its obligations under this Agreement. Further, Caremark shall ensure
that individuals meeting the definition of "Covered Persons" (as such term is defined in the Corporate Integrity
Agreement between the Office of Inspector General of the Department of Health and Human Services and
AdvancePCS) shall comply with Caremark's Compliance Program, including training related to the Anti - Kickback
Statute and the Stark Law. In addition, Caremark's Code of Conduct and policies and procedures on the Anti- Kickback
Statute and Stark Law may be accessed at http: / /www.caremark.com /vps /portal/ s.155/3370?cms=CMS-2-007764.
e. Change in Law. The parties will attempt to equitably adjust the terms of this Agreement to take into
account any Change in Law or any material change in drug industry practice that materially alters the rights or
obligations of either party under this Agreement. If the parties are unable to agree upon an equitable adjustment within
sixty days after either party notifies the other of such a Change in Law or material change in drug industry practice, this
Agreement will automatically terminate.
f. Limitations. In no event shall either party be liable to the other party, nor shall Caremark be liable to
any Participant for any indirect, special, or consequential damages or lost profits, arising out of or related to
performance of this Agreement or a breach of this Agreement, even if advised of the possibility of such damages or lost
profits.
Caremark (and its affiliates, directors, employees, agents, successors or assigns) will not be liable for any claim which is
asserted by Member County or Customer more than ninety days after Member County or Customer is or reasonably
should have been aware of such claim, and will in no event be liable for any claim which is asserted more than twelve
months after the event resulting in damages or loss.
Caremark does not direct or exercise any control over the professional judgment exercised by any pharmacist in
dispensing prescriptions or otherwise providing pharmaceutical related services at a Participating Pharmacy.
Participating Pharmacies are independent contractors, not subcontractors or agents of Caremark, and Caremark shall
have no liability to Member County or Customer for a claim arising out of any act or omission of any Participating
Pharmacy or its agents or employees.
Caremark shall be entitled to rely on First Data Bank, Medi -Span or any other nationally available reporting service of
pharmaceutical prices selected by Caremark to determine AWP for purposes of establishing the pricing provided to
Customer under this Agreement. Customer acknowledges that Caremark does not establish AWP, and Caremark shall
have no liability to Customer arising from the use of First DataBank, Medi -Span or any other nationally available
reporting service. Customer acknowledges that if the reporting source for determining Customer's AWP should not
continue to support AWP, Customer shall cooperate with Caremark to negotiate the pricing hereunder to maintain the
parties' respective economic position under this Agreement as of the Effective Date.
7
7. TERM AND TERMINATION OF AGREEMENT.
a. Term. This Agreement is for an initial term of five years from the Effective Date, through December
31, 2016 (the "Initial Term "), and will automatically continue in effect for successive one year terms thereafter, subject
to the remaining provisions of this Section.
b. Termination. This Agreement may be terminated as follows:
a. By any party, with or without cause, at the end of the Initial Term or any renewal term, by
giving written notice to the others at least 60 days prior to the end of such Initial Term or renewal term;
b. Automatically, if the parties are unable to agree on an equitable adjustment under Section 6.e
of this Agreement;
c. By any party if another materially defaults in its performance of this Agreement and such
default continues without cure for a period of sixty days after the terminating party provides written notice to
the defaulting party specifying the nature of the default;
d. By any party, at its option, if any court, or governmental or regulatory agency issues to
another party an order or finding of impairment or insolvency, or an order to cease and desist from writing
business. The party receiving notice of an order or finding must provide the others written notice within two
business days of receipt;
e. By any party if another party: (i) makes an assignment for the benefit of creditors; (ii) has a
petition filed (whether voluntary or involuntary) under Title 11 of the United States Code, or any other similar
statute now or hereafter in effect; (iii) has a receiver, custodian, conservator, or trustee appointed with respect
to all or a substantial part of its property; or (iv) has a proceeding commenced against it which substantially
impairs performance hereunder; or
f. By Caremark, immediately on written notice to Member County or Customer, if (i) either
fails to comply with the provisions of Section 3.a of this Agreement, or (ii) Caremark determines, in its sole
discretion that Member County or Customer's program may not fully comply with all applicable Laws.
7.3 Effect of Termination and Survival.
Sections 4, 5 and 6 of this Agreement, and obligations arising under this Agreement prior to the
effective date of any termination, will survive termination.
8. NOTICES.
All notices under this Agreement must be in writing, delivered in person, sent by certified mail, delivered by air courier,
or transmitted by facsimile and confirmed in writing (by air courier or certified mail) to a party at the facsimile number
and address shown in this Agreement. A party may notify the other party of any changes in the listed address or
facsimile number in accordance with the provisions of this Section. All notices are effective upon receipt.
Notices to Caremark must be addressed as follows:
Vice President, Client Contract Services
Caremark Inc.
