How to File an Appeal of a Prescription Drug Denial For denials of a prescription drug claim based on our determination that the service was not medically necessary or appropriate, or that the service was experimental or investigational, you may request an appeal without first submitting a request for reconsideration. You or your physician may file a written or verbal prescription drug appeal with our pharmacy benefits manager (PBM). The prescription drug appeal must be submitted to us within one hundred and eighty (180) calendar days of the initial determination letter. You will receive written notification of our determination within thirty (30) calendar days from the receipt of your appeal. How to File an Expedited Appeal Your appeal may require immediate action if a delay in treatment could seriously jeopardize your health or your ability to regain maximum function, or would cause you severe pain. To request an expedited appeal of a denial related to services that have not yet been rendered (a preauthorization review) or for on-going services (a concurrent review), you or your healthcare provider should call: • our Grievance and Appeals Unit; or • our pharmacy benefits manager for a prescription drug appeal. Please see Section 9 for contact information. You will be notified of our decision no later than seventy-two (72) hours after our receipt of the request. You may not request an expedited review of covered healthcare services already received.
Time Limit for Filing The parties may mutually agree in writing to extend any of the time limits set forth in this Agreement.
Motion for Preliminary Approval The Parties agree to jointly prepare and file a motion for preliminary approval (“Motion for Preliminary Approval”) that complies with the Court’s current checklist for Preliminary Approvals.
Accurate and Timely Submission of Reports a) The reports and administrative fees shall be accurate and timely and submitted in accordance with the due dates specified in this section. Vendor shall correct any inaccurate reports or administrative fee payments within three (3) business days upon written notification by DIR. Vendor shall deliver any late reports or late administrative fee payments within three (3) business days upon written notification by DIR. If Vendor is unable to correct inaccurate reports or administrative fee payments or deliver late reports and fee payments within three
Office of Inspector General Investigative Findings Expert Review In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government Code, Section 531.102(m-1)(2) is applicable to this Contract, Contractor affirms that it possesses the necessary occupational licenses and experience.
REPORT SUBMISSION 1. Copies of reporting packages for audits conducted in accordance with 2 CFR Part 200, Subpart F-Audit Requirements, and required by PART I of this form shall be submitted, when required by 2 CFR 200.512, by or on behalf of the recipient directly to the Federal Audit Clearinghouse (FAC) as provided in 2 CFR 200.36 and 200.512
HHS Single Audit Unit will notify Grantee to complete the Single Audit Determination Form If Grantee fails to complete the form within thirty (30) calendar days after receipt of notice, Grantee maybe subject to sanctions and remedies for non-compliance.
Deadline for Submission of Bids 19.1 Bids must be received by the Purchaser at the address specified under ITB Clause 18.2 no later than the time and date specified in the Bid Data Sheet. 19.2 The Purchaser may, at its discretion, extend this deadline for the submission of bids by amending the bidding documents in accordance with ITB Clause 7, in which case all rights and obligations of the Purchaser and bidders previously subject to the deadline will thereafter be subject to the deadline as extended.
Examination of an application for an industrial design 1. A formal examination of the application for an industrial design received by the federal executive authority for intellectual property is carried out which includes checks on presence of the documents specified in clause 2 of Article 1377 of the Civil Code of the Russian Federation and its compliance with the established requirements. If the result of the formal examination is positive, then a substantive examination of an application for an industrial design is carried out, which includes: information search in relation to the claimed industrial design to determine the publicly available information, which shall be taken into account when examining the design patentability; examination of the claimed industrial design for the compliance with the requirements under Article 1231.1, clause 4 of Article 1349 of the Civil Code of the Russian Federation, and the patentability criteria under the first paragraph of clause 1, clause 5 of Article 1352 of the Civil Code of the Russian Federation; examination of the claimed industrial design for the compliance with the patentability criteria under the second paragraph of clause 1 of Article 1352 of the Civil Code of the Russian Federation. An information search in relation to the objects specified in sub-clause 4 of clause 4 of Article 1349 of the Civil Code of the Russian Federation shall not be carried out, and the federal executive authority on intellectual property notifies the applicant about it. 2. If, as a result of the substantive examination of an application for an industrial design, it is found that the claimed industrial design represented on the reproductions of an external appearance of the article does not relate to the objects specified in Article 1231.1 or clause 4 of Article 1349 of the Civil Code of the Russian Federation and meets the patentability criteria under Article 1352 of the Civil Code of the Russian Federation, the federal executive authority for intellectual property makes a decision to grant a patent for an industrial design. The date of filing of the application for the industrial design and the priority date of the industrial design shall be specified in the decision. If, during the process of substantive examination of an application for an industrial design, it is found that the claimed object does not meet at least one of the requirements or patentability criteria specified in paragraph one of this clause, the federal executive authority for intellectual property makes a decision to refuse the issuance of a patent.
Filing a Grievance Grievances may be filed by the Union on behalf of an employee or on behalf of a group of employees. If the Union does so, it will set forth the name of the employee or the names of the group of employees.
