PacifiCare’s Right to Modify the PacifiCare-Sponsored Carve-Out Programs Sample Clauses

PacifiCare’s Right to Modify the PacifiCare-Sponsored Carve-Out Programs. On a semi-annual basis and or as directed by applicable law or regulatory requirement(s), and at its sole discretion, PacifiCare reserves the right to make additions or deletions to the list of Carve-Out Program Covered Services, drugs and agents. PacifiCare shall provide Medical Group with 30 days’ advanced notice of such changes. Upon any such change, PacifiCare shall notify Medical Group of any adjustment to Medical Group’s compensation resulting from such changes, which adjustment shall be determined using reasonable actuarial standards, taking into account other changes in compensation made pursuant to Section 5.1, all as determined by PacifiCare.
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PacifiCare’s Right to Modify the PacifiCare-Sponsored Carve-Out Programs. On a semi-annual basis and or as directed by applicable law or regulatory requirement(s), and at its sole discretion, PacifiCare reserves the right to propose additions or deletions to the list of Carve-Out Program Covered Services, drugs and agents. PacifiCare shall provide Medical Group with forty-five (45) calendar days’ advanced notice of such changes, which notice shall include PacifiCare’s proposed adjustment to Medical Group’s compensation resulting from such changes, which adjustment shall be determined using reasonable actuarial standards, taking into account other changes in compensation made pursuant to Section 5.1 , all as determined by PacifiCare. Medical Group shall use reasonable efforts to review PacifiCare’s proposal within thirty (30) calendar days. Medical Group and PacifiCare shall enter into an Amendment to this Agreement documenting any agreement they may reach on any changes to the list of Carve-Out Program Covered Services, drugs and agents.
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