2211 Sanders Road, NBT9
Northbrook, IL 60062
Fax No.: 847 -559 -4302
With a copy to:
Managing Counsel, Client and Account Services
8
Caremark Inc.
2211 Sanders Road, NBT9
Northbrook, IL 60062
Fax No.: 847 -559 -4879
Notices to Customer must be addressed as follows:
National Association of Counties
25 Massachusetts Avenue, NW
Suite #500
Washington, DC 20001
Attn: Mr. Andrew Goldschmidt, Director, Membership Marketing
Fax No.: (202) 393 -2630
9. MISCELLANEOUS.
a. Entire Agreement; Interpretation; Amendment; Counterparts. This Agreement (including
exhibits, schedules, attachments, or any addendum to this Agreement) constitutes the entire understanding and
obligation of the parties with respect to the Services and supersedes any prior agreements, writings, or understandings,
whether oral or written. The headings in this Agreement are used only for convenience of reference and do not affect
the meaning or interpretation of any provision. The parties may amend this Agreement only through a properly
executed writing authorized by both parties. This Agreement may be executed in several counterparts, all of which
taken together constitute a single agreement between the parties.
b. Binding Effect; Assignment. This Agreement is binding on the parties and their respective
successors and permitted assigns. None of the parties may assign this Agreement, in whole or in part, without the prior
written consent of the others (which consent will not be unreasonably withheld); except that Caremark may assign this
Agreement, in whole or in part, to any entity that controls, is controlled by, or is under common control with Caremark.
c. Independent Contractor; Third Parties. The parties to this Agreement are independent contractors,
and have no other legal relationship under or in connection with this Agreement. No term or provision of this
Agreement is for the benefit of any person who is not a party hereto (including, without limitation, any Participant or
broker), and no such party will have any right or cause of action hereunder.
d. Waivers. Any failure by a party to comply with any covenant, agreement, or condition herein or in
any other agreements or instruments executed and delivered hereunder may be waived in writing by the party in whose
favor such obligation or condition runs; except that failure to insist upon strict compliance with any such covenant,
agreement, or condition will not operate as a waiver of, or estoppel with respect to, any subsequent or other failure.
e. Severability. In the event any term or provision of this Agreement is declared to be invalid or illegal
for any reason, this Agreement will remain in full force and effect and will be interpreted as though such invalid or
illegal provision were not a part of this Agreement. The remaining provisions will be construed to preserve the intent
and purpose of this Agreement and the parties will negotiate in good faith to modify any invalidated provisions to
preserve each party's anticipated benefits.
f. Enforcement Costs. If any party hereto institutes an action or proceeding to enforce any rights
arising under this Agreement, the party prevailing in such action or proceeding will be paid all reasonable attorneys'
fees and costs to enforce such rights by the other party, such fees and costs to be set by the court, not by a jury, and to
be included in the judgment entered in such proceeding.
g. Authority. Each party represents and warrants that it has the necessary power and authority to enter
into this Agreement and to consummate the transactions contemplated by this Agreement.
h. Exclusivity. Member County and Customer hereby grant Caremark during the term of this
Agreement, and any renewals hereof, the exclusive right to provide a Consumer Card Program to Member County and
Customer. This exclusive right is solely applicable to Participants designated by Member County as eligible for the
9
Member County's discount consumer card program and shall not affect any other benefits or programs provided to
Participants by Member County. Member County and Customer further agree that, during the term of this Agreement
and any renewals hereof, it will not negotiate, contract, or agree with any drug manufacturer for the purpose of
obtaining Rebates or other discounts related to Participants under this Agreement. Member County and Customer also
agree to cancel any existing agreements or contracts with any drug manufacturers related to such drug Rebates or
discounts as of the Effective Date of this Agreement. In the event of a breach of this Section by Member County or
Customer, Caremark may terminate this Agreement. By entering into this Agreement, Customer does not endorse, and
Caremark will not represent Customer's endorsement of any other programs or services which Caremark may offer to a
Member County or Participant.
i. Drug Classification and Pricing. Caremark shall use the indicators of Medi -Span Master Drug
Database (Medi- Span), and their associated files, as updated regularly by Medi -Span, or another nationally available
reporting service of pharmaceutical drug information in determining the classification of drugs (e.g. legend vs. over the
counter, brand vs. generic, single - source vs. multi- source) for purposes of this Agreement.
j. Customer - Specific Programming. Upon request by the Customer for services or changes to
Services that require customized programming or systems work, Caremark will estimate the time and cost for
completion of such work. If Customer authorizes Caremark to perform such work, it will pay Caremark the cost of
performing such work at the established programming rate.
