Microsoft word - iam 2011 agreement.november 11, 2011 18 draft 4

Case No. A-13575
MEDIATION AGREEMENT
THIS AGREEMENT, made this ___ day of _________, 201_ by and
between the participating carriers listed in Exhibit A attached hereto and
represented by the National Carriers’ Conference Committee, and the
employees shown thereon and represented by the International
Association of Machinists and Aerospace Workers, witnesseth:
IT IS HEREBY AGREED:

ARTICLE I - WAGES

Section 1 - First General Wage Increase

On July 1, 2010, all hourly, daily, weekly, and monthly rates of pay
in effect on the preceding day for employees covered by this Agreement
shall be increased in the amount of two (2) percent applied so as to give
effect to this increase in pay irrespective of the method of payment.
The increase provided for in this Section 1 shall be applied as follows:
Add 2 percent to the existing hourly rates of pay. Add 2 percent to the existing daily rates of pay. Add 2 percent to the existing weekly rates of pay. Add 2 percent to the existing monthly rates of pay. Rates of pay resulting from application of paragraphs (a) to (d), inclusive, above which end in fractions of a cent shall be rounded to the nearest whole cent, fractions less than one-half cent shall be dropped, and fractions of one-half cent or more shall be increased to the nearest full cent. The increase in wages provided for in this Section 1 shall be applied in accordance with the wage or working conditions agreement in effect between each carrier and the labor organization party hereto. Special allowances not included in fixed hourly, daily, weekly or monthly rates of pay for all services rendered, and arbitraries representing duplicate time payments, will not be increased. Overtime hours will be computed in accordance with individual schedules for all overtime hours paid for. Any cost-of-living allowance amounts rolled in to basic rates of pay on or after June 30, 2011 pursuant to Article III, Part B of the National IAM Agreement dated October 1, 2008 (or any local counterpart agreement) shall be excluded before application of the general wage increases provided for in this Section 1 and eliminated from basic rates of pay after application of such increases.
Section 2 - Second General Wage Increase
Effective July 1, 2011 all hourly, daily, weekly and monthly rates of pay in effect on June 30, 2011 for employees covered by this Agreement shall be increased by two-and-one-half (2.5) percent applied in the same manner as provided for in Section 1 hereof and applied so as to give effect to this increase irrespective of the method of payment. Section 3 - Third General Wage Increase

Effective July 1, 2012, all hourly, daily, weekly and monthly rates of pay in effect on June 30, 2012 for employees covered by this
Agreement shall be increased in the amount of four-and-three-tenths
(4.3) percent applied in the same manner as provided for in Section 1
hereof and applied so as to give effect to this increase irrespective of
the method of payment.
Section 4 - Fourth General Wage Increase

Effective July 1, 2013, all hourly, daily, weekly and monthly rates of pay in effect on June 30, 2013 for employees covered by this
Agreement shall be increased in the amount of three (3) percent
applied in the same manner as provided for in Section 1 hereof and
applied so as to give effect to this increase irrespective of the method
of payment.
Section 5 - Fifth General Wage Increase

Effective July 1, 2014, all hourly, daily, weekly and monthly rates of pay in effect on June 30, 2014 for employees covered by this
Agreement shall be increased in the amount of three-and-eight-tenths
(3.8) percent applied in the same manner as provided for in Section 1
hereof and applied so as to give effect to this increase irrespective of
the method of payment.
Section 6 - Sixth General Wage Increase

Effective January 1, 2015, all hourly, daily, weekly and monthly rates of pay in effect on December 31, 2014 for employees covered
by this Agreement shall be increased in the amount of three (3)
percent applied in the same manner as provided for in Section 1
hereof and applied so as to give effect to this increase irrespective of
the method of payment.
ARTICLE II – LUMP SUM PAYMENT

(a) A lump sum payment shall be made to each employee subject to this Agreement who has an employment relationship with the carrier as of the date such lump sum is paid or who has retired or died subsequent to October 31, 2010. Such lump sum shall be paid no later than ninety (90) days after the date of this Agreement. There shall be no duplication of lump sum payments by virtue of employment under an agreement with another organization. (b) The lump sum amount payable to an eligible employee shall be a lump sum equivalent to 1% of straight time earnings paid
to that employee for the twelve month period November 1, 2010
through October 31, 2011, after application of the July 1, 2010 and
July 1, 2011 general wage increases provided for in Article I.
ARTICLE III -
COST-OF-LIVING PAYMENTS

Section 1

Article III, Part B, of the October 1, 2008 IAM Mediation Agreement (Case No. A-13431) shall be eliminated effective June 30,
2011. All cost-of-living allowance payments made thereunder to
employees for periods on and after July 1, 2011 shall be recovered
from any retroactive wage increase payments made under Article I of
this Agreement.

