HOOSIER HEALTHWISE SCOPE OF WORK. Independently developed and implemented PA criteria will be displayed, in a common format, alongside fee for service and other Contractor criteria. Additionally, the Contractor shall implement retrospective drug use review to identify patterns of fraud, abuse, gross overuse, or inappropriate or medically unnecessary care, among physicians, pharmacists and individuals receiving benefits, or associated with specific drugs or groups of drugs.
Appears in 4 contracts
Samples: Contract Amendment, Amendment to Contract, Contract