k. Pricing Assumptions. In addition to any pricing assumptions set forth in any pricing implementation or
similar document that is executed by Customer:
(a) Upon thirty (30) days prior written notice to Customer, Caremark may modify or amend the financial
provisions in this Agreement in a manner which accounts for the impact of the events identified below. Such
notice will include Caremark's explanation of the manner in which the modification accounts for the impact of
the event:
1. Any government imposed or industry wide change that would impede Caremark's ability to
provide the pricing described in this Agreement, including any prohibition or restriction on the ability
to receive Rebates or discounts for pharmaceutical products; or
2. A change in any of the pricing assumptions set forth in this Agreement, including, Exhibit A.
(b) Pricing Benchmarks. The parties acknowledge that the pricing indices historically used by Caremark
are the basis for the financial offer of this Agreement and are outside the control of the parties. In the event
First DataBank, Medi -Span or other nationally. available AWP reporting source discontinues the reporting of
AWP or changes the manner in which AWP is calculated prior to the Effective Date, or during the Term, then
Caremark reserves the right to modify the pricing terms of this Agreement, to be effective as of the Effective
Date or such later effective date of such discontinuation or change, so as to maintain the parties' relative
economic positions as existed immediately before the effective date of such discontinuation in reporting or
change in the calculation of AWP, as measured across all products on an aggregate basis. Such modifications
may include, without limitation, the adjustment of AWP to the methodology relied on by such reporting source
prior to such modification of AWP methodology, the adjustment of the AWP discount, or the utilization of
alternate pricing benchmarks.
10. DEFINITIONS. The following terms and phrases, when capitalized, have the meanings set forth below.
a. "AWP" means the "average wholesale price" for a standard package size of a prescription drug from
the most current pricing information provided to Caremark by First DataBank®, Medi -Span Prescription Pricing Guide
(with supplements), or following notice to Client, any other nationally available reporting service of pharmaceutical
prices as utilized by Caremark as a pricing source for prescription drug pricing. The standard package size applicable to
a mail service pharmacy shall mean one hundred (100) units (i.e., pills, tablets, capsules, etc.), unless only a smaller
package size is available from the manufacturer, or the actual package size dispensed for liquids and topical treatments.
The standard package size applicable to a Participating Pharmacy shall be the actual package size dispensed from a
Participating Pharmacy as reported by such Participating Pharmacy to Caremark.
10
b. "Change in Law" means any (i) change in or adoption of any Law, (ii) change in the judicial or
administrative interpretation of any Law, or (iii) change in the enforcement of any Law, occurring after the date
Customer is implemented or the Effective Date, whichever is earlier.
c. "Claim(s)" mean those claims processed through the Caremark on -line claims adjudication system or
otherwise transmitted or processed in accordance with the terms of this Agreement in connection with the Consumer
Card Program.
d. "Covered Items" mean the prescription drug benefits for which Participants are eligible pursuant to
Member County's drug benefit plan.
e. "Law" means any federal, state, local or other constitution, charter, act, statute, law, ordinance, code,
rule, regulation, order, specified standrds or objective criteria contained in any applicable permit or approval, or other
legislative or administrative action of the United States of America, or any state or any agency, department, authority,
political subdivision or other instrumentality thereof or a decree or judgment or order of a court.
f. "Manufacturer" means a pharmaceutical company that has contracted with Caremark (or its affiliate
or agent) to offer discounts for pharmaceutical products in connection with Caremark's Formulary Services.
g. "Maximum Allowable Cost (MAC)" means the unit price that has been established by Caremark for
a multi- source drug (i.e., a drug with more than two sources) included on the MAC drug list applicable to Customer,
which list may be amended from time to time by Caremark in maintaining its generic pricing program. Customer
acknowledges that the MAC list applicable to Client is not the same as the MAC list published by the Centers for
Medicare and Medicaid Services (formerly known as the Health Care Financing Administration, or "HCFA MAC "). A
copy of such MAC drug list shall be provided to Customer prior to execution of this Agreement and thereafter upon
Customer's reasonable request.
h. "Participant" means an individual designated by Member County as eligible for Covered Items
under the terms of the Consumer Card Program.
i. "Participating Pharmacy" means a pharmacy that has agreed to provide certain pharmacy services
to Participants in accordance with the terms of its agreement with Caremark. A list of Participating Pharmacies can be
accessed via Caremark's Internet website, which is subject to change from time to time.
j. "Rebate(s)" means, for any period, all rebates, reimbursements, or other discounts received under a
pharmaceutical manufacturer's discount program with respect to pharmaceutical products dispensed to a Participant
under the Consumer Card Program for such period.
11
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed by their respective duly authorized
officers or agents as of the date first above written.
NATIONAL ASSOCIATION OF COUNTIES CAREMARKPCS HEALTH, L.L.C.
By:
7)ad.
Title:
Date:
12
By: ` 71(6 (•/)-) 4 L __
Title: V D V
Date: 5-/ 2-
EXHIBIT A
National Association of Counties
Effective January 1, 2012.