Section 2

Any local counterpart to the above-referenced Article III, Part B that is in effect on a carrier party to this Agreement shall be amended
in the same manner as provided in Section 1.
ARTICLE IV - HEALTH AND WELFARE
Part A - Plan Changes
Section 1 - Continuation of Plans
The Railroad Employees National Health and Welfare Plan ("the Plan"), the Railroad Employees National Dental Plan ("the Dental Plan"), the Railroad Employees National Early Retirement Major Medical Benefit Plan (“ERMA”), and the Railroad Employees National Vision Plan ("the Vision Plan"), modified as provided in this Article with respect to employees represented by the organization and their eligible dependents, will be continued subject to the provisions of the Railway Labor Act. Section 2 - Plan Design Changes
(a) The Plan's Managed Medical Care Program ("MMCP") shall (1) There shall be a separate, stand-alone, Annual Deductible for In-Network Services for which a fixed-dollar copayment does not apply. For the six-month period from July 1 through December 31, 2012, inclusive, this Annual Deductible shall be $100 per individual and $200 per family. For calendar year 2013, this Annual Deductible shall be $150 per individual and $300 per family. Beginning January 1, 2014, this Annual Deductible shall be $200 per individual per year and $400 per family per year. (2) The percentage of Eligible Expenses paid by the Plan for any In-Network Services for which a fixed-dollar copayment does not apply (as defined by procedure code) shall be 95% of the Eligible Expenses that exceed the applicable Annual Deductible provided for in clause (1) above; the amount payable by the employee as a result of this “coinsurance” shall be capped at (i) $500 per individual and $1000 per family for the six-month period from July 1 through December 31, 2012, inclusive, and at $750 per individual and $1500 per family for calendar year 2013. Beginning January 1, 2014, the amount payable by the employee as the result of this “coinsurance” shall be capped at $1000 per individual per year and $2000 per family per year. (3) The Emergency Room Co-Payment for In-Network Services shall be increased to $75.00 for each visit, but shall not apply if the visit results in admission to the hospital. (4) The Urgent Care Center Co-Payment for In-Network Services shall be decreased to $20.00 for each visit. (5) In cases where a fixed-dollar copayment of $20 currently applies to an office visit, the copayment shall be reduced to $10 if the office is in a “convenient care clinic.” A “convenient care clinic” means, for purposes of this Section, a health care facility typically located in a high-traffic retail store, supermarket or pharmacy that provides affordable treatment for uncomplicated minor illness and/or preventative care to consumers. (6) The Plan shall not cover radiological services (b) The Plan’s Managed Medical Care Program (“MMCP”) and its Comprehensive Health Care Benefit (“CHCB”) shall both be revised to include: (1) Participation in a “Radiology Notification Program” (as (2) Arrangements for covered employees and their covered dependents to receive, on a wholly voluntary basis and without any copayment or coinsurance, the following additional “Centers of Excellence Resource Services” (as described in Exhibit B hereto): Bariatric Resource Services, Cancer Resource Services, and Kidney Resource Services; (3) Arrangements for covered employees and their covered dependents to receive, on a wholly voluntary basis and without any copayment or coinsurance, the resource services made available under a “Treatment Decision Support Program” (as described in Exhibit B hereto). (c) The Plan’s Prescription Drug Card and Mail Order Prescription Drug Programs shall be revised as follows: (1) Prior Authorization by the Plan’s current pharmacy benefit manager (or any successor pharmacy benefit manager) (“PBM”) shall be required, in accordance with such PBM’s Prior Authorization Program then in effect, before any prescription drugs in the therapeutic drug categories shown on Exhibit C hereto as subject to such Program shall be dispensed; provided, however, that no more than a three to five-day supply of such a drug may be dispensed at retail in accordance with the PBM’s Temporary Override Program without Prior Authorization. (2) Employees and their covered dependents shall be required to adhere to Step Therapy and Quantity/Duration