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<br />18.2 N.C. Gen. Stat. § 58-3-227(h), Contract Negotiations. When offering a contract to a Health Care
<br />Provider, WellCare or Payor shall make available to Health Care Provider its schedule of fees associated with the top
<br />30 services or procedures most commonly billed by the class of Provider. Upon the request of the Health Care
<br />Provider, WellCare or Payor shall also make available the full schedule of fees for services or procedures billed by
<br />that class of provider(s). If Health Care Provider requests fees for more than 30 services and procedures, WellCare
<br />or Payor may require the Health Care Provider to specify the additional requested services and procedures and may
<br />limit the Health Care Provider’s access to the additional schedule of fees to those associated with services and
<br />procedures performed by or reasonably expected to be performed by such Health Care Provider. (Section VII,
<br />G(1)(x)(ii)).
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<br />18.3 N.C. Gen. Stat. § 58-50-275(a)-(b), Notice Contact. Provider and WellCare have set forth in the
<br />Agreement a “notice contact” provision listing the name or title and address of the person to whom all
<br />correspondence, including proposed Amendments and other notices, pertaining to the contractual relationship
<br />between the Parties shall be sent. Notwithstanding anything in the Agreement to the contrary, means for sending all
<br />notices provided under the Agreement is one or more of the following, calculated as (i) five business days following
<br />the date the notice is placed, first-class postage prepaid, in the United States mail; (ii) on the day the notice is hand
<br />delivered; (iii) for certified or registered mail, the date on the return receipt; or (iv) for commercial courier service,
<br />the date of delivery. Nothing in this section prohibits the use of an electronic medium for a communication other
<br />than an Amendment if agreed to by WellCare and Provider (Section VII, G(1)(x)(iv)).
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<br />18.4 N.C. Gen. Stat. § 58-50-280(a)-(d), Proposed Amendment. WellCare shall date, label
<br />“Amendment,” sign, include an effective date, and send any proposed Amendment to this Agreement or this
<br />Attachment to the notice contact of Provider. Provider will have sixty (60) days from the date of receipt to object to
<br />the proposed Amendment in writing. If Provider fails to object in writing within such sixty (60) days, the Amendment
<br />will be effective. If Provider timely objects to a proposed Amendment in writing, then WellCare may terminate the
<br />Agreement or this Attachment upon sixty (60) days’ written notice to Provider. (Section VII, G(1)(x)(v)).
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<br />18.5 N.C. Gen. Stat. § 58-50-285 (a)-(b), Policies and Procedures. WellCare or Payor shall provide a
<br />Health Care Provider with a copy of its policies and procedures prior to execution of a new or amended contract and
<br />annually to all Participating Providers. Such policies and procedures may be provided in hard copy, CD or other
<br />electronic format, and may also be provided by posting the policies and procedures on the WellCare or Payor website.
<br />Such policies and procedures will not conflict with or override any term of a contract, including contract fee
<br />schedules. In the event of a conflict between a policy or procedure and the language in a contract, the contract
<br />language shall prevail. (Section VII, G(1)(x)(vi)).
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<br />18.6 N.C. Gen. Stat. § 58-51-37(d)-(e), Pharmacy Participation. To the extent Participating Provider is a
<br />pharmacy or pharmacist, this Section applies. Participating Provider shall not waive, discount, rebate, or distort a
<br />copayment or a Covered Person’s portion of a prescription drug coverage or reimbursement. If Participating Provider
<br />provides a pharmacy service to a Covered Person that meets the terms and requirements of the Coverage Agreement,
<br />Participating Provider shall provide its pharmacy services to all Covered Persons covered by that Coverage
<br />Agreement on the same terms and requirements. A violation of the foregoing is a violation of the Pharmacy Practice
<br />Act subjecting the pharmacist to disciplinary authority of the North Carolina Board of Pharmacy. At least sixty (60)
<br />days before the effective date of a Payor providing reimbursement to North Carolina residents for prescription drugs,
<br />which restricts pharmacy participation, WellCare or Payor shall notify, in writing, all pharmacies within the
<br />geographical coverage area of the Coverage Agreement and offer to the pharmacies the opportunity to participate
<br />under identical reimbursement terms for providing pharmacy services, including prescription drugs. WellCare shall,
<br />through reasonable means, on a timely basis, and on regular intervals in order to effectuate the purposes of this
<br />section, inform the Covered Persons of the Coverage Agreement of the names and locations of pharmacies that are
<br />participating in the plan as providers of pharmacy services and prescription drugs. Additionally, participating
<br />pharmacies shall be entitled to announce their participation to their customers through a means acceptable to the
<br />pharmacy and WellCare. The pharmacy notification provisions of this section do not apply when an individual or
<br />group is enrolled, but when WellCare enters a particular county of the State. (Section VII, G(1)(x)(vii)).
<br />DocuSign Envelope ID: 2EC1F0FD-FAF9-4B42-B52E-D419F55A6210
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