Common use of Preferred Drug List Clause in Contracts

Preferred Drug List. (A) The Contractor shall develop policies and procedures to govern prescription drug Service Authorization Requests , the policies and procedures shall follow those same Service Authorization Requests policies found in Article 7 and shall be in accordance with 42 CFR 438.210. (B) The Contractor may use the Department’s Preferred Drug List or may create its own Preferred Drug List. (C) If the Contractor decides to create its own Preferred Drug List, the Contractor’s Preferred Drug List shall adhere to the following requirements: (1) On a yearly basis, the Contractor’s Preferred Drug list and the methodology used by the Contractor to set is Preferred Drug List shall be subject to review by the Department’s P&T Committee. Additionally, the P&T Committee at its discretion, may request and review Contractor’s Preferred Drug List and require the Contractor to provide an explanation of the methodology used by the Contractor in making its Preferred Drug List. (i) The Contractor shall provide any documents requested by the P&T Committee within 15 days of the request. (ii) The Department’s P&T Committee may require the Contractor to amend its Preferred Drug List if the Board determines that the Contractor’s Preferred Drug List violates this Contract, violates applicable State and Federal Laws, or appears to create an adverse selection process. (2) The Contractor shall make its Preferred Drug List, and the criteria used to create the Preferred Drug List available to the Department and to Contractor’s Enrollees, upon request. (3) If the Contractor fails to respond to P&T Committee request for information in a timely manner, the Department may impose sanctions as described in Article 14 of this Contract. (4) The Contractor may file a request for an administrative hearing if it disagrees with the decision made by the Department’s P&T Committee. The Contractor shall file its request for a State Fair hearing within 30 days of the P&T Committee’s decision.

Preferred Drug List. (A) The Contractor shall develop policies and procedures to govern prescription drug Service Authorization Requests Requests, the policies and procedures shall follow those same Service Authorization Requests policies found in Article 7 and shall be in accordance with 42 CFR 438.210. (B) The Contractor may use the Department’s Preferred Drug List or may create its own Preferred Drug List. (C) If the Contractor decides to create its own Preferred Drug List, the Contractor’s Preferred Drug List shall adhere to the following requirements: (1) On a yearly basis, the Contractor’s Preferred Drug list and the methodology used by the Contractor to set is Preferred Drug List shall be subject to review by the Department’s P&T Committee. Additionally, the P&T Committee at its discretion, may request and review Contractor’s Preferred Drug List and require the Contractor to provide an explanation of the methodology used by the Contractor in making its Preferred Drug List. (i) The Contractor shall provide any documents requested by the P&T Committee within 15 days of the request. (ii) The Department’s P&T Committee may require the Contractor to amend its Preferred Drug List if the Board determines that the Contractor’s Preferred Drug List violates this Contract, violates applicable State and Federal Laws, or appears to create an adverse selection process. (2) The Contractor shall make its Preferred Drug List, and the criteria used to create the Preferred Drug List available to the Department and to Contractor’s Enrollees, upon request. (3) If the Contractor fails to respond to P&T Committee request for information in a timely manner, the Department may impose sanctions as described in Article 14 of this Contract. (4) The Contractor may file a request for an administrative hearing if it disagrees with the decision made by the Department’s P&T Committee. The Contractor shall file its request for a State Fair hearing Hearing within 30 calendar days of the P&T Committee’s decision.

Preferred Drug List. (A) The Contractor shall develop policies and procedures to govern prescription drug Service Authorization Requests Requests, the policies and procedures shall follow those same Service Authorization Requests policies found in Article 7 and shall be in accordance with 42 CFR 438.210. (B) The Contractor may use the Department’s Preferred Drug List or may create its own Preferred Drug List. (C) If the Contractor decides to create its own Preferred Drug List, the Contractor’s Preferred Drug List shall adhere to the following requirements: (1) On a yearly basis, the Contractor’s Preferred Drug list and the methodology used by the Contractor to set is its Preferred Drug List shall be subject to review by the Department’s P&T Committee. Additionally, the P&T Committee at its discretion, may request and review Contractor’s Preferred Drug List and require the Contractor to provide an explanation of the methodology used by the Contractor in making its Preferred Drug List. (i) The Contractor shall provide any documents requested by the P&T Committee within 15 days of the request. (ii) The Department’s P&T Committee may require the Contractor to amend its Preferred Drug List if the Board determines that the Contractor’s Preferred Drug List violates this Contract, violates applicable State and Federal Laws, or appears to create an adverse selection process. (2) The Contractor shall make its Preferred Drug List, and the criteria used to create the Preferred Drug List available to the Department and to Contractor’s Enrollees, upon request. (3) If the Contractor fails to respond to P&T Committee request for information in a timely manner, the Department may impose sanctions as described in Article 14 of this Contract. (4) The Contractor may file a request for an administrative hearing if it disagrees with the decision made by the Department’s P&T Committee. The Contractor shall file its request for a State Fair hearing Hearing within 30 calendar days of the P&T Committee’s decision.

Preferred Drug List. (A) The Contractor shall develop policies and procedures to govern prescription drug Service Authorization Requests Requests, the policies and procedures shall follow those same Service Authorization Requests policies found in Article 7 and shall be in accordance with 42 CFR § 438.210. (B) The Contractor may use the Department’s Preferred Drug List PDL or may create its own Preferred Drug ListPDL. (C) If the Contractor decides to create its own Preferred Drug ListPDL, the Contractor’s Preferred Drug List PDL shall adhere to the following requirements: (1) On a yearly basis, the Contractor’s Preferred Drug list PDL and the methodology used by the Contractor to set is Preferred Drug List its PDL shall be subject to review by the Department’s P&T Committee. Additionally, the P&T Committee at its discretion, may request and review Contractor’s Preferred Drug List PDL and require the Contractor to provide an explanation of the methodology used by the Contractor in making its Preferred Drug List.PDL; (i) The Contractor shall provide any documents requested by the P&T Committee within 15 calendar days of the request. (ii) The Department’s P&T Committee may require the Contractor to amend its Preferred Drug List PDL if the Board determines that the Contractor’s Preferred Drug List PDL violates this Contract, violates applicable State and Federal Lawsfederal laws, or appears to create an adverse selection process.; (2) The Contractor shall make its Preferred Drug List, and the criteria used to create the Preferred Drug List available to the Department and to Contractor’s Enrollees, upon request.; (3) If the Contractor fails to respond to P&T Committee request for information in a timely manner, the Department may impose sanctions as described in Article 14 15 of this Contract.attachment; and (4) The Contractor may file a request for an administrative hearing if it disagrees with the decision made by the Department’s P&T Committee. The Contractor shall file its request for a State Fair hearing Hearing within 30 calendar days of the P&T Committee’s decision.