Limits Programs then in effect of the Plan’s PBM with respect to the prescription drugs in the therapeutic drug categories shown on Exhibit C hereto as subject to such Step Therapy Program and/or Quantity/Duration Limits Program, as the case may be. (3) Employees and their covered dependents may, on a wholly voluntary basis and in accordance with program criteria, participate in the PBM’s Personalized Medicine and/or Generic Rx Advantage Program then in effect. (d) The Plan's Prescription Drug Card Program Co-Payments to In-Network Retail Pharmacies per prescription are revised as follows: (2) Brand Name (Non-Generic) Drug On Program Administrator's Formulary - increase to $25.00; (3) Brand Name (Non-Generic) Drug Not On Program Administrator's Formulary - increase to $45.00; (e) The Plan's Mail Order Prescription Drug Program Co- Payments per prescription are revised as follows: (2) Brand Name (Non-Generic) Drug on Program Administrator's Formulary - increase to $50.00; (3) Brand Name (Non-Generic) Drug not on Program Administrator's Formulary - increase to $90.00. (f) The design changes contained in this Section shall become Section 3 - Plan Design Changes - ERMA
(a) ERMA’s Prescription Drug Card and Mail Order Prescription Drug Programs shall be revised as follows: (1) Prior Authorization by ERMA’s current pharmacy benefit manager (or any successor pharmacy benefit manager) (“PBM”) shall be required, in accordance with such PBM’s Prior Authorization Program then in effect, before any prescription drugs in the therapeutic drug categories shown on Exhibit C hereto as subject to such Program shall be dispensed; provided, however, that no more than a three to five-day supply of such a drug may be dispensed at retail in accordance with the PBM’s Temporary Override Program without Prior Authorization. (2) Retirees and their covered dependents shall be required to adhere to Step Therapy and Quantity/Duration Limits Programs then in effect of ERMA’s PBM with respect to the prescription drugs in the therapeutic drug categories shown on Exhibit C hereto as subject to such Step Therapy Program and/or Quantity/Duration Limits Program, as the case may be. (3) Retirees and their covered dependents may, on a wholly voluntary basis and in accordance with program criteria, participate in the PBM’s Personalized Medicine and/or Generic Rx Advantage Program then in effect. (b) The design changes contained in this Section shall become effective on July 1, 2012, and shall apply only to individuals who
become eligible for ERMA coverage on or after July 1, 2012.
Part B - Employee Sharing of Cost of H&W Plans
Section 1 - Monthly Employee Cost-Sharing Contributions
(a) Effective January 1, 2010, the employee monthly cost- sharing contribution amount shall be $200.00 (b) Effective January 1, 2011, the employee monthly cost (c) Effective January 1, 2012, each employee covered by this Agreement shall contribute to the Plan, for each month that his employer is required to make a contribution to the Plan on his behalf for foreign-to-occupation health benefits coverage for himself and/or his dependents, a monthly cost-sharing contribution in an amount equal to the lesser of 15% of the Carriers' Monthly Payment Rate for 2012 or $200. (d) The employee monthly cost-sharing contributions amount shall be adjusted, effective July 1, 2016, so as to equal the lesser of 15% of the Carrier's Monthly Payment Rate for 2016 or $230.00, unless otherwise mutually agreed by the parties during negotiations commencing when this Agreement becomes amendable pursuant to Article VI. (e) For purposes of subsections (c) and (d) above, the "Carriers' Monthly Payment Rate" for any year shall mean one twelfth of the sum of what the carriers' monthly payments to – (1) the Plan for foreign-to-occupation employee and dependent health benefits, employee life insurance benefits and employee accidental death and (2) the Dental Plan for employee and dependent dental (3) the Vision Plan for employee and dependent vision would have been during that year, per non-hospital association road employee, in the absence of any employee contributions to such Plans. Section 2 - Pre-Tax Contributions
Employee cost-sharing contributions made pursuant to this Part shall be made on a pre-tax basis pursuant to the existing Section 125 cafeteria plan to the extent applicable. Section 3 - Method of Making Employee Cost-Sharing
Contributions