EXHIBIT A
Subject to the terms and conditions of this Agreement, Program Participants utilizing the Program shall receive from the
Participating Pharmacies the discounts set forth below. Customer Specific Programming or additional services not
identified herein will be quoted upon Customer request.
Program Participants will receive an average 22% discount on their prescription drug transactions when
prescriptions are purchased at a Participating retail pharmacy, a Caremark Mail or a Caremark SpecialtyRx pharmacy as
compared to the pharmacy's aggregate usual and customary price (the cash paying customer price). Program
Participants will not pay more for a prescription drug transaction by using the Program. There will be prescription drug
transactions under this program that will be priced at the pharmacy's usual and customary price when that price is equal
to or more favorable to their contractual discount rate with Caremark.
Prices may vary in certain areas for reasons such as local legal requirements, geographic location, specialized
manufacturer processes, limited availability, extraordinary shipping requirements or other factors beyond Caremark's
control. Participating Pharmacies shall collect from the Program Participant all applicable taxes for covered items, and
Caremark is not liable for the payment of applicable taxes. Caremark does not guarantee Participant savings; the
estimate set forth above is based upon anticipated pharmacy network performance. All claims may be aggregated for
purposes of determining the actual average discount rate. Actual discount rates may vary by drug, Participating
Pharmacy, Caremark Mail Pharmacy and Caremark SpecialtyRx Pharmacy. Certain retail, mail, and Specialty claims
may be excluded from these rates, including but not limited to Claims for select injectable drugs and select oral drugs
that are bio- technical in nature, compound drugs, and those requiring special handling.
13
EXHIBIT B
EXHIBIT B
CAREMARKPCS HEALTH, L.L.C.
NATIONAL ASSOCIATION OF COUNTIES
MANAGED PHARMACY BENEFIT SERVICES AGREEMENT
FOR MEMBER COUNTY
This Managed Pharmacy Benefit Services Agreement for Member County effective
is entered into by and between CaremarkPCS Health, L.L.C. ( "Caremark ") and
( "Member County"). Reference is hereby made to
the Managed Pharmacy Benefit Services Agreement Consumer Card Program dated as of January 1, 2012 (the
"Agreement ") among National Association of Counties ( "Customer "), Member County, and Caremark under
which Customer has engaged Caremark to provide services to prescription drug plans for Customer and its Member
Counties ( "Services ").
MEMBER COUNTY does hereby agree to be bound by, and to assume and perform, each and all of the terms,
covenants and conditions of the Agreement as Member County (as defined in the Agreement) in the same manner
and to the same extent as if it were a party thereto. Member County acknowledges and agrees that Customer and
Caremark may amend all or any portion of the Agreement, and Member County hereby agrees to be bound by any
such amendment, except with respect to Term. The Term of Services for Member County shall begin on the
effective date above and, so long as the Agreement is in effect, shall continue for a period of three years ( "Initial
Member County Term "). The Term of Service shall thereafter automatically renew, so long as the Agreement is in
effect, for successive one -year terms, unless Member County notifies Caremark and Customer of Member County's
intent not to renew at Least sixty (60) days prior to the end of the Initial Member County Term, or any renewal Term.
Customer shall give Member County reasonable notice prior to the effective date of any non -Term amendment
between Customer and Caremark. If such non -Term amendment is adverse to Member County or its Participants,
Member County may, within ninety (90) days of receiving such notice from Customer, terminate its participation in
the Agreement by giving prior written notice to Customer and Caremark.
Customer and Caremark, by their signatures hereto, accept and agree to Member County's participation with the
Agreement under the terms and conditions of the Agreement. By signing this Managed Pharmacy Benefit Services
Agreement for Member County, Member County acknowledges and agrees that the terms of the Agreement have
been completely read, fully understood and voluntarily accepted and further agrees to be bound thereby.
NATIONAL ASSOCIATION OF COUNTIES CAREMARKPCS HEALTH, L.L.C.
By: By:
Title: Title:
Date: Date:
MEMBER COUNTY:
[County Name]
By:
Title:
Date:
14
RIDER 1
With respect to County' s participation in the Consumer Card Program, the parties
intend and agree to revise the terms of the Agreement as follows:
1 The following is added as a new Section 1.8.e of the Agreement:
Transaction Revenue Sharing Fee. For each retail Claim processed by Caremark during the
term of this Agreement on which a transaction fee is collected by the Participating Pharmacy, Caremark
shall pay to Member County the Transaction Revenue Sharing Fee of $1.00. Transaction Revenue
Sharing Fees are due and payable no later than 60 days following the end of each calendar quarter.
Transaction Revenue Sharing Fee checks shall be accompanied by a summary report prepared by
Caremark setting forth the calculation of the Transaction Revenue Sharing Fees. It is the intention of the
parties that, for purposes of the Federal Anti- Kickback Statute and any required government reporting,
this fee shall constitute and shall be treated by Member County as a discount against the price of drugs
within the meaning of 42 U.S.C. 1320a 7b(b)(3)(A), if applicable.
