Compounded Prescriptions Sample Clauses

Compounded Prescriptions. For prescriptions requiring the skills and expertise of a pharmacist to mix two or more ingredients (at least one of which must be a federal legend drug) (“Compounding”), the reimbursement rate will be the lower of the sum of the AWPs of the ingredients in the compound plus a $5.00 dispensing fee or Pharmacy’s then current Usual and Customary Charge. Pharmacy agrees to submit its then current Usual and Customary Charge via the Designated Claim Adjudication System with each Claim submission. “Compounding” rates will not apply to the mixing of two or more liquids or to the reconstitution of lyophilized powders. Compounded prescriptions must be submitted via the Designated Claim Adjudication System per NCPDP D.0 standards for submitting compounded prescriptions.
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Compounded Prescriptions. The MCO shall ensure that the dispensing pharmacist is responsible for collecting the co-payment at the time of the service unless the pharmacist, in filling certain prescriptions, does not normally have face-to face contact with the Member. If the pharmacist does not have face-to-face contact with the Member in dispensing a prescription, the provider has the right to xxxx the Member for the $1.00 co-payment. Pursuant to 42 U.S.C. Section 1396o(e), no provider may deny care or services to an individual eligible for such care or services because of an inability to pay a co-payment. The MCO shall ensure that its providers do not refuse to render the service or fill a prescription if the Member is unable to pay the co-payment. The MCO may permit its providers to ask for the unpaid co-payment at a subsequent visit or to xxxx the Member for the outstanding co-payment. The pharmacist shall accept the Member's declaration that he is unable to pay the co-payment.
Compounded Prescriptions. The MCO shall ensure that the dispensing pharmacist is responsible for collecting the co-payment at the time of the service unless the pharmacist, in filling certain prescriptions, does not normally have face to face contact with the Member. If the pharmacist does not have face-to-face contact with the Member in dispensing a prescription, the provider has the right to xxxx the Member for the $1.50 co-payment.
Compounded Prescriptions. A compounded prescription is a mixture of ingredients which the provider prepares in the pharmacy. (See the NE-POP System User’s manual for billing instructions.) Reimbursement for compounded prescriptions will be limited to those ingredients which are indicated as covered on the NE-POP System or listed on the Department’s website. Any mixture of drugs which results in a commercially available OTC preparation is not considered a compounded prescription, for example, dilute HCL, MOM with cascara, OTC hydrocortisone preparations. (See the NE-POP System user's manual for billing instructions.) 16-002.02 Over-the-Counter (OTC) Drugs: NMAP covers only OTC drugs indicated as covered on the NE-POP System or listed LISTED on the Department’s website. OTC drugs shall must be prescribed by a licensed practitioner.

Related to Compounded Prescriptions

  • Prescriptions and bottles of these medications may be sought by individuals with chemical dependency and should be closely safeguarded. It is expected that you will take the highest possible degree of care with your medication and prescription. They should not be left where others might see or otherwise have access to them.

  • Prescription Glasses This plan covers prescription glasses as follows: • Frames - one (1) collection frame per plan year; • Lenses - one (1) pair of glass or plastic collection lenses per plan year. This includes single vision, bifocal, trifocal, lenticular, and standard progressive lenses. This plan covers the following lens treatments: • UV treatment; • tint (fashion, gradient, and glass-grey); • standard plastic scratch coating; • standard polycarbonate; and • photocromatic/transitions plastic. This plan covers one (1) supply of contact lenses as follows: • conventional contact lenses - one (1) pair per plan year from a selection of • extended wear disposable lenses - up to a 6-month supply of monthly or two- week single vision spherical or toric disposable contact lenses per plan year; or • daily wear disposable lenses - up to a 3-month supply of daily single vision spherical disposable contact lenses per plan year. This plan also covers the evaluation, fitting, or follow-up care related to contact lenses. This plan covers additional contact lenses if your prescribing network provider submits a verification form, with the regular claim form, verifying that you have one of the following conditions: • anisometropia of 3D in meridian powers; • high ametropia exceeding -10D or +10D in meridian powers; • keratoconus when the member’s vision is not correctable to 20/25 in either or both eyes using standard spectacle lenses; and • vision improvement for members whose vision can be corrected two lines of improvement on the visual acuity chart when compared to the best corrected standard spectacle lenses.

