Notwithstanding any other terms, conditions, and provisions of this AGREEMENT, the CONTRACTOR shall pay a PARTICIPATING PHARMACY as determined by the provisions of the agreement between the CONTRACTOR and PARTICIPATING PHARMACY. Disputes as to payment will be referred, on a timely basis, to the CONTRACTOR who shall actively attempt to settle the dispute with the PARTICIPATING PHARMACY in a reasonable time frame. The CONTRACTOR shall inform the DEPARTMENT as soon as is reasonably possible of any such disputes. If no settlement is reached after such referral and a lawsuit is brought against a PARTICIPANT, the PARTICIPANT shall contact the DEPARTMENT or the CONTRACTOR within fourteen (14) DAYS of the date on which the lawsuit is received by the PARTICIPANT. Within two (2) DAYS of the CONTRACTOR becoming aware of a lawsuit, the CONTRACTOR shall notify the DEPARTMENT about the lawsuit. 130D Automated Clearinghouse (ACH) The CONTRACTOR shall support an ACH mechanism to request and receive electronic funds transfer (EFT) of claims payments for BENEFITS. 135 Participant Materials and Marketing 135A Informational/Marketing Materials All materials and communications shall be pre-approved by the DEPARTMENT prior to distribution to PARTICIPANTS, potential PARTICIPANTS, and EMPLOYERS of the PHARMACY BENEFIT PLAN. This includes written and electronic communication, such as marketing, informational letters, explanation of BENEFITS, summary plan descriptions, claim denials and appeals, and summary of BENEFITS and coverage. All CONTRACTORs must follow the guidance issued in of the Affordable Care Act (ACA) and Federal civil rights laws. Upon request, the CONTRACTOR will provide information on programs, services, and activities in alternate formats to PARTICIPANTS with qualified disabilities as defined by the Americans with Disabilities Act (ADA) of 1990, as well as those whose primary language is not English. The notice in Appendix A of the federal ACA regulations must be published in conspicuously-visible font size in all significant communications and significant publications, both print and web, related to the State of Wisconsin and Wisconsin Public Employers Group Health Insurance Programs. The CONTRACTOR must use the notice as provided below, or a significantly similar version that meets the regulation requirements. and not defined in the law, are “Significant communications” “significant publications,” while interpreted broadly to include the following: Documents intended for the public, such as outreach, education, and marketing materials; Written notices requiring a response from an individual; and,
Notwithstanding any other terms, conditions, and provisions of this AGREEMENT, the CONTRACTOR shall pay a PARTICIPATING PHARMACY as determined by the provisions of the agreement between the CONTRACTOR and PARTICIPATING PHARMACY. Disputes as to payment will be referred, on a timely basis, to the CONTRACTOR who shall actively attempt to settle the dispute with the PARTICIPATING PHARMACY in a reasonable time frame. The CONTRACTOR shall inform the DEPARTMENT as soon as is reasonably possible of any such disputes. If no settlement is reached after such referral and a lawsuit is brought against a PARTICIPANT, the PARTICIPANT shall contact the DEPARTMENT or the CONTRACTOR within fourteen (14) DAYS of the date on which the lawsuit is received by the PARTICIPANT. Within two (2) DAYS of the CONTRACTOR becoming aware of a lawsuit, the CONTRACTOR shall notify the DEPARTMENT about the lawsuit. 130D Automated Clearinghouse (ACH) The CONTRACTOR shall support an ACH mechanism to request and receive electronic funds transfer (EFT) of claims payments for BENEFITS. 135 Participant Materials and Marketing 135A Informational/Marketing Materials All materials and communications shall be pre-approved by the DEPARTMENT prior to distribution to PARTICIPANTS, potential PARTICIPANTS, and EMPLOYERS of the PHARMACY BENEFIT PLAN. This includes written and electronic communication, such as marketing, informational letters, explanation of BENEFITS, summary plan descriptions, claim denials and appeals, and summary of BENEFITS and coverage. All CONTRACTORs must follow the guidance issued in of the Affordable Care Act (ACA) and Federal civil rights laws. Upon request, the CONTRACTOR will provide information on programs, services, and activities in alternate formats to PARTICIPANTS with qualified disabilities as defined by the Americans with Disabilities Act (ADA) of 1990, as well as those whose primary language is not English. The notice in Appendix A of the federal ACA regulations must be published in conspicuously-visible font size in all significant communications and significant publications, both print and web, related to the State of Wisconsin and Wisconsin Public Employers Group Health Insurance Programs. The CONTRACTOR must use the notice as provided below, or a significantly similar version that meets the regulation requirements. “Significant communications” and “significant publications,” while not defined in the law, are interpreted broadly to include the following: Documents intended for the public, such as outreach, education, and marketing materials; Written notices requiring a response from an individual; and,