MA-PD SPONSOR REIMBURSEMENT TO PHARMACIES. 1. If MA-PD Sponsor uses a standard for reimbursement of pharmacies based on the cost of a drug, MA-PD Sponsor will update such standard not less frequently than once every 7 days, beginning with an initial update on January 1 of each year, to accurately reflect the market price of the drug. 2. MA-PD Sponsor will issue, mail, or otherwise transmit payment with respect to all claims submitted by pharmacies (other than pharmacies that dispense drugs by mail order only, or are located in, or contract with, a long-term care facility) within 14 days of receipt of an electronically submitted claim or within 30 days of receipt of a claim submitted otherwise. 3. MA-PD Sponsor must ensure that a pharmacy located in, or having a contract with, a long-term care facility will have not less than 30 days (but not more than 90 days) to submit claims to MA-PD Sponsor for reimbursement.
Appears in 4 contracts
Samples: Contract With Eligible Medicare Advantage Organization (Wellcare Health Plans, Inc.), Contract With Eligible Medicare Advantage Organization (Wellcare Health Plans, Inc.), Contract With Eligible Medicare Advantage Organization (Wellcare Health Plans, Inc.)