Accepted and Agreed:
MEMBER COUNTY:
[County Name]
By:
Title:
Date:
Prescription Drug Program
Alio
National Association of Counties
I.......„.."....„406..
The Voice of America's Counties
NACo Prescription Drug Discount Card Program
MONTH
Hawaii County, HI
% OF % OF AVG
PLAN PLAN RETAIL RETAIL MEMBER MEMBER
TOTAL PRICED PRICED PRICED: PRICED COST COST
AVG
RETAIL RETAIL
SUBMITTED SUBMITTED
PRICE PRICE
AVG % OF TOTAL
PRICE PRICE PRICE UTIL-
SAVINGS SAVINGS SAVINGS IZERS
2012
MARCH
732
506
69.13%
226
30.87%
$ 29,886.79
$ 40.83
$ 40,458.60
$ 55.27
$ 10,571.81
$ 14.44
26.13%
320
FEBRUARY
739
506
68.47%
233'31.53
%$
27,994.32
$ 37.88
$ 38,521.35
$ 52.13
$ 10,527.03
$ 14.24
27.33%
323
JANUARY
789
HO
69.71%
239
30.29%
$ 29,384 10
$ 37.24
$ 40,906.85
$ 51.85
$ 11,522.75
$ 14.60
28.17%
332
2011
r u : •
700
491
70.14%
209
29.86%
$ 29,092.44
$ 41.56
$ 39,881.09
$ 56.97
$ 10,788.65
$ 15.41
27.05%
317
NOVEMBER
760
54::
71.32%
218
28.68 %$
30,319.91
$ 39.89
$ 41,972.00
$ 55.23
$ 11,652.09
$ 15.33
27.76%
334
OCTOBER
738
54874.25%
190
25.75%
$ 30,201.67'
40.92
$ 44,110.39
$ 59.77
$ 13,908.72
$ 18.85
31.53%
344
SEPTEMBER
752
584
77.66%
168
22.34% $ 30,304.59
$ 40.30
$ 43,129.77
$ 57.35
$ 12,825.18
$ 17.05
29.74%
343
UGUST
836
646
77.27%
190
22.73%$ 32,546.84
$ 38.93
$ 47,012.85
$ 56.24
$ 14,466.01
$ 17.30
30.77%
369
JULY
736
56676.90%
170
23.10% $ 28,741.14
$ 39.05
$ 41,035.75
$ 55.76
$ 12,294.61
$ 16.70
29.96%
340
JUNE
838
656
78.28%
182
21.72 %'$ 32,535.56'
$ 38.83
$ 49,021.20
$ 58.50
$ 16,485.64
$ 19.67
33.63%
407
MAY
823
624
75.82%
199
24.18% $ 32,449.20
$ 39.43
$ 45,839.37
$ 55.70
$ 13,390.17
$ 16.27
29.21 %
383
PRIL
834
663
79.50%
171
20.50 %$ 34,858.51:
$ 41.80
$ 48,777.26
$ 58.49
$ 13,918.75
$ 16.69
28.54%
403
MARCH
973
75d
77.49%
219
22.51% $ 39,640.11
$ 40.74
$ 54,994.19
$ 56.52
$ 15,354.08
$ 15.78
27.92%
444
FEBRUARY
931
731
78.52%
200
21.48% $ 39,543.74
$ 42.47
$ 53,989.10
$ 57.99
$ 14,445.36
$ 15.52
26.76%
421
JANUARY
970
736
75.88%
234
24.12% $ 38,779.17
$ 39.98
$ 53,454.30
$ 55.11
$ 14,675.13
$ 15.13
27.45%
427
2010
DECEMBER
1,073
829
77.26%
244
22.74% $ 45,027.63
$ 41.96
$ 62,076.45
$ 57.85
$ 17,048.82
$ 15.89
27.46%
477
NOVEMBER
989
749
75.73%
240
24.27% $ 36,615.84
$ 37.02
$ 50,101.14
$ 50.66
$ 13,485.30
$ 13.64
26.92%
437
OCTOBER
996
772
77.51 %
224
22.49 %'$ 38,556.31:
$ 38.71
$ 54,553.95
$ 54.77
$ 15,997.64
$ 16.06
29.32%
458
SEPTEMBER
1,067
818
76.66%
249
23.34 %$ 41,460.97
$ 38.86
$ 56,895.83
$ 53.32
$ 15,434.86
$ 14.47
27.13%
498
• UGUST
1,095
857
78.26%
238
21.74 %$ 43,130.17
$ 39.39
$ 60,160.91
$ 54.94
$ 17,030.74
$ 15.55
28.31%
541
JULY
1,028
778
75.68%
250
24.32% $ 40,407.81
$ 39.31
$ 55,690.39
$ 54.17
$ 15,282.58
$ 14.87
27.44%
519
JUNE
1,063
806
75.82
%24.18
%'$ 41,725.89
$ 39.25
$ 58,317.20
$ 54.86
$ 16,591.31
$ 15.61
28.45%
551
MAY
1,167
868
74.38%
299
25.62 %$ 45,633.82
$ 39.10
$ 63,565.71
$ 54.47
$ 17,931.89
$ 15.37
28.21%
602
• PRIL
1,176
883
75.09%
293
24.91%
$ 48,448.20
$ 41.20
$ 65, 594.91
$ 55.78
$ 17,146.71
$ 14.58
26.14%
629
MARCH
1,333
1,017
76.29%
316
2371%
$ 55,503.29
$ 41.64
$ 75,382.05
$ 56.55
$ 19,878.76
$ 14.91
26.37%
678
FEBRUARY
1,119
843
75.34%
276
24.66%
$ 45,385.85
$ 40.56
$ 60,884.44
$ 54.41
$ 15,498.59
$ 13.85
25.46%
587
JANUARY
1,191
893
74.98%
298
25.02%
$ 46,764.03
$ 39.26
$ 64,746.55
$ 54.36
$ 17,982.52
$ 15.10
27.77%
671
2009 .
