SUPDL and Formulary Requirements Sample Clauses

SUPDL and Formulary Requirements. For purposes of this section, the “formulary” is defined as the SUPDL and “non- formulary” is defined as covered outpatient drugs not included in the SUPDL. The Contractor shall maintain formulary (i.e., SUPDL) and covered non-formulary (i.e., non-SUPDL) drug lists for the Hoosier Care Connect packages. The Contractor must use the SUPDL as its formulary and may not develop and use its own PDL for any therapeutic categories that are part of the SUPDL. The Contractor will be provided opportunities to offer feedback on the SUPDL to the State. The State shall provide the Contractor with fifteen (15) calendar days’ notice of any change to the SUPDL, except those changes resulting from a drug shortage, recall or discontinuation, and the Contractor shall have an additional fifteen (15) calendar days to implement the change, including any system change. A drug that is on the SUPDL must have the same criteria and forms as the FFS PDL even if it is reimbursed as a medical claim. The Contractor shall submit any changes to the contents of the approved non- formulary drug list and any changes to prior authorization or medical necessity criteria applied to the non-formulary drug list to OMPP at least 60 days prior to the intended implementation date. OMPP may disapprove or modify the proposed changes within 30 days of receipt. If no response is received from OMPP within 30 days, the Contractor may implement the proposed changes. The formulary and non-formulary covered drug lists shall support the coverage and non-coverage requirements for legend and non-legend drugs by Indiana Medicaid. More information can be found in 405 IAC 5-24-3, 405 IAC 5-24-4, 405 IAC 5-24-5 and 407 IAC 3-10-1. In accordance with CMS-2390-F and 42 CFR 438.210, the Contractor shall demonstrate prescription drug coverage consistent with the amount, duration, and scope of the fee-for-service program. Per 42 CFR § 423.100, prescription drug coverage means coverage of Part D drugs that is either standard prescription drug coverage or basic alternative coverage. The Contractor shall follow the SUPDL prior authorization criteria for SUPDL drug classes. Per 42 CFR § 419.81, preauthorization (or prior authorization) means the process through which a request for provisional affirmation of coverage is submitted to CMS or its contractors for review before the service is provided to the beneficiary and before the claim is submitted for processing. Per 42 CFR 438.10(i)(1)-(2), the Contractor shall make availab...
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SUPDL and Formulary Requirements. For purposes of this section, the “formulary” is defined as the SUPDL and “non- formulary” is defined as covered outpatient drugs not included in the SUPDL. The Contractor shall maintain formulary (i.e., SUPDL) and covered non-formulary (i.e., non-SUPDL) drug lists for the Contractor’s Healthy Indiana Plan packages. The Contractor must use the SUPDL as its formulary and may not develop and use its own PDL for any therapeutic categories that are part of the SUPDL. The Contractor will be provided opportunities to offer feedback on the SUPDL to the State. The State shall provide the Contractor with fifteen (15) calendar days’ notice of any change to the SUPDL, except those changes resulting from a drug shortage, recall or discontinuation, and the Contractor shall have an additional fifteen (15) calendar days to implement the change, including any system change. A drug that is on the SUPDL must have the same criteria and forms as the FFS PDL even if it is reimbursed as a medical claim.

Related to SUPDL and Formulary Requirements

  • Policy Requirements All of the policies of insurance referred to in this Article XIII shall be written in form reasonably satisfactory to Landlord and any Facility Mortgagee and issued by insurance companies with a minimum policyholder rating of “A-” and a financial rating of “VII” in the most recent version of Best’s Key Rating Guide, or a minimum rating of “BBB” from Standard & Poor’s or equivalent. If Tenant obtains and maintains the general liability insurance described in Section 13.1(e) above on a “claims made” basis, Tenant shall provide continuous liability coverage for claims arising during the Term. In the event such “claims made” basis policy is canceled or not renewed for any reason whatsoever (or converted to an “occurrence” basis policy), Tenant shall either obtain (a) “tail” insurance coverage converting the policies to “occurrence” basis policies providing coverage for a period of at least three (3) years beyond the expiration of the Term, or (b) an extended reporting period of at least three (3) years beyond the expiration of the Term. Tenant shall pay all of the premiums therefor, and deliver certificates thereof to Landlord prior to their effective date (and with respect to any renewal policy, prior to the expiration of the existing policy), and in the event of the failure of Tenant either to effect such insurance in the names herein called for or to pay the premiums therefor, or to deliver such certificates thereof to Landlord, at the times required, Landlord shall be entitled, but shall have no obligation, to effect such insurance and pay the premiums therefor, in which event the cost thereof, together with interest thereon at the Overdue Rate, shall be repayable to Landlord upon demand therefor. Tenant shall obtain, to the extent available on commercially reasonable terms, the agreement of each insurer, by endorsement on the policy or policies issued by it, or by independent instrument furnished to Landlord, that it will give to Landlord thirty (30) days’ (or ten (10) days’ in the case of non-payment of premium) written notice before the policy or policies in question shall be altered, allowed to expire or cancelled. Notwithstanding any provision of this Article XIII to the contrary, Landlord acknowledges and agrees that the coverage required to be maintained by Tenant may be provided under one or more policies with various deductibles or self-insurance retentions by Tenant or its Affiliates, subject to Landlord’s approval not to be unreasonably withheld. Upon written request by Xxxxxxxx, Tenant shall provide Landlord copies of the property insurance policies when issued by the insurers providing such coverage.

