Formulary Exception Process Sample Clauses

Formulary Exception Process. We have a formulary exception process that allows you to request coverage for a prescription drug that is not in our formulary. This process is available when:
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Formulary Exception Process. We have a formulary exception process that allows you to request coverage for a prescription drug that is not in our formulary. This process is available when (i) the requested prescription drug is NOT a generic equivalent of a formulary drug and your doctor determines that a formulary drug is not effective for you; or (ii) the requested non-formulary prescription drug has a generic equivalent and you have a clinical reason why you are unable to take the generic prescription drug (such as, you have had an adverse reaction to the generic medication). The process for obtaining an exception is described below. For a formulary exception where the requested prescription drug is NOT a generic equivalent of a formulary drug the prescribing provider may obtain a Medical Exception Form by visiting our Web site at XXXXXX.xxx or calling the Physician and Provider Service Center. Requests may be submitted in one of the following ways:  by fax: submit the form to Catamaran at 0-000-000-0000;  by phone: contact Catamaran at 0-000-000-0000; or  by mail: send the completed form to: Catamaran Prior Authorization
Sample 1Sample 2Sample 3See All (12)
Formulary Exception Process. We have a formulary exception process that allows you to request coverage for a prescription drug that is not in our formulary. This process is available when (i) the requested prescription drug is NOT a generic equivalent of a formulary drug and your doctor determines that a formulary drug is not effective for you; or (ii) the requested non-formulary prescription drug has a generic equivalent and you have a clinical reason why you are unable to take the generic prescription drug (such as, you have had an adverse reaction to the generic medication). The process for obtaining an exception is described below.
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Related to Formulary Exception Process

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  • Review and Selection Process The Project Narratives of SAMHSA applications are peer-reviewed according to the evaluation criteria listed above. Decisions to fund a grant are based on the strengths and weaknesses of the application as identified by peer reviewers. The results of the peer review are advisory in nature. The program office and approving official make the final determination for funding based on the following: • Individual awards over $250,000 are approved by the Center for Mental Health Services National Advisory Council; • Availability of funds; • Equitable distribution of awards in terms of geography (including urban, rural, and remote settings) and balance among populations of focus and program size; • Submission of any required documentation that must be submitted prior to making an award; and • SAMHSA is required to review and consider any information about your organization that is in the Federal Award Performance and Integrity Information System (FAPIIS). In accordance with 45 CFR 75.212, SAMHSA reserves the right not to make an award to an entity if that entity does not meet the minimum qualification standards as described in section 75.205(a)(2). If SAMHSA chooses not to award a fundable application in accordance with 45 CFR 75.205(a)(2), SAMHSA must report that determination to the designated integrity and performance system accessible through the System for Award Management (XXX) [currently, FAPIIS]. You may review and comment on any information about your organization that a federal awarding agency previously entered. XXXXXX will consider your comments, in addition to other information in FAPIIS in making a judgment about your organization’s integrity, business ethics, and record of performance under federal awards when completing the review of risk posed as described in 45 CFR 75.205 HHS Awarding Agency Review of Risk by Applicants.

  • 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;

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  • Application Process The employees wishing to enter into a job share arrangement will apply in writing to the Employer and forward a copy to the Union outlining the proposed commencement date of the job share, how the hours and days of work will be shared and how communication and continuity of work will be maintained. The Employer shall communicate a decision on a job share request in writing to the applicants. Applications to Job Sharing shall not be unreasonably denied.

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  • Notification Procedure (i) Each such notice shall be deemed to have been delivered:

  • Mediation Process A. Mediation is a form of Alternative Dispute Resolution (ADR) that may be requested by the City or the PBA. It is an alternative, not a substitute for the formal arbitration process contained in Section 19.7 above. Mediation is an informal process in which a neutral third party assists the opposing parties in reaching a voluntary, negotiated resolution of a charge of discipline. The decision to mediate is completely voluntary for the PBA and the City. Mediation gives the parties the opportunity to discuss the issues raised in the charging document, clear up misunderstandings, determine the underlying interests or concerns, find areas of agreement and, ultimately, incorporate those areas of agreement into solutions. A mediator does not resolve the charge or impose a decision on the parties. Instead, the mediator helps the parties to agree on a mutually acceptable resolution. The mediation process is strictly confidential. Information disclosed during mediation will not be revealed to anyone.

  • Application Procedures a) An employee applies for a listing on the system-wide registry through the employee’s Human Resources Department by completing the form in Appendix B.

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