31

Aug

2016

CVS/Caremark: Amendment to 2016 Caremark Provider Manual - Georgia Addendum to Caremark Provider Agreement

Effective: Immediately

A. In the Georgia Addendum to Caremark Provider Agreement, Georgia Medicaid sub-section of the Provider Manual (beginning on page 97), the following language: "To the extent Provider provides Pharmacy Services to Eligible Persons who are enrollees under the Georgia Medicaid program administered by the Plan Sponsor, Provider agrees to the following:" is deleted in its entirety and replaced with the following: "To the extent Provider provides Pharmacy Services to Eligible Persons who are enrollees under the Georgia Medicaid program administered by a Care Management Organization ("CMO" or "Plan Sponsor"), Provider agrees to the following:" B. In the Georgia Addendum to Caremark Provider Agreement, Georgia Medicaid sub-section of the Provider Manual (beginning on page 97), the following new section is added: 31. "Provider shall comply with DCH lock-in programs applicable to an Eligible Person by referring the Eligible Person to the appropriate pharmacy."

30

Aug

2016

US Script: US Script and CVS/caremark Network Transition ALERT – IMPORTANT CLAIMS PROCESSING NOTIFICATION

Effective: September 1, 2016

Effective September 1, 2016 - pharmacy claims processing for Peach State