OptumRx : UnitedHealthCare - Retroactive Payment Adjustments for Pharmacies Contracted with UnitedHealthcare Community Plan in Mississipp

Author: Erica Lawrence/Thursday, December 28, 2017/Categories: APCI Choice

On April 1, 2017, UnitedHealthcare Community Plan in Mississippi changed how it reimbursed all contracted pharmacies for covered outpatient drugs to be compliant with the Mississippi Division of Medicaid (DOM) reimbursement requirements. During the implementation of the new pricing change, OptumRx, our pharmacy benefits manager, processed a small subset of pharmacy claims for drugs with invaild reimbursement rates.

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