Caremark: Audit Tips and Collecting Copays

The CVS Caremark Pharmacy Audit Department is providing its network pharmacies with reminder information regarding contractual and Medicare Part D requirements for copay collections.

Please login to view the full post

Keywords: Audit, Caremark, Centers for Medicaid & Medicare (CMS), Medicaid, Medicare, Processing, TrOOP

Catalyst Rx: Prescriber NPI Validation Edits at Point of Sale

Effective April 26, 2012 Catalyst Rx will implement edits at (POS) Point of Sale on submitted prescriber NPI’s for all Medicare Part D claims.

Please login to view the full post

Keywords: Catalyst Rx, Centers for Medicaid & Medicare (CMS), Edits, Medicaid, Medicare, Processing

Express Scripts: Medicare Part D Formulary Changes

The product changes noted below will be implemented on the Medicare Part D Plan for the following Express Scripts Medicare Part D clients.

Please login to view the full post

Keywords: Centers for Medicaid & Medicare (CMS), Express Scripts, Formulary, Medicaid, Medicare, Processing

Perform Rx: New CMS Revised Standardized Pharmacy Notice Medicare D

On February 13, 2012, PerformRx provided pharmacies with a copy of CMS’s Revised Standardized Pharmacy Notice (CMS-10147). Pharmacies must hand this notice to Part D enrollees when a prescription cannot be covered under the Medicare Part D benefit at the point-of-sale (POS).

Please login to view the full post

Keywords: Centers for Medicaid & Medicare (CMS), Medicaid, Medicare, PerformRx, Processing

MedImpact: Freshkote Removed From Group Health Clear Care Part D Formulary

Effective immediately, Freshkote Sterile Opthalmic Solution has been removed from the Group Health Clear Care Part D Formulary.

Please login to view the full post

Keywords: Centers for Medicaid & Medicare (CMS), Formulary, Medicaid, Medicare, MedImpact, Processing

MedImpact: Health Plus NY Medicaid Processor Change

Effective May 1, 2012, prescription benefits for HealthPlus Amerigroup Medicaid should be filled using the following information.

Please login to view the full post

Keywords: Centers for Medicaid & Medicare (CMS), Medicaid, Medicare, MedImpact, New York, Processing

Prescription Solutions: 2012 Formulary Changes Effective 7/1/2012

Changes to the 2012 formulary, for the following plans, will be posted on the websites listed in the table below.

Please login to view the full post

Keywords: Formulary, Prescription Solutions, Processing

Prescription Solutions: Morgan Stanley

Prescription Solutions by OptumRx will assume responsibility for claims processing for members of Morgan Stanley.

Please login to view the full post

Keywords: Prescription Solutions, Processing

Caremark: State of Hawai`i Employer-Union Health Benefits Trust Fund

Per the notification sent to your pharmacy on April 23, 2012, effective May 1, 2012, Caremark will begin processing claims for Hawai`i Employer-Union Health Benefits Trust Fund.

Please login to view the full post

Keywords: Caremark, Hawaii, Processing

Windsor Health Plan: MTM Program

Windsor Health Plan would like to thank those pharmacists who participated in its 2011 Medication Therapy Management (MTM) program and invite those who haven’t yet signed-up to become a participating provider in 2012.

Please login to view the full post

Keywords: Medication therapy management (MTM)