Common use of Program Responsibilities Clause in Contracts

Program Responsibilities. A. The Program agrees to reimburse the Provider in accordance with the rules and policies governing the WCSF Program. B. The Program will adjust payment to the Provider for the amount of any disapproved cost or expenditure in connection with this Agreement. C. The Program shall make a good faith effort to mail all Providers, no less than five (5) days before implementation, all final regulations and bulletins in connection with this Agreement. D. The Program agrees to pay to pharmacy providers a dispensing fee of $4.00 or the amount set forth by WCSF for approval, reimbursable WCSF claims. E. Provider reimbursement is determined as the lesser of usual and customary charge or AWP minus 12% plus a dispensing fee or Federal Upper Limits (FUL) plus a dispensing fee. Providers shall be reimbursed based upon the most current listing of Federal Upper Limits established in the Medicaid Program under 42 CFR § 447.332 (relating to Upper Limits for multiple source drugs). F. The Department shall update the Average Wholesale Costs and the Federal Upper Limits on a regular basis, at least every 30 days.

Program Responsibilities. A. The Program agrees to reimburse the Provider in accordance with the rules and policies governing the WCSF AUTOCAT Program. B. The Program will adjust payment to the Provider for the amount of any disapproved cost or expenditure in connection with this Agreement. C. The Program shall make a good faith effort to mail all Providers, no less than five (5) days before implementation, all final regulations and bulletins in connection with this Agreement. D. The Program agrees to pay to pharmacy providers a dispensing fee of $4.00 or the amount set forth by WCSF AUTOCAT for approval, reimbursable WCSF AUTOCAT claims. E. Provider reimbursement is determined as the lesser of usual and customary charge or AWP minus 12% plus a dispensing fee or Federal Upper Limits (FUL) plus a dispensing fee. Providers shall be reimbursed based upon the most current listing of Federal Upper Limits established in the Medicaid Program under 42 CFR § 447.332 (relating to Upper Limits for multiple source drugs). F. The Department shall update the Average Wholesale Costs and the Federal Upper Limits on a regular basis, at least every 30 days.