Precluded Prescriber

In accordance with CMS Final Rule CMS-4182-F, CVS Caremark will begin rejecting any claims prescribed be an individual on the Preclusion List effective April 1, 2019.  Claims will reject with the following or similar:

CVS Caremark® Medicare Part D Services may add or remove drugs from our formulary during the year. If we remove drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug and/or move a drug to a higher cost-sharing tier, we will notify you of the changes at least sixty (60) days before the date the change becomes effective.

As has been previously communicated, CVS Caremark requires all contracted network providers to complete General Compliance and Fraud, Waste and Abuse (FWA) training on behalf of our client PDP plans.

To comply with CMS regulations, CVS Caremark requires all contracted network pharmacies to complete General Compliance and Fraud, Waste and Abuse (FWA) training.

CVS Caremark® Medicare Part D Services may add or remove drugs from our formulary during the year.