Member Transition of Care for Prescription Drugs Sample Clauses

Member Transition of Care for Prescription Drugs. The MCP is responsible for implementing transition of care processes that prevent access problems for members that are transitioning from the FFS pharmacy benefit administrator to an MCP. The transition of care processes must be prior approved by ODM and at a minimum include the following: i. The MCP may not require prior authorization (PA) of prescriptions filled according to paragraph ii. below, until the MCP has educated the member that further administration will require the prescribing provider to request PA and, if applicable, the option of using an alternative medication that may be available without PA. Written member education notices must use ODM-specified model language. Verbal member education may be done in place of written education but must contain the same information as a written notice. MCP member notices and call scripts must be prior approved by ODM. ii. For new members who transition from FFS to an MCP, the MCP may not require PA in the first month of membership, for at least one prescription refill for claims approved by Ohio Medicaid during the prior FFS enrollment period. iii. For antidepressant and antipsychotic medications, the MCP must abide by the restrictions on PA described in Appendix X.0.x.xx of this Agreement.
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Related to Member Transition of Care for Prescription Drugs

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

  • 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

  • Medicaid Enrollment Treatment Grantees shall enroll as a provider with Texas Medicaid and Healthcare Partnership (TMHP) and all Medicaid Managed Care organizations in Grantee’s service region within the first quarter of this procurement term and maintain through the procurement term.

  • HIPAA To the extent (if any) that DXC discloses “Protected Health Information” or “PHI” as defined in the HIPAA Privacy and Security Rules (45 CFR, Part 160-164) issued pursuant to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) to Supplier or Supplier accesses, maintains, uses, or discloses PHI in connection with the performance of Services or functions under this Agreement, Supplier will: (a) not use or further disclose PHI other than as permitted or required by this Agreement or as required by law; (b) use appropriate safeguards to prevent use or disclosure of PHI other than as provided for by this Agreement, including implementing requirements of the HIPAA Security Rule with regard to electronic PHI; (c) report to DXC any use or disclosure of PHI not provided for under this Agreement of which Supplier becomes aware, including breaches of unsecured protected health information as required by 45 CFR §164.410, (d) in accordance with 45 CFR §164.502(e)(1)(ii), ensure that any subcontractors or agents of Supplier that create, receive, maintain, or transmit PHI created, received, maintained or transmitted by Supplier on DXC’s behalf, agree to the same restrictions and conditions that apply to Supplier with respect of such PHI; (e) make available PHI in a Designated Record Set (if any is maintained by Supplier) in accordance with 45 CFR section 164.524;

  • Random Drug Testing All employees covered by this Agreement shall be subject to random drug testing in accordance with Appendix D.

  • Commercialization Reports Throughout the term of this Agreement and during the Sell-Off Period, and within thirty (30) days of December 31st of each year, Company will deliver to University written reports of Company’s and Sublicensees’ efforts and plans to develop and commercialize the innovations covered by the Licensed Rights and to make and sell Licensed Products. Company will have no obligation to prepare commercialization reports in years where (a) Company delivers to University a written Sales Report with active sales, and (b) Company has fulfilled all Performance Milestones. In relation to each of the Performance Milestones each commercialization report will include sufficient information to demonstrate achievement of those Performance Milestones and will set out timeframes and plans for achieving those Performance Milestones which have not yet been met.

  • Clinical Data and Regulatory Compliance The preclinical tests and clinical trials, and other studies (collectively, “studies”) that are described in, or the results of which are referred to in, the Registration Statement or the Prospectus were and, if still pending, are being conducted in all material respects in accordance with the protocols, procedures and controls designed and approved for such studies and with standard medical and scientific research procedures; each description of the results of such studies is accurate and complete in all material respects and fairly presents the data derived from such studies, and the Company and its subsidiaries have no knowledge of any other studies the results of which are inconsistent with, or otherwise call into question, the results described or referred to in the Registration Statement or the Prospectus; the Company and its subsidiaries have made all such filings and obtained all such approvals as may be required by the Food and Drug Administration of the U.S. Department of Health and Human Services or any committee thereof or from any other U.S. or foreign government or drug or medical device regulatory agency, or health care facility Institutional Review Board (collectively, the “Regulatory Agencies”); neither the Company nor any of its subsidiaries has received any notice of, or correspondence from, any Regulatory Agency requiring the termination, suspension or modification of any clinical trials that are described or referred to in the Registration Statement or the Prospectus; and the Company and its subsidiaries have each operated and currently are in compliance in all material respects with all applicable rules, regulations and policies of the Regulatory Agencies.

  • Substance Abuse Program The SFMTA General Manager or designee will manage all aspects of the FTA-mandated Substance Abuse Program. He/she shall have appointing and removal authority over all personnel working for the Substance Abuse Program personnel, and shall be responsible for the supervision of the SAP.

  • HEALTH PROGRAM 3701 Health examinations required by the Employer shall be provided by the Employer and shall be at the expense of the Employer. 3702 Time off without loss of regular pay shall be allowed at a time determined by the Employer for such medical examinations and laboratory tests, provided that these are performed on the Employer’s premises, or at a facility designated by the Employer. 3703 With the approval of the Employer, a nurse may choose to be examined by a physician of her/his own choice, at her/his own expense, as long as the Employer receives a statement as to the fitness of the nurse from the physician. 3704 Time off for medical and dental examinations and/or treatments may be granted and such time off, including necessary travel time, shall be chargeable against accumulated income protection benefits.

  • Program Compliance The School Board shall be responsible for monitoring the program to provide technical assistance and to ensure program compliance.

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