Employee cost-sharing contributions will be made for the employee by the employee's employer. The employer shall deduct the amount of such employee contributions from the employee's wages and retain the amounts so deducted as reimbursement for the employee contributions that the employer had made for the employee. PART C – Rescission of Side Letter
Side Letter #7 to the parties’ October 1, 2008 Mediation Agreement (Case No. A-13431) is rescinded. ARTICLE V - SUPPLEMENTAL SICKNESS
The March 29, 1979 Supplemental Sickness Benefit Agreement, as amended by Article V of the October 1, 2008 National IAM Agreement (Sickness Agreement), shall be further amended as

Section 1 - Adjustment of Plan Benefits

(a) The benefits provided under the Plan established pursuant to the Sickness Agreement (“SSB Plan”) shall be adjusted as provided in paragraph (b) so as to restore the same ratio of benefits to rates of pay as existed on December 31, 2009 under the terms of that Agreement. (b) Section 4 of the Sickness Agreement shall be revised as (as of 12/31/09) Class II Employees Earning Basic and Maximum Benefit Amount Per Month
Section 2 - Further Adjustment of Plan Benefits

(a) Effective July 1, 2012, the benefits provided under the Plan shall be adjusted so as to restore the same ratio of benefits to rates of pay as existed on the effective date of this Article. (b) The benefit adjustment described in Section 2(a) above shall be made effective on each of the following dates: July 1, 2013, July 1, 2014, and January 1, 2015. (c) The benefit adjustment described in Section 2(a) above shall be made effective on the date of each general wage increase that
becomes effective after January 1, 2015.
ARTICLE VI - GENERAL PROVISIONS

Section 1 - Court Approval

This Agreement is subject to approval of the courts with respect to participating carriers in the hands of receivers or trustees.


Section 2 - Effect of this Agreement

(a) The purpose of this Agreement is to settle the disputes growing out of the notices served upon the organization by the carriers listed in Exhibit A on or subsequent to November 1, 2009 (including any notices outstanding as of that date), and the notices served by the organization signatory hereto upon such carriers on or subsequent to November 1, 2009 (including any notices outstanding as of that date). (b) This Agreement shall be construed as a separate agreement by and on behalf of each of said carriers and their employees represented by the organization signatory hereto, and shall remain in effect through December 31, 2014 and thereafter until changed or modified in accordance with the provisions of the Railway Labor Act, as amended. (c) No party to this Agreement shall serve or progress, prior to November 1, 2014 (not to become effective before January 1, 2015), any notice or proposal. (d) This Article will not bar management and the organization on individual railroads from agreeing upon any subject of mutual interest.
SIGNED AT WASHINGTON, DC, THIS __TH DAY OF ____________, 201_.

FOR THE PARTICIPATING
FOR THE EMPLOYEES
CARRIERS LISTED IN
REPRESENTED
EXHIBIT A REPRESENTED INTERNATIONAL ASSO-
BY THE NATIONAL CAR-

CIATION OF MACHINISTS
RIERS’
CONFERENCE
AEROSPACE
WORKERS:
COMMITTEE:

