Title:
Consider and take action on a resolution authorizing Addendum No. 1 to the Interlocal Agreement with the Galveston County Health District d/b/a Coastal Health & Wellness to expand eligible pharmacy services and establish payment for required medical visits (Director of Human Resources and Civil Service)
Background:
Approval of this item will authorize Addendum No. 1 to the existing interlocal agreement with the Galveston County Health District d/b/a Coastal Health & Wellness to expand the 340B pharmacy program to eligible non-specialty medications that provide a net financial savings and to establish City payment for required medical visits.
Human Resources reports that the program has generated $75,633.57 in savings during the current fiscal year. Participation is voluntary. Employees who elect to participate have a $0 copay for medications provided through the program; however, employees enrolled in a high-deductible health plan may receive the $0 copay only after satisfying the applicable plan deductible. Only medications that produce a net savings under the City's prescription benefit will be included in the program.
The proposed addendum expands the program beyond specialty medications by allowing non-specialty medications when the parties mutually determine that a medication is clinically appropriate and results in a net financial savings under the City's prescription benefit. The parties may establish and revise the list of eligible medications through written mutual agreement without further amendment, provided Coastal Health & Wellness can replenish the medication through the 340B Program in the manufacturer's full package size.
The addendum also establishes a flat rate of $190 for each required medical visit. Covered individuals must complete an initial appointment to establish care and an annual medical visit every 12 to 18 months. Coastal Health & Wellness will not bill the covered individual's insurance for a required visit. Additional se...
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