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Delaware State Supplemental Rebate Agreement And [MANUFACTURER NAME] The Delaware Department of Health and Social Services, Division of Medicaid and Medical Assistance (hereinafter Department or EMMA)

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How to fill out model supplemental rebate agreement

01

Review the terms and conditions of the model supplemental rebate agreement.

02

Fill in the required information such as company name, address, contact details, etc.

03

Specify the products or services covered by the agreement and the corresponding rebate amounts.

04

Include any special clauses or provisions that both parties agree to.

05

Sign and date the agreement to make it legally binding.

Who needs model supplemental rebate agreement?

01

Pharmaceutical companies that want to offer rebates to healthcare providers.

02

Healthcare providers looking to receive rebates for purchasing specific products or services.

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What is model supplemental rebate agreement?

Model supplemental rebate agreement is a agreement between a manufacturer and a Medicaid program to provide additional rebates for certain drugs.

Who is required to file model supplemental rebate agreement?

Manufacturers of prescription drugs are required to file model supplemental rebate agreement.

How to fill out model supplemental rebate agreement?

Model supplemental rebate agreement can be filled out by providing the required information about the drugs, pricing, and rebates.

What is the purpose of model supplemental rebate agreement?

The purpose of model supplemental rebate agreement is to ensure that Medicaid programs receive the best possible pricing for prescription drugs.

What information must be reported on model supplemental rebate agreement?

The information reported on model supplemental rebate agreement includes drug pricing, rebates, and Medicaid utilization data.

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