Exception Process Sample Clauses

Exception Process. A Participating Agency which does not fully meet the standards set forth in this Section XV may submit a proposed plan to share Data to the Data Governing Board during the process of coming into full compliance with the stated requirements.
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Exception Process. If a Prescription Drug, including contraceptives, is not on Our Formulary, You, Your designee or Your prescribing Health Care Professional may request a Formulary exception for a clinically- appropriate Prescription Drug in writing, electronically or telephonically. The request should include a statement from Your prescribing Health Care Professional that all Formulary drugs will be or have been ineffective, would not be as effective as the non-Formulary drug, or would have adverse effects. If coverage is approved, the costs will count toward the Out-of-Pocket Maximum. If coverage is denied under Our standard or expedited Formulary exception process, You are entitled to an external appeal as outlined in the Complaints, Appeals and External Review section of this Policy. Visit Our website at xxx.xxxxxxx.xxx or call 0-000-XXXXX-00 to find out more about this process. For contraceptives only, We will defer to Your Provider’s recommendation of Medical Necessity and will provide the contraceptive service or FDA approved item without cost sharing upon request. Standard Review of a Formulary Exception. We will make a decision and notify You or Your designee and the prescribing Health Care Professional no later than 72 hours after Our receipt of Your request. If We approve the request, We will cover the Prescription Drug while You are taking the Prescription Drug, including any refills. Expedited Review of a Formulary Exception. If You are suffering from a health condition that may seriously jeopardize Your health, life or ability to regain maximum function or if You are undergoing a current course of treatment using a non-Formulary Prescription Drug, You may request an expedited review of a Formulary exception. The request should include a statement from Your prescribing Health Care Professional that harm could reasonably come to You if the requested drug is not provided within the timeframes for Our standard Formulary exception process. We will make a decision and notify You or Your designee and the prescribing Health Care Professional no later than 24 hours after Our receipt of Your request. If We approve the request, We will cover the Prescription Drug while You suffer from the health condition that may seriously jeopardize Your health, life or ability to regain maximum function or for the duration of Your current course of treatment using the non-Formulary Prescription Drug. Prescription Drug Program Limitations and Exclusions Limitations Coverage and benefit...
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Exception Process. For any potential Tax Equity Investment presented by GEV IA under this Agreement that does not satisfy all of the Tax Equity Investment Requirements, GEV IA and Parent agree to discuss such potential investment in good faith and consider any exceptions that could be made by Parent on a case-by-case basis. Any exception to the Tax Equity Investment Requirements in respect of a Tax Equity Investment will require the written approval of Parent, in its sole discretion, prior to the Parent Investor entering into any Tax Equity Transaction Documents or the execution of any term sheet or the like in relation thereto. GEV IA will provide Parent with written notice, as promptly as reasonably practicable, and in no event less than fifteen (15) Business Days’ prior to the date that GEV IA requests that such term sheet be issued, or the Tax Equity Investment Transaction Documents in respect of such potential Tax Equity Investment be entered into (including all information and underwriting materials related to such proposed exception), for Parent to consider whether to grant any such exception in its sole discretion. If such an exception is granted by Parent for a Tax Equity Investment in accordance with this Section 3.03, such Tax Equity Investment will be deemed to comply with the Tax Equity Investment Requirements if the Tax Equity Investment satisfies all requirements and conditions to the granting of the exception.
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Exception Process. In the case of patients who need a drug that is not included in the FDC, healthcare service providers and, as applicable, insurance companies must use the process described below to obtain approval of the drug by exception. This procedure will consider the particular merits of each case, which may include: a. Contraindication to the drug(s) included in the FDC; b. History of a clinically significant adverse reaction to the drug(s) included in the FDC; c. Evidence of therapeutic failure of all alternatives available in the FDC; and/or d. Lack of a therapeutic alternative in the FDC. This exception process requires a clinical justification that is duly documented by the service provider with the clinical reasons justifying the use of a non-formulary drug, which will be evaluated on a case-by-case basis by a clinical team at the insurance company(ies) contracted by ASES.
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Exception Process. If Franchisee proposes to purchase materials or supplies not theretofore approved by Pretzel Time as meeting its specifications, or from a supplier or distributor not previously approved by Pretzel Time, Franchisee shall first notify Pretzel Time and request Pretzel Time's approval using the special exception form provided to Franchisee in its Operations Manual, and pay any reasonable fees that Pretzel Time designates therefor. Further, Franchisee agrees to use all forms specified and developed by Pretzel Time for requesting any exceptions in products or suppliers. Pretzel Time may require submission of sufficient information and samples to determine whether such materials, supplies or suppliers meet its specifications as well as financial information regarding the supplier. Pretzel Time will advise Franchisee within a reasonable time whether such materials or supplies meet its specifications. Pretzel Time does not maintain a formal criteria for approving materials, supplies or suppliers. All approvals, disapprovals and revocations of approval of suppliers will be communicated to Franchisee, in writing, and shall be in the sole discretion of Pretzel Time. Franchisee must comply with the following conditions in order to seek a substitution for a Pretzel Time approved Product:
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Exception Process. In the case of patients who need a drug that does not appear in the PDL or in the FMU, the insurance companies, mental health organizations and health service providers must utilize the process described herein for the approval of the drugs. This procedure shall consider the particular merits of each case, which may include:
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Related to Exception Process

