Pursuant to attached Informational Letter #1783 issued by the state of Iowa, effective 30 days from the notice date, the dispensing fee for state of Iowa Medicaid pharmacy claims is being changed to $10.02, and will be retroactive to August 1, 2016.

Express Scripts administers the pharmacy benefit for Amerigroup members. Effective April 1, 2016, the following benefit changes will be implemented for these members. Claims Reimbursement Beginning April 1, 2016, reimbursement for Amerigroup Medicaid/CHIP claims will be based on the National Average Drug Acquisition Cost (NADAC) as posted by CMS. If the NADAC price is not available for a drug, the rates contracted for this plan sponsor will apply. Maximum Allowable Cost (MAC) pricing will not be applied to an Amerigroup Medicaid/CHIP claim if a NADAC price is available. Claims excluded from NADAC pricing will be as follows:  Claims for members designated as "Medically Needy" with an unmet spenddown balance.  Claims for members with other primary prescription insurance (TPL).

Beginning April 1, 2016, Express Scripts will be the pharmacy benefits manager (PBM) for Amerigroup Iowa Medicaid members. Following are some important updates about the pharmacy benefit for these members. Member