________________________ ________________________
Mr. Robert Roach Jr. General Vice President International Associations of Machinists & Aerospace Workers 9000 Machinists Place Upper Marlboro, MD 20772-2687 Dear Mr. Roach: This confirms our understanding with respect to the general wage increases provided for in Article I, Sections 1 and 2 of the Agreement of this date. The carriers will make all reasonable efforts to pay the retroactive portion of such general wage increases as soon as possible and no later than sixty (60) days after the date of this Agreement. If a carrier finds it impossible to make such payments by that date, such carrier shall notify you in writing explaining why such payments have not been made and indicating when the payments will be made. Very Mr. Robert Roach Jr. General Vice President International Associations of Machinists & Aerospace Workers 9000 Machinists Place Upper Marlboro, MD 20772-2687 Dear Mr. Roach: This refers to the increase in wages provided for in Sections 1 and 2 of Article I of the Agreement of this date. It is understood that the retroactive portion of those wage increases shall be applied only to employees who have an employment relationship with a carrier on the date of this Agreement or who retired or died subsequent to June 30, 2010. Please acknowledge your agreement by signing your name I agree: ____________________ Robert Roach, Jr. Mr. Robert Roach Jr. General Vice President International Associations of Machinists & Aerospace Workers 9000 Machinists Place Upper Marlboro, MD 20772-2687 Dear Mr. Roach: This confirms our understanding with respect to application of certain provisions of the October 1, 2008 Mediation Agreement (“2008 Agreement”) pending ratification of our tentative agreement that would resolve our respective bargaining notices served on or subsequent to November 1, 2009 (“Tentative Agreement or TA”). Article III, Part B, Section 1 of the 2008 Agreement provides for payment of a cost-of-living allowance effective January 1, 2012. Article IV, Part C, Section 1(c) of the 2008 Agreement provides for an increase, effective January 1, 2012, to the per month employee cost-sharing contribution amount in effect on December 31, 2011. This confirms our understanding that, pending completion of the ratification process concerning the Tentative Agreement, application of the above-referenced provisions shall be suspended. If the Tentative Agreement is ratified, the final disposition of those provisions is addressed in Article III, Section 1 and Article IV, Part B, Section 1 of the TA. Please acknowledge your agreement by signing your name in I agree: ___________________ Robert Roach, Jr. Mr. Robert Roach Jr. General Vice President International Associations of Machinists & Aerospace Workers 9000 Machinists Place Upper Marlboro, MD 20772-2687 Dear Mr. Roach: This confirms our understanding with respect to Article I, Section 6 of the Agreement of this date. Article I, Section 6 of the Agreement provides for a three (3) percent general wage increase effective January 1, 2015. Article VI, Section 2(c) of the Agreement provides that the parties to the Agreement may serve and progress notices or proposals to amend the Agreement and other existing agreements on or after November 1, 2014 (not effective before January 1, 2015) (“2015 Bargaining Notices”). This will confirm our understanding that if disposition of the 2015 Bargaining Notices is referred to any third party (including but not limited to a Presidential Emergency Board or arbitration board), this Letter may be provided to such body to confirm the parties’ mutual understanding that Article I, Section 6 was intended to constitute a complete resolution of the compensation adjustment issue for calendar year 2015. Please acknowledge your agreement by signing your name I agree: ___________________ Robert Roach, Jr. Mr. Robert Roach Jr. General Vice President International Associations of Machinists & Aerospace Workers 9000 Machinists Place Upper Marlboro, MD 20772-2687 Dear Mr. Roach: This confirms our understanding with respect to Article IV, Part A, Sections 2(c)(1) & (2) of the Agreement of this date. The prescription drug management rules identified in the aforementioned provisions of the Agreement are those that have been recommended by the Plan’s current pharmacy benefit manager, Medco Health Solutions. The same is true of the therapeutic drug categories listed on Exhibit C to the Agreement; they are the therapeutic drug categories that Medco Health Solutions has recommended be subject to one or more of those rules. The parties intend that new prescription drug management rules for which there are no existing therapeutic drug categories listed in Exhibit C shall not apply to the Plan unless such application has been (a) recommended by an independent committee of experts generally relied upon by the Plan’s pharmacy benefit manager, (b) such recommendation is also made by the pharmacy benefit manager itself, and (c) the recommendation is accepted and approved by the Plan’s Joint Committee. Please acknowledge your agreement by signing your name I agree: ____________________ Robert Roach, Jr. Mr. Robert Roach Jr. General Vice President International Associations of Machinists & Aerospace Workers 9000 Machinists Place Upper Marlboro, MD 20772-2687 Dear Mr. Roach: This confirms our understanding regarding the Agreement of this date regarding local discussions between the organization and the Soo Line Railroad Company dba Canadian Pacific (“Soo”), regarding certain asserted wage rate disparities between Soo and other carriers involved in national handling. Upon written request by the organization’s designated representative to Soo, the parties shall commence local discussions regarding those matters on a voluntary and informal basis (i.e., not under Section 6 of the Railway Labor Act). Such discussions shall conclude by the earlier of the date on which a voluntary agreement is reached or December 31, 2012, unless extended by mutual agreement. Please acknowledge your agreement by signing your name I agree: ___________________ Robert Roach, Jr. EXHIBIT A
RAILROADS REPRESENTED BY THE NATIONAL
CARRIERS' CONFERENCE COMMITTEE IN
CONNECTION WITH NOTICES SERVED ON OR
SUBSEQUENT TO NOVEMBER 1, 2009 BY AND ON
BEHALF OF SUCH CARRIERS UPON THE
INTERNATIONAL ASSOCIATION OF MACHINISTS &
AEROSPACE WORKERS AND NOTICES SERVED ON
OR SUBSEQUENT TO NOVEMBER 1, 2009 BY THE
GENERAL CHAIRMEN, OR OTHER RECOGNIZED
REPRESENTATIVES, OF THE INTERNATIONAL
ASSOCIATION OF MACHINISTS & AEROSPACE
WORKERS UPON SUCH CARRIERS.

