Please see attached monthly Argus MAC list.

©2015 by Argus Health Systems, Inc. All Rights Reserved. The computer systems, procedures, databases, software programs, documentation and other materials (collectively "Information") created, maintained or provided by Argus Health Systems, Inc. ("Argus"), are proprietary to Argus and are confidential. Bulletin MAC Pricing Changes Date: December 31, 2015 What You Need to Know Attention Argus WEST VIRGINIA Network Pharmacies: The MCO (Managed Care Organizations for Medicaid) requires that you have the option to be notified in advance of changes to the generic pricing utilized for West Virginia Family Health beneficiaries. Later this fall, we will be implementing enhancements to our Argus Pharmacy Portal which will allow you to subscribe to an alert system which will notify you when changes to the MAC pricing are being made. When that enhancement is completed, we will send another bulletin with instructions on how to register for those alerts. In the interim, we will be emailing the MAC changes to you at this email address. If you wish to OPT OUT, please reply to the email notification and add "OPT OUT" to the subject line before sending. We will gladly remove you from our distribution list. Action Required If you have any questions, please feel free to reach out to our MAC team via email to macinquiries@argushealth.com.

What You Need to Know   Attention Argus WEST VIRGINIA Network Pharmacies:   The MCO (Managed Care Organizations for Medicaid) requires that you have the option to be notified in advance of changes to the generic pricing utilized for West Virginia Family Health beneficiaries.  Later this fall, we will be implementing enhancements to our Argus Pharmacy Portal which will allow you to subscribe to an alert system which will notify you when changes to the MAC pricing are being made.  When that enhancement is completed, we will send another bulletin with instructions on how to register for those alerts.   In the interim, we will be emailing the MAC changes to you at this email address.  If you wish to OPT OUT, please reply to the email notification and add “OPT OUT” to the subject line before sending.  We will gladly remove you from our distribution list. Action Required If you have any questions, please feel free to reach out to our MAC team via email to macinquiries@argushealth.com

Effective January 1, 2016 This notice is to provide you with information on the actions taken by OptumRx to implement Maximum Allowable Cost (MAC) pricing and disclosure requirements that are effective beginning January 1, 2016. On April 6, 2015, CMS issued “Announcement of Calendar Year (CY) 2016 Medicare Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter.” In the Final Call Letter, CMS codified the MAC pricing requirements included in CMS-4159-F (final rule). The final rule added MAC pricing to existing prescription drug pricing standards, which requires pharmacy drug cost pricing to be updated at least every seven calendar days. Sponsors are also required now to disclose MAC prices to applicable pharmacies in advance of their use for reimbursement. The portion of the Final Call Letter that speaks to the MAC pricing disclosure requirement is below:

Effective January 1, 2016, in accordance with the Centers for Medicare and Medicaid Services (CMS) regulations in §§ 423.501, 423.505(b)(21), and 423.505(i)(3)(viii) Part D plans are required to disclose to pharmacies MAC prices to be updated in advance of their use for reimbursement of claims. To comply with these requirements, CVS/caremark Part D Services has implemented enhancements to its Pharmacy Portal/MAC inquiry tool, located at https://rxservices.cvscaremark.com/. The following is intended to assist pharmacies when navigating within the Pharmacy Portal in order to use the Medicare Part D MAC enhancements that will be effective on January 1, 2016.