Common use of Potential Claims Reports Clause in Contracts

Potential Claims Reports. (i) For periods commencing after October 31, 2006, PharMerica shall furnish to Ceres on at least a monthly or more frequent basis as reasonably determined by PharMerica, within a reasonable time not to exceed fifteen days following the end of the subject reporting period, a written report, in form and substance reasonably determined by PharMerica (the “Potential Claims Report”). The Potential Claims Report shall identify each claim of PharMerica to an Accepted Plan for Products supplied by a Pharmacy Operator to a Covered Resident (A) during the period for which the Potential Claims Report was prepared that remains unpaid by the Accepted Plan on account of stop edits or step edits pursuant to the terms of such Accepted Plan, as of the end of the period covered by the Potential Claims Report, and (B) each such claim that was included in a prior Potential Claims Report that remains unpaid as of the end of such period. (ii) Each Potential Claims Report shall identify (A) the name and Facility of the applicable Covered Resident, (B) the name of the applicable Accepted Plan, (C) the applicable Product that was dispensed to the Covered Resident, (D) the date on which such Product was dispensed, and (E) the charge for such Product to the Accepted Plan. (iii) Notwithstanding anything in Section 9(e)(iii) to the contrary, for periods commencing after October 31, 2006, (A) no Ceres Party shall be responsible under Section 9(e)(iii) for the payment of any Product dispensed by a Pharmacy Operator to any Covered Resident that is unpaid by an Accepted Plan on account of stop edits or step edits pursuant to the terms of such Accepted Plan if such claim (1) is invoiced to Ceres more than sixty (60) days after the date the Product giving rise to such claim was dispensed, and (2) has not been included in a Potential Claims Report supplied to Ceres within sixty (60) days after the date the Product giving rise to such claim was dispensed, and (B) if such claim is not timely invoiced and included on a Potential Claims Report as provided by the foregoing provisions of this Section 9(f)(iii), PharMerica shall not stop providing Products to the subject Covered Resident.