Subject to indicated footnotes, this authorization is
co-extensive with notices filed and with provisions
of current schedule agreements applicable to
employees represented by the International
Association of Machinists & Aerospace Workers.

Alameda Belt Line Alton & Southern Railway Company The Belt Railway Company of Chicago BNSF Railway Company Consolidated Rail Corporation CSX Transportation, Inc. Gary Railway Company - 1 Indiana Harbor Belt Railroad Company The Kansas City Southern Railway Company New Orleans Public Belt Railroad Norfolk Southern Railway Company The Alabama Great Southern Railroad Company Central of Georgia Railroad Company The Cincinnati, New Orleans & Texas Pacific Railway Georgia Southern and Florida Railway Company Interstate Railroad Company Tennessee, Alabama and Georgia Railway Company Tennessee Railway Company Northeast Illinois Regional Commuter Railroad Corporation (METRA) - 2 Oakland Terminal Railway Port Terminal Railroad Association Soo Line Railroad Company d.b.a. Canadian Pacific South Carolina Public Railways Terminal Railroad Association of St. Louis Union Pacific Railroad Company 1 - Wages and Rules and Health and Welfare only 2 - Health and Welfare and Supplemental Sickness only EXHIBIT B
Clinical Support Services 1
Radiology Notification Program (RNS) – Under this program,
a radiology notification process is required for participating
(network) physicians, health care professionals, facilities and
ancillary providers for certain advanced outpatient imaging
procedures, prior to performance, with administrative claim
denial for failure to provide notification. The program is a prior
notification requirement only, not a precertification,
preauthorization or medical necessity determination program,
and currently applies to the following outpatient advanced
imaging procedures: CT, MRI, PET and Nuclear Medicine,
including Nuclear Cardiology. These services that take place
in an emergency room, observation unit, urgent care center, or
during an inpatient stay do not require notification.
The process may require a physician-to-physician discussion, the purpose of which is to engage the ordering physician in a discussion about the use of evidence-based clinical guidelines. However, the final decision authority rests with the ordering physician. This program is invisible to the covered member – non-compliance (i.e., non-notification) will result in an administrative denial of the claim with no balance billing to the patient. Centers of Excellence (COE) Resource Services – this service
are based on the foundation that certain facilities treat patients
who consistently achieve favorable clinical outcomes, as
demonstrated by reduced hospital lengths of stay and
readmission rates, lower infection rates, etc. Programs are
typically designed around specific disease states or conditions
in which COEs can be clearly identified. The following
programs develop national COE networks and specialty nurse resources that provide specific case management interventions: - Bariatric Resource Services (BRS) - BRS provides a national Center of Excellence network of bariatric surgery centers and hospitals with an upfront case management component. - Cancer Resource Services (CRS)/Cancer Support Program (CSP) - This clinical consulting with cancer specialists, combined with an extensive nationwide COE network will deliver clinical and financial value. - Kidney Resource Services (KRS) – KRS provides a large network of dialysis facilities meeting strict quality outcomes with kidney nurse specialists assisting patients.
Treatment Decision Support (TDS) – These services include
enhanced one-to-one coaching for individuals facing potential
procedures that have been carefully targeted as having varied
treatment practices and inconsistent patient outcomes. TDS
normally targets back pain, knee/hip replacement, benign
prostate disease, prostate cancer, benign uterine conditions,
hysterectomy, breast cancer, coronary artery disease and
bariatric surgery.
1 The actual program names, specific services/processes, and administration will vary by medical vendor. Exhibit C - Drugs for Coverage Authorization and Step Therapy Therapeutic Drug
Category
Specialty Drugs
Gout Therapy
Rheumatological
(RA Agents)
Misc Agents
Erythroid
Stimulants
Growth Hormones

