Pharmacy Reimbursement Sample Clauses

Pharmacy Reimbursement i. Contractor will be required to use the reimbursement rates reflected in the most current CMS NADAC file, and must utilize the most current NADAC file published by CMS. Without specific state authorization, the Contractor will be required to use a “lesser of” methodology that includes NADAC, Contract #37109 U&C, and all related processes relevant to the method used. A MAC rate cannot be used if a NADAC rate is available. The NADAC rate and process applies to every type of pharmacy claim of whatever type or name if there is a NADAC rate. The Contractor can negotiate provider-specific contracts for rates that will apply to those drugs without a published NADAC rate, and must follow the requirements of the Pharmacy Maximum Allowable Cost provisions in Section X(G) below. ii. Any notice that goes to providers regarding pharmacy reimbursement rates of any kind must first be submitted to the State for review and approval. The notice should not be distributed to providers without the State’s approval. iii. Contractor is required to reflect the actual pharmacy paid amount on encounter claims. The State must be able to confirm what pharmacy paid amount was made to the pharmacy, and must be able to verify use of NADAC rates or, when appropriate, MAC cost structure. Implementation and operational details related to the 2016 changes regarding pharmacy reimbursement in this section and the following section will be provided to Contractor in governing KDHE policies and guidance documents.
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Pharmacy Reimbursement 

Related to Pharmacy Reimbursement

  • Meal Reimbursement When an employee is specifically directed by the City to work two (2) hours or longer at the beginning or end of their normal work shift away from their place of residence of at least eight (8) hours or work two (2) hours or longer at the end of their work shift of at least eight (8) hours when the employee is called in to work on their regular day off, or otherwise works under circumstances for which meal reimbursement is authorized per Ordinance 111768 and the employee actually purchases a reasonably priced meal away from his place of residence as a result of such additional hours of work, the employee shall be reimbursed for the "reasonable cost" of such meal in accordance with Seattle Municipal Code (SMC) 4.20.

  • Educational Reimbursement A) The City will reimburse tuition costs and general fees for courses taken at an educationally accredited college or university by full-time permanent employees. Such course work must be approved prior to enrolling by submitting documentation that the course(s) is necessary toward a degree which is required for a position in the City (including electives for that degree). Thereafter, the course work must be approved by the Department Head and finally to the Director of Human Resources. The fact that a specific course is required for a degree major where the degree with such a major exists as a minimum requirement for a higher classification will be relevant. B) The City will also reimburse for technical courses. Courses must either be directly related to the employee’s current job or related to another classification career path. The determination of relatedness shall be made by the Director of Human Resources. To be related to a career path the course work must be within three (3) normal promotional steps. Technical courses will be fully reimbursed for a passing grade. C) The City will reimburse the employee the cost of tuition and general fees for ten (10) credit hours per quarter/semester at the percentage rate of 100% for a grade of "A" "B" or "C". Reimbursement shall be limited to tuition levels and general fees charged by the University of Toledo. These costs will be reimbursed upon the documented presentation of a "C" or 2.0 grade or better. D) If licensing or certification is a requirement of a classification held by an employee, the City shall pay the employee's licensing or certification expenses. Expenses for required training and/or educational units necessary for maintaining licenses or certifications used or mandated for any classification shall also be reimbursed by the City. E) The City shall provide training and/or educational programs for full-time permanent employees to enhance career development under a program established jointly by the parties. (refer to Section 2106.72) F) The City and AFSCME Local 2058 recognize the importance of maintaining and upgrading skills as changes occur in the workplace. The parties are committed to identifying resources to assist employees with upgrading their skills. Training in these new areas may be done by City personnel. When it is beyond the scope of City personnel, training may be conducted through outside services. These costs shall be borne under the City's continuing education program. G) Any employee participating in the tuition reimbursement program that resigns, retires (non- disability) or is terminated must repay in full the tuition reimbursement paid by the City for courses completed less than five (5) years prior to the date of resignation, retirement, or termination. If necessary, this amount shall be deducted from the employee’s severance pay and/or his or her final paycheck. In the event the employee’s severance pay and/or final paycheck are insufficient to cover the full tuition reimbursement owed to the City, the employee must make arrangements to repay the amount owed. The City may pursue collection of the amount owed, if necessary. An employee who resigns or is terminated for cause or performance will lose all rights and benefits under the educational reimbursement refund policy effective on the date of his or her resignation, retirement, or termination. 2106.92 Base Annual Salaries A) Hourly Wages B) In accordance with Section 2106.02 “Classifications,” effective January 1, 2019, the Supervisor – Communications position will be divided into Supervisor - Police Communications and Supervisor - Fire Communications. The Supervisor - Fire Communications classification will be assigned to salary group eleven (11) and the Supervisor - Police Communications classification will be assigned to salary group thirteen (13). The employees will not receive another base wage increase for the duration of the agreement. CD) An employee who is promoted or who works above his classification will receive the Starting Rate of the class to which the employee has been promoted unless the Starting Rate of the new classification is less than four percent (4%) greater than the rate the employee was earning in his regular classification. If the Starting Rate of the new classification is not at least four percent (4%) greater than the rate the employee was earning in his regular classification, then the employee shall receive the full rate of the new classification. When an employee falls into a pay status that reflects less than one (1) cent, between the start rate and the full rate, then the City shall pay the full rate of pay. The Mayor may decide to pay a promoted employee at the full rate of pay that is applicable, provided that such decisions shall not establish a precedent or practice. Promoted employees at the Starting Rate will remain at the rate for one thousand forty (1,040) actual work hours after their appointment.

