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To: IPA Members From: Heather Rodgers 1/24/071. AETNA PRICING ON GENERIC OXYCONTINThe prices below have been backdated effective 12/05/06 to 12/31/06; you should now reverse and reprocess your claims to be reimbursed at this adjusted rate.
OXYCODONE TAB 10MG CR 1.1743 per unit OXYCODONE TAB 20MG CR 2.247 per unit OXYCODONE TAB 40MG CR 3.987 per unit OXYCODONE TAB 80MG CR 6.2 per unit The prices below have been backdated effective 01/01/07; you should now reverse and reprocess your claims to be reimbursed at this adjusted rate. OXYCODONE TAB 10MG CR removed from MAC list OXYCODONE TAB 20MG CR removed from MAC list OXYCODONE TAB 40MG CR removed from MAC list OXYCODONE TAB 80MG CR 6.2 per unit
2. HORIZON BLUE CROSS AND BLUE SHIELD OF NJ CO-PAY WAIVER
Some of you may have filled prescriptions for Horizon BCBSNJ patients and received a $0 co-pay. This is not an error. Horizon BCBSNJ has implemented a pilot program in which co-pays for some members are waived when they switch from the multi-source brand or a non-preferred to the generic equivalent. Claims will be adjudicated with a $0.00 co-pay for the prescriptions that qualify.
3. HORIZON NJ HEALTH MAC ADJUSTMENT
The MAC price for Vitafol PN has been increased from $0.385 to $0.42 per tablet. They are still reviewing the MAC price and will likely increase it again in the near future. If you filled any of these claims, reverse and resubmit for proper payment. We will send out an update if and when the new MAC price is determined.
4. PHARMACY FREEDOM FUND UPDATE
“It has been more than two years since we have been able to bring you any GOOD NEWS on our lawsuits against the PBMs, but this truly is good news. The judge’s ruling in our lawsuit against Advance PCS, wherein he ordered us into arbitration, has been rescinded. Therefore, the stalled lawsuit is now proceeding.” Bob Gude, R.Ph., President.
If you have any questions please call Heather Rodgers at 800-575-2667. |