1,382
1,063
76.92%
319
23.08%
$ 54,004.82
$ 39.08
$ 74,929.68
$ 54.22
$ 20,924.86
$ 15.14
27.93%
730
NOVEMBER
1,215
932
76.71 %
283
23.29%
$ 47,447.26
$ 39.05
$ 65,375.02
$ 53.81
$ 17,927.76
$ 14.76
27.42%
677
OCTOBER,
1,377
1,384
1,011
1,025
73.42%
74.06%
366
359
26.58% $ 53,232.31
25.94% $ 52,922.66
$ 38.66
$ 38.24
$ 74,613.36
$ 54.19
$ 21,381.05
$ 15.53
28.66%
742
SEPTEMBER
$ 73,147.33
$ 52.85
$ 20,224.67
$ 14.61
27.65%
766
UGUST
1,487
1,106
74.38%
381
25.62 %$ 55,400.95
$ 37.26
$ 77,058.78
$ 51.82
$ 21,657.83
$ 14.56
28.11%
787
JULY
1,530
1,126
73.59%
404
26.41% $ 62,782.18
$ 41.03
$ 85,266.07
$ 55.73
$ 22,483.89
$ 14.70
26.37%
800
http://www.uscounties.org/cffiles/drug_program/private/drug res.__cty.cfm ?getacct= 2070[4/18/2012 4:55:28 PM]
County of Hawaii
PROJECT DATA /FINANCIAL IMPACT STATEMENT
,:tdrtit €r2r3i'UE ri:r 3r I0 2 i:r.', Prrijecfs
1. DEPARTMENT AND DIVISION: Department of Environmental Management - Wastewater Division 2. DATE: 11/21/2009
3. PROJECT NAME: Alahou Sewer Basin 4. SUBMITTER: Dora Beck, Division Chief
5. COUNCIL BENEFIT DISTRICT(5): 7,8 6. TMK: 7 -5
7. LOCATION (JUDICIAL DISTRICT): 7 8. TOTAL COUNTY FUNDS NEEDED THIS FY: $1,320
9. CAPITAL PROJECT ELIGIBIILTY (List Criteria):
Infrastructure Improvement; Planning, feasibility, engineering, or design studies
10. PROJECT /PROGRAM DESCRIPTION:
Installation of approximately 0.4 miles of gravity sewer to service the areas above Kuakini which are within the Critical Wastewater Disposal Aread (CWDA) established by HAR 11 -62,
Wastewater Systems.
11. PROJECT JUSTIFICATION & OUTCOME(S) Addresses Public Health and Safety, Enhances Quality of Life, Service Improvements
Installation of the new sewer system within the Alahou basin which is within the CWDA allows properties to connect to the County Sewer thereby helping in protecting the shoreline
water quality.
12. LONG RANGE PLANS /COMMUNITY VALUES: The project is consistent with the Department's goal of protecting the environment by minimizing discharge of raw sewage to the
and is consistent with the goals established by the Kona Community Development Plans
13. COUNTY MATCHING FUNDS REQ'D? NO: YES {_ -' DESCRIBE:
14. LEGAL r. NO R, YESr DESCRIBE:
15. IMPACT ON OPERATIONAL BUDGET:
Additional operating costs to be offset by establishment of sewer rates commensurate with operating expenses.