  • Prescription Drugs The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance abuse disorders are covered under

  • Mileage Measurement Where required, the mileage measurement for LIS rate elements is determined in the same manner as the mileage measurement for V&H methodology as outlined in NECA Tariff No. 4.

  • Prescription Drug Plan Retail and mail order prescription drug copays for bargaining unit employees shall be as follows:

  • Prescription Safety Glasses Prescription safety glasses will be furnished by the employer. The employer retains the authority to establish reasonable rules and procedures regarding frequency of issue, replacement of damaged glasses, limits on reimbursement costs and coordination with the employer's vision plan.

  • Prescription Claims against the Issuer or any Guarantor for the payment of principal or Additional Amounts, if any, on the Notes will be prescribed ten years after the applicable due date for payment thereof. Claims against the Issuer or any Guarantor for the payment of interest on the Notes will be prescribed five years after the applicable due date for payment of interest.

  • Mail Order Catalog Warnings In the event that, the Settling Entity prints new catalogs and sells units of the Products via mail order through such catalogs to California consumers or through its customers, the Settling Entity shall provide a warning for each unit of such Product both on the label in accordance with subsection 2.4 above, and in the catalog in a manner that clearly associates the warning with the specific Product being purchased. Any warning provided in a mail order catalog shall be in the same type size or larger than other consumer information conveyed for such Product within the catalog and shall be located on the same display page of the item. The catalog warning may use the Short-Form Warning content described in subsection 2.3(b) if the language provided on the Product label also uses the Short-Form Warning.

  • Prescription Plan The PPO plan will include a comprehensive prescription 29 program:

  • Salary Packaging (1) For the purposes of this Agreement, salary packaging shall mean an arrangement whereby the wage or salary benefit arising under a contract of employment is reduced, with another or other benefits to the value of the replaced salary being substituted and due to the practitioner. (2) A practitioner may, by agreement with the employer, enter into a salary packaging arrangement. (3) The employer shall not unreasonably withhold agreement to salary packaging on request from a practitioner. (4) The employer shall not require a practitioner to enter into a salary packaging arrangement, provided that this clause will not impinge on any additional employer provided benefits. (5) A salary packaging arrangement shall be formulated and operate on the basis that, on balance, there shall be no material disadvantage to the practitioner concerned, and shall be cost neutral in relation to the total employment cost to the employer. (6) A salary packaging arrangement must comply with relevant taxation laws and the employer shall not be liable for additional tax, penalties or other costs payable or which may become payable by the practitioner. (7) In the event of any increase or additional payments of tax or penalties associated with the employment of the practitioner, or the provision of employer benefits under the salary packaging agreement, such tax, penalties and any other costs shall be borne by the practitioner. (8) A practitioner may elect to cancel any salary packaging arrangement by giving a minimum of four weeks notice. (9) The employer may elect to cancel any salary packaging arrangement by giving a minimum of four weeks notice if the employer incurs a liability to pay fringe benefits tax or any other tax in respect of the non-cash benefits provided, provided that the employer cannot retrospectively cancel any salary packaging arrangement. (10) Notwithstanding subclauses (8) and (9) of this clause, the employer and the Practitioner may agree to forgo the notice period. (11) The cancellation of salary packaging will not cancel or otherwise effect the operation of this Agreement. (12) For the purposes of this provision, any penalty rate, loading or other salary related allowances which would ordinarily be calculated on the basis of the salary rates expressed in Schedule 1 Full Time Annual Base Salary Rates shall continue to be so calculated despite an election to participate in any salary packaging arrangement. (13) For the purposes of this provision, statutory 9% employer superannuation contributions shall be made on the basis of pre-packaging salary rates. To avoid doubt, employer contributions shall not be reduced as a result of a practitioner participating in salary packaging pursuant to this provision. (14) The employer may at any time vary the range of benefits provided or the conditions under which benefits are provided however the employer shall not differentiate between different class of practitioners across WA Health in terms or range of benefits or the conditions under which benefits are provided. (15) If a practitioner is found to have committed misconduct in the claiming a salary packaging benefit the employer is entitled to prospectively cease to provide some or all salary packing benefits either indefinitely or for any period determined by the employer.

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