Humatrope® Increlex™ IPlex™ Norditropin® Nutropin® Omnitrope® Saizen® Serostim® Tev-Tropin,® Zorbtive® Interferons
Interleukins
Multiple Sclerosis
Copaxone® Extavia® GilenyaTM Novantrone® Rebif® Tysabri ® Myeloid Stimulants
and Hemostatics
Vaccines & Misc
Immunologicals
Vaccines & Misc
Immunologicals
(Immune Globulins) S-D® Gammaplex® Gamimune-
N® Gamunex® Gamunex-C® Hizentra™ Privigen™ Vivaglobin® Dermatologicals -
Psoriasis

Therapeutic Drug
Category
Cancer Therapy
Herceptin Istodax Jevtana Nexavar® Sprycel® Sutent® Tarceva™ Tasigna® Temodar® Torisel™ Tykerb® Vectibix™ Vidaza® Votrient™ Zolinza™ Zytiga™ Cancer Therapy
(Misc.)
Cancer Therapy

(Misc.)
Misc Antineoplastic

Misc Antineoplastic
Antivirals
(Ribavirin Therapy)
HIV/AIDS Therapy
RSV Agents
Parkinson's
Hormone Therapy
Misc Agents
Misc Neurological
Hormone Therapy
(Misc.)
Hormone Therapy

(Misc.)
Hormone Therapy

(Misc.)
Hormone Therapy

Therapeutic Drug
Category
Non-Narcotic Pain
(Hyaluronic Acid
Derivatives)

Hepatitis C
Misc. Pulmonary
Misc. Pulmonary
Misc. Pulmonary
Pulmonary Arterial
Hypertension
Tracleer® Ventavis® Adcirca™ Tyvaso® Veletri® Non Specialty/Traditional Drugs
Hypnotics
chloral hydrate Dalmane® Doral® EdluarTM Halcion® Lunesta® Nembutal® Prosom® Restoril® Rozerem® Silenor® Sonata® Zolpimist™ Migraine
Frova Imitrex® Imitrex Inj® ImitrexNS® Maxalt® MaxaltMLT® Migranal NS® Relpax Sumavel® Treximet™ Zomig® Zomig ZMT® Narcolepsy
Narcotic Pain Relief Abstral® Actiq® Fentora™
Non-Narcotic Pain
Relief (Misc.)
Dermatologicals -
Therapeutic Drug
Category
Anorexiants/Weight Adipex-P® Bontril® Didrex®
loss
Hormone Therapy
(Select Androgens
& Anabolic
Steroids)
Anzemet® Cesamet™ Emend® Emend Trifold Pack® Kytril® Sancuso ®Zofran® Zofran ODT® Zuplenz® 1/ The Coverage Authorization Program consists of traditional prior authorization, smart prior authorization, step therapy and quantity/dose rules which are based on FDA-approved prescribing and safety information, clinical guidelines, and uses that are considered reasonable, safe, and effective. These rules are recommended by an outside, independent organization based on information and data specific to the Railroad membership. Each Therapeutic Drug Category has a rule(s) specific to that category. Preferred Drug Step Therapy 2/
Proton Pump
Inhibitors
Agents/Hypnotic
s
Depression

Osteoporosis
Intranasal
Steroids
Angiotensin II
Receptor
Blockers
Migraine
Glaucoma
Hormones
(specialty drug)
Tumor Necrosis
Factor (specialty
Enbrel, Humira
2/ Preferred Drug Step Therapy identifies users of non-preferred/non-covered medications and communicates less expensive generic and preferred brand alternatives (when appropriate).

Source: http://www.iamdl19.org/Nationa_Frt_10_!_08/Nat_frt_2011/IAM%202011%20Agreement_2011.pdf

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