  • Education Reimbursement The County will provide education reimbursement for education costs incurred by regular employees who apply for such reimbursement in accordance with the policies and procedures governing the education reimbursement program. The maximum reimbursement shall be $1,500 per year.

  • Tuition Reimbursement Any regular full time employee covered by this contract is eligible for financial assistance for tuition cost for college or university courses taken in a technical, undergraduate, or graduate program after one (1) complete year of full time County employment. The Employer shall reimburse fifty percent (50%) of tuition cost of up to a maximum of $1,000.00 per year if: 1. Recommended by the employee's supervisor and approved by the Chief Judge of the applicable Court prior to enrollment in the course; and, 2. The course taken meets one (1) of the following criteria: (a) it is directly job related, as determined by the Chief Judge; (b) it is in preparation of a job related promotion; (c) it is required or is elective subject mandatory to obtain a diploma, certificate, or undergraduate degree in preparation for advancement to a higher classification in employment with the Court. 3. Under special circumstances a supervisor may authorize an employee to attend classes during normal working hours. HOWEVER, IT IS THE RESPONSIBILITY OF THE INDIVIDUAL EMPLOYEE TO ENSURE THE INDIVIDUAL MAKES UP ALL LOST WORK TIME. 4. Prior to being reimbursed for tuition expenses, the employee must present to the Employer a receipt for payment and proof of a grade of C (or its equivalent) or higher. 5. Employees eligible for education compensation under the veterans G.I. Xxxx or other government sponsored programs will have to exhaust their other benefits prior to being eligible for Employer education benefits. 6. Reimbursement includes tuition only and does not include registration, books, lab fees, etc. 7. Reimbursement is subject to and conditioned upon money being appropriated in the Employer's budget for this specific purpose and employees must apply for the tuition reimbursement by August prior to the calendar year for which the funds are requested so the applicable court can seek funding for the request through the annual budget process. 8. Tuition reimbursement is subject to all IRS required tax withholdings. 9. Repayment to the Employer in one lump sum will be required by an employee who voluntarily resigns or is discharged from employment within three (3) years following completion of coursework. In the event the employee does not continue employment for the prescribed period, the employee will be required to reimburse the Employer on a prorated basis for tuition reimbursement received as follows:

  • Transportation Reimbursement Employees who, during the course of their normal duties, are required to actually transport clients/consumers/felons in their own personal vehicle on a regular basis, are eligible for reimbursement for the cost of an automobile rider to their existing insurance policy. To be eligible for the reimbursement, the employee must demonstrate the following: 1. That he/she is normally required to transport clients/consumers/felons in the course of their duties. 2. That there is no access to or available State vehicles. 3. That public transportation cannot be used. 4. That their insurance company requires a special rider on their existing automobile policy. 5. Proof that such a rider has been purchased. 6. Proof of a valid driver’s license and insurance policy. By receiving such reimbursement, employees acknowledge that they may be required to use their own personal vehicle to transport clients/consumers/felons in the normal course of their duties. The reimbursement to such employee(s) is the actual cost of the rider not to exceed seventy-five dollars ($75) per year whichever is less. This reimbursement will be paid on a yearly basis in the pay period that includes July 1st. Employees who either resign, retire, or have their employment terminated during the year and employees who start during any part of the year will have the reimbursement prorated. In the case of employees who either retire, resign, or have their employment terminated will have that portion of the reimbursement repaid to the State, in the last paycheck.

  • Expense Reimbursement The Executive shall be entitled to receive reimbursement for all appropriate business expenses incurred by him in connection with his duties under this Agreement in accordance with the policies of the Company as in effect from time to time.

  • Cost Reimbursement This payment method is based on an approved budget and submission of a request for reimbursement of expenses Xxxxxxx has incurred at the time of the request;

  • Compensation; Reimbursement At the closing of each Offering (each, a “Closing”), the Company shall compensate Xxxxxxxxxx as follows:

  • Expense Reimbursements To the extent that any reimbursements payable pursuant to this Agreement are subject to the provisions of Section 409A of the Code, any such reimbursements payable to Executive pursuant to this Agreement shall be paid to Executive no later than December 31 of the year following the year in which the expense was incurred, the amount of expenses reimbursed in one year shall not affect the amount eligible for reimbursement in any subsequent year, and Executive’s right to reimbursement under this Agreement will not be subject to liquidation or exchange for another benefit.

  • Unreimbursed medical expenses If you take payments to pay for unreimbursed medical expenses that exceed a specified percentage of your adjusted gross income, you will not be subject to the 10 percent early distribution penalty tax. For further detailed information and effective dates you may obtain IRS Publication 590-B, Distributions from Individual Retirement Arrangements (IRAs), from the IRS. The medical expenses may be for you, your spouse, or any dependent listed on your tax return.

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