Common use of Pharmacy Services Clause in Contracts

Pharmacy Services. CONTRACTOR shall provide sufficient controls over both its contracted and employed physicians/psychiatrists to be able to ensure strict adherence to the FDC’s drug formulary. Compliance with the FDC’s DER policy is required with one exception, an appropriately qualified CONTRACTOR representative shall stand in place of FDC to review and approve or deny DER, prior to prescribing any non-formulary medications. Subsets or restricted use of the FDC’s formulary that effectively limit, in any manner, the use of the FDC’s formulary are prohibited. Additionally, all medications shall be prescribed appropriately as indicated in the current edition of Drug Facts and Comparisons and the most recent Physicians’ Desk Reference. CONTRACTOR shall not prescribe non-therapeutic doses, or change, increase or decrease medication or dosages without providing ample time for the medication to take effect as provided for in the package insert. If this occurs, CONTRACTOR shall be considered non-compliant with the provisions of care in the Contract. Should there be a requirement for use of a non-therapeutic dosage or the need to prematurely change medication or dosages, there must be appropriate clinical justification documented in the chart as well as adherence to the DER process to gain approval. Practitioners’ prescribing practices shall be tracked monthly and reported by CONTRACTOR. Prescribing practices shall also be monitored for performance measure compliance.