Between Dates of Service from April 1, 2017 through February 2, 2018, Envolve Pharmacy Solutions experienced errors within their system that prevented successful processing of some claims which reimbursed using the National Average Drug Acquisition Cost (NADAC) prices. The following errors have been identified and corrected as of February 2, 2018.

1. The September 2017 price file used by Envolve Pharmacy Solutions did not contain an actual NADAC price for 4 NDCs. These 4 NDCs without a true NADAC will now pay at WAC/AAC/U&C (as outlined in SPA 17-0002 Pharmacy Reimbursement).

2. On December 5, 2017, a file processing error led to new NADAC pricing not being loaded. Therefore, claims reimbursed at historic NADAC pricing. This file has been updated. As of February 2, 2018, all claims are being paid at the updated NADAC prices. To ensure that this does not occur again, the system will be monitored.

3. A Specialty Pharmacy claims error was discovered on November 2, 2017, and corrected on November 9, 2017. This error, which was a result of GCNs matched to NDCs incorrectly, impacted 71 specialty claims causing incorrect reimbursement.

*Please see attached for more information.