  • Selection Process The Mortgage Loans were selected from among the outstanding one- to four-family mortgage loans in the Seller's portfolio at the related Closing Date as to which the representations and warranties set forth in Subsection 9.02 could be made and such selection was not made in a manner so as to affect adversely the interests of the Purchaser;

  • Escalation Process 9.1. There will be times when the pharmacist will need additional advice or will need to escalate the patient to a higher acuity care location (e.g. back to their GP or an Urgent Treatment Centre or A&E).

  • Evaluation Process A. The immediate supervisor will meet with an employee at the start of the employee’s probationary, trial services, transition, and annual review period to discuss performance expectations. The employee will receive copies of their performance expectations as well as notification of any modifications made during the review period. Employee work performance will be evaluated during probationary, trial service and transition review periods and at least annually thereafter. Notification will be given to a probationary or trial service employee whose work performance is determined to be unsatisfactory.

  • Negotiation Process (a) If either the Chief Executive Officer of ICANN (“CEO”) or the Chairperson of the Registry Stakeholder Group (“Chair”) desires to discuss any revision(s) to this Agreement, the CEO or Chair, as applicable, shall provide written notice to the other person, which shall set forth in reasonable detail the proposed revisions to this Agreement (a “Negotiation Notice”). Notwithstanding the foregoing, neither the CEO nor the Chair may

  • Arbitration Process Any arbitration will be conducted pursuant to the applicable rules (the “Arbitration Rules”) of the American Arbitration Association, as modified herein, to the extent such modifications are not prohibited by the Arbitration Rules. The arbitration will be conducted in Indianapolis, Indiana. The parties will select a single arbitrator, but in the event that the parties are unable to agree, the arbitrator will be appointed pursuant to the Arbitration Rules. The arbitrator will be a practicing attorney with significant expertise in litigating and/or presiding over cases involving the substantive legal areas involved in the dispute. The parties to the arbitration will not request, and the arbitrator will not order, that any discovery be taken or provided, including depositions, interrogatories or document requests, except to the extent the amount in controversy exceeds $50,000. The arbitration will be concluded within three months of the date the arbitrator is appointed. The arbitrator’s findings, reasoning, decision, and award will be stated in writing and based upon applicable law. Judgment on the arbitration award may be entered in any court having jurisdiction. In the event that the arbitration results in an award which imposes an injunction or contains a monetary award in excess of $100,000, the award will be reviewable on appeal initiated by filing notice of appeal with the AAA office within 30 days of the award, governed by the AAA Optional Appellate Arbitration Rules and conducted by a panel of three new arbitrators, ruling by majority, under the procedure for appointment from the national roster of arbitrators. Unless the applicable Arbitration Rules require otherwise, arbitration fees and costs will be shared equally by the claimant(s) and respondent(s), respectively, in any arbitration proceeding. Should the AAA be unavailable, unable or unwilling to accept and administer the arbitration of any claim under these arbitration provisions as written, the parties will agree on a substitute arbitration organization, such as JAMS, that will enforce the arbitration provisions as written. Because this Agreement memorializes a transaction in interstate commerce, the Federal Arbitration Act governs the interpretation and enforcement of these arbitration provisions. More information about arbitration, including the Arbitration Rules, is available at xxx.xxx.xxx or by calling 0-000-000-0000.

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