  • Technology Requirements In order to receive electronic communications, including Legal Disclosures, you must have: ● A computer or mobile device with an internet connection. ● iPhone versions iOS 10+ ● iPadOS 13.1 or Android 4.3+ ● A web browser that includes 256-bit encryption, with cookies enabled. ● The ability to view and retain Portable Document Format (PDF) files. ● A valid email address and mobile phone number. ● Sufficient storage space to save any Legal Disclosure or an installed printer to print them. ● We may change these requirements, but we will notify you promptly of any material changes.

  • Match Requirements There is no match required on the part of the Grantee under this Agreement.

  • Safety Requirements 17.1.1 The Concessionaire shall comply with the provisions of this Agreement, Applicable Laws and Applicable Permits and conform to Good Industry Practice for securing the safety of the Users. In particular, the Concessionaire shall develop, implement and administer a surveillance and safety programme for providing a safe environment on or about the Project, and shall comply with the safety requirements.

  • Health Requirements This is an active trip that requires you to make a realistic assessment of your health. To enjoy the trips as intended, a minimum level of fitness is required. All Participants are expected to be in active good health, to be comfortable traveling as part of a group, and to be ready to experience cultural differences with grace. Air Journey will require prior notice if any participant has any physical or other condition or disability that would prevent them from participating in active elements of any trip and/or could create a hazard to him or herself or to other members of the group. Air Journey may require guests to produce a doctor’s certificate certifying that they are fit to participate. Any physical condition requiring special attention, diet, or treatment should be reported in writing when the reservation is made. We will make reasonable efforts to accommodate Participants with special needs; however, we cannot accommodate wheelchairs. . Walking and climbing stairs are required in many hotels and airports, and are part of many excursions. If you require a slower pace, extra assistance, or the use of a cane or walking stick, arrangements will be made for private touring at each destination, if necessary, at the discretion of our Journey staff. Any extra cost for such arrangements will be the responsibility of the Participant. If you would like to forego some of the scheduled sightseeing to rejuvenate and relax, please feel free to do so at any time. Acting reasonably, if Air Journey is unable to properly accommodate the need of the person(s) concerned or believes that health and safety may be compromised, Air Journey reserves the right to refuse participation. Air Journey also reserves the right to remove from the trip, at the participant’s own expense, anyone whose physical condition or conduct negatively impacts the enjoyment of the other guests or disrupts the tour. Malaria and other diseases may be present in some of the countries featured in this itinerary; proof of yellow fever inoculation may be required. For the latest recommendations on specific health precautions for the areas you will visit, consult your physician and the Centers for Disease Control. The participant represents that neither he nor she nor anyone traveling with him or her has any physical or other condition or disability that could create a hazard to himself or herself or other members of the tour. Itinerary Changes The itinerary and Journey leaders are subject to modification and change by Air Journey. Every reasonable effort will be made to operate the Journey as planned; however, should unforeseen world events and conditions require our itinerary to be altered, Air Journey reserves the right to do so for the safety and best interest of the group without prior notification or consultation. The operation of these flights is subject to the foreign governments involved granting landing rights for the flight. If the air carrier cannot obtain these rights for any particular flight leg of the Journey, that flight leg will be canceled and alternative arrangements may be made, at the discretion of Air Journey. Every effort will be made to operate tours as planned but alterations may occur after the final itinerary has been issued.

  • Health and Safety Requirements The Contractor and his subcontractors ensure at all times compliance with safety regulations imposed by any Act of Parliament, ordinance or any regulation or by¬law of any local or statutory authority. Occupational Health and Safety Act (Act of 1993-Section 37) The Contractor shall comply with:  The Occupational Health and Safety Xxx, 0000, and all Regulations made there under;  All Eskom Safety and Operating Procedures listed in this Works Information. The Contractor acknowledges that it is fully aware of the requirements of all the above and undertakes to employ only people who have been duly authorised in terms thereof and who have received sufficient training to ensure that they can comply therewith. The Contractor undertakes not to do, or not to allow anything to be done which will contravene any of the provisions of the Act, Regulations or Safety and Operating Procedures. The Contractor shall appoint a person who will liaise with the Eskom Safety Officer responsible for the premises relevant to this contract. The person so appointed shall, on request:  Supply the Eskom Safety Officer with copies of minutes of all Health and Safety Committee meetings, whenever he is required to do so;  Supply the Eskom Safety Officer with copies of all appointments in respect of employees employed on this contract, in terms of the Act and Regulations and shall advise the Eskom Safety Officer of any changes thereto. Eskom may, at any stage during the currency of this agreement, be entitled to:  Do safety audits at the Contractor’s premises, its work-places and on its employees;  Refuse any employee, sub-contractor or agent of the Contractor access to its premises if such person has been found to commit any unlawful act or any unsafe working practice or is found to be not authorised or qualified in terms of the Act;

  • Residency Requirements 1. All single first-year freshmen students are required to live in University housing for at least two academic semesters. All single students who have earned less than 30 credit hours and have not resided in University housing for two academic semesters are required to live on campus for two academic semesters. This policy does not apply to single first-year students who have been out of high school for more than one year, or to single first-year freshmen who live with their parents in Miami-Dade or Broward Counties. Neither does it apply to those students who, for disciplinary or administrative reasons, may be denied the privilege of continued residency on campus.

  • Academic Requirements A. The Institutions agree to follow the joint program curriculum and course by course articulation delineated in Appendix 1, which is attached hereto and made a part of this Agreement.

  • Federal Medicaid System Security Requirements Compliance Party shall provide a security plan, risk assessment, and security controls review document within three months of the start date of this Agreement (and update it annually thereafter) in order to support audit compliance with 45 CFR 95.621 subpart F, ADP System Security Requirements and Review Process.

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