16. SUSTAINABILITY FOCUS (List all that apply): Promotes Economic Vitality, Preserves and Protects our Natural Environment, Promotes Health and Safety
Fosters Inter - Departmental Collaboration and Cross - Sector Implementation
17. PROJECT READINESS (List all that apply): Planning and Design needs to be accoumplished
18. EXPENDITURE PHASING (X $1000):
Prior Funds
Received
This FY 09 -10
Request
FY 10 -11
FY 11-12
FY 12 -13
FY 13 -14
FY 14-15
Beyond 6 Years
TOTAL:
Planning
106
$106
Land Acquisition
Design /Survey
158
$158
Construction
1,056
$1,056
TOTAL:
$1,320
$1,3201
19. 0 & M COSTS (x $1000):
20. FUNDING SOURCE (x $1000):
Cty G.O. Bond /Other
1,320
$1,320
State Revolving Fund
State CIP
Federal
Private (Grants)
CBA (Fair Share /Park Dedication, etc)
Special Financing District
TOTAL:
I $1,3201
I
1 ]1 1
11
$1,3201
Prescription Drug Program
JUNE
1,472
1,117
75.88%
355
24.12 %$
56,456.81
$ 38.35
$ 78,961.61
$ 53.64
$ 22,504.80
$ 15.29
28.50%
799
MAY
1,422
1,109
77.99%
313
22.01%
$ 58,881.55
$ 41.41
$ 81,239.23
$ 57.13
$ 22,357.68
$ 15.72
27.52%
785
APRIL
1,420
1,116
78.59%
304
21.41%
$ 52,714.07'
$ 37.12
$ 75,838.37
$ 53.41
$ 23,124.30
$ 16.28
30.49%
782
MARCH
1,352
1,097
81.14%
255
18.86%
$ 55,098.37
$ 40.75
$ 78,637.05
$ 58.16
$ 23,538.68
$ 17.41
29.93%
734
FEBRUARY
1,138
938
82.43%
200
17.57 %$
45,529.55
$ 40.01
$ 63,867.87
$ 56.12
$ 18,338.32
$ 16.11
28.71%
655
JANUARY
1,076
856
79.55%
220
20.45 %$
41,909.39
$ 38.95
$ 59,494.19
$ 55.29
$ 17,584.80
$ 16.34
29.56%
600
2008
DECEMBER
941
745
79.17%
19620.83
%$
35,874.34
$ 38.12
$ 50,323.13
$ 53.48
$ 14,448.79
$ 15.35
28.71%
500
NOVEMBER
832
669
80.41%
163
19.59%
$ 32,248.98
$ 38.76
$ 45,918.14
$ 55.19
$ 13,669.16
$ 16.43
29.77%
453
OCTOBER
728
590
81.04%
138
18.96%
$ 28,988.27'
$ 39.82
$ 39,556.59
$ 54.34
$ 10,568.32
$ 14.52
26.72%
391
SEPTEMBER
411
332
80.78%
79
19.22%
$ 18,722.22
$ 45.55
$ 24,754.73
$ 60.23
$ 6,032.51
$ 14.68
24.37%
238
TOTALS: 144,6151 34,048176.32 %110,567 23.68%
1$ 2,460,054.751 $ 55.141$ 692,903.121$
15.531 28.17 %122,594.00
Column Headers from left to right:
1. Total Rxs: This is the total number of Rxs that were adjudicated or attempted to adjudicate through the use of the card
(the explanation of the next couple of headers will help explain the necessity of this column).
2. Plan Priced Rxs: Caremark tracks all attempts to use the cards including when the pharmacy offers a lower price than
the card can give. This is usually when the pharmacy sells a drug at cost or below cost to create foot traffic for the
pharmacy or under a special purchase arrangement. This is the amount of Rxs that the card gave the best price vs.
the pharmacy.
3. % Plan Priced Rxs: What percentage of the total attempted Rxs adjudicated via best price with the card.
4. Retail Priced Rxs: How many prescriptions where the pharmacy had a lower price.
5. % Retail Priced Rxs: Percentage of Rxs where the pharmacy had a lower price.
6. Total Drug Cost: All prescriptions totaled together at their card discount prices.
7. Average Drug Cost: Average Drug Cost per Rx at the card discounted price.
8. Retail Submitted Price: What the price would have been if the prescriptions weren't filled with the card.
9. Average Retail Submitted Price: Average Per Prescription price if the card wasn't presented at a discount.
10. Price Savings: Total dollar savings for all Rxs filled with the card.
11. Average Price Savings: Average price savings per prescription.
12. % Price Savings: Percentage price savings per prescription.
13. Total Utilizers: This is the total amount of people who represent the total amount of prescriptions i.e. some people fill
multiple prescriptions. This gives you an indication of how many residents you are helping.
As always, if you have questions, don't hesitate to contact me. Thank you for being a member county, borough or parish and
participating in this member program.
