RightCare from Scott & White Health Plan is the Medicaid Managed Care Program provided by Scott & White Health Plan (SWHP) which provides both medical and pharmacy benefits.

This communiqué is being sent to prescribers and pharmacies who are TennCare’s most frequent providers of compounded prescriptions. As a result of the State of Tennessee’s Legislature adoption of budget reductions this coming fiscal year, TennCare will be managing prescription compounds by requiring prior authorization to ensure medical necessity, and by implementing a level of effort compound fee structure.

Dear Valued Provider,

Effective July 1, 2015, Blue Cross and Blue Shield of Minnesota (BCBSMN) Covered Person(s) compound claims that include bulk chemical ingredients (e.g. liquids, powders) or compounding kits will no longer be eligible for payment.

Effective July 1, 2015, Blue Cross Blue Shield of Alabama will be changing the coverage criteria for Non Part D compound claims.

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