Andrew Goldschmidt
Director, Membership /Marketing
NACo -- National Association of Counties
http : / /www.uscounties.org /cffiles/ drug__ program / private /drug _res__cty.cfm ?getacct= 2070[4/18/2012 4:55:28 PM]
County of Hawaii
PROJECT DATA /FINANCIAL IMPACT STATEMENT
l dditk: o? T(O:63 : , r '.''::1 PtU,TICIs
1. DEPARTMENT AND DIVISION: Department of Environmental Management - Wastewater Division 2. DATE: 11/21/2009
3. PROJECT NAME: Kealohi Kai Sewer Basin 4. SUBMITTER: Dora Beck, Division Chief
5. COUNCIL BENEFIT DISTRICT(S): 7,8 6. TMK: 7-7-004
7. LOCATION (JUDICIAL DISTRICT): 7 8. TOTAL COUNTY FUNDS NEEDED THIS FY: $1,386
9. CAPITAL PROJECT ELIGIBIILTY (List Criteria):
Infrastructure Improvement; Planning, feasibility, engineering, or design studies
10. PROJECT /PROGRAM DESCRIPTION:
Installation of approximately 0.7 miles of gravity sewer to service the Kealohi Kai Subdivison and areas above Alii Drive above the Kealohi Kai Subdivision which are within the Critical
Wastewater Disposal Aread (CWDA) established by HAR 11 -62, Wastewater Systems.
11. PROJECT JUSTIFICATION & OUTCOME(S) Addresses Public Health and Safety, Enhances Quality of Life, Service Improvements
Installation of the new sewer system in the Kealohi Kai Subdivision and areas above the Kealohi Kai Subdivision within the CWDA allows properties to connect to the County Sewer
thereby helping in protecting the shoreline water quality.
12. LONG RANGE PLANS /COMMUNITY VALUES: The project is consistent with the Department's goal of protecting the environment by minimizing discharge of raw sewage to the
and is consistent with the goals established by the Kona Community Development Plans
13. COUNTY MATCHING FUNDS REQ'D? NON YES; - DESCRIBE:
14. LEGAL MADATE? NON YES ; "° DESCRIBE:
15. IMPACT ON OPERATIONAL BUDGET:
Additional operating costs to be offset by establishment of sewer rates commensurate with operating expenses.
16. SUSTAINABILITY FOCUS (List all that apply): Promotes Economic Vitality, Preserves and Protects our Natural Environment, Promotes Health and Safety
Fosters Inter - Departmental Collaboration and Cross - Sector Implementation
17. PROJECT READINESS (List all that apply): Planning and Design needs to be accoumplished
18. EXPENDITURE PHASING (X $1000):
Prior Funds
Received
This FY 09 -10
Request
FY 10 -11
FY 11 -12
FY 12 -13
FY 13 -14
FY 14 -15
Beyond 6 Years
TOTAL:
Planning
111
$111
Land Acquisition
Design /Survey
166
$16.
Construction
1,109
$1,109
TOTAL:
$1,386
$1,386
19. 0 & M COSTS (x $1000):
- --
--
- --
- --
- --
- -
- -
- -
1,386
-
-
-
$1,38611
_
--
--
--
I
20. FUNDING SOURCE (x $1000):
II
Cty G.O. Bond /Other
$1,386
State Revolving Fund
State CIP
Federal
Private (Grants)
CBA (Fair Share /Park Dedication, etc)
Special Financing District
II
I
$1,380
TOTAL:
If
PRESCRIPTION DISCOUNT CARD USAGE AS A DOLLAR VALUE TO COUNTY
CALENDAR YEAR FISCAL YEAR
total: I $ 2,912.00 I $ 16,255.00 I $ 13,297.00 I $ 9,891.00 I $ 2,260.00
Total
$ 44,615.00
2008
2009
2010
2011
2012
JAN
1530
1076
1191
970
789
FEB
1095
1138
1119
931
739
MAR
752
1352
1333
973
732
APR
NOV
1420
1176
834
760
MAY
941
1422
1167
823
JAN
JUN
1191
1472
1063
838
1138
JUL
931
1530
1028
736
1333
AUG
732
1487
1095
836
834
SEP
411
1384
1067
752
OCT
728
1377
996
738
NOV
832
1215
989
760
DEC
941
1382
1073
700
total: I $ 2,912.00 I $ 16,255.00 I $ 13,297.00 I $ 9,891.00 I $ 2,260.00
Total
$ 44,615.00
total: I $ 10,792.00 I $ 15,424.00 I $ 11,617.00 I $ 6,782.00
Total
$ 44,615.00
FY 08 -09
FY 09 -10
FY 10 -11
FY 11 -12
JUL
1530
1028
736
AUG
1487
1095
836
SEP
411
1384
1067
752
OCT
728
1377
996
738
NOV
832
1215
989
760
DEC
941
1382
1073
700
JAN
1076
1191
970
789
FEB
1138
1119
931
739
MAR
1352
1333
973
732
APR
1420
1176
834
MAY
1422
1167
823
JUN
1472
1063
838
total: I $ 10,792.00 I $ 15,424.00 I $ 11,617.00 I $ 6,782.00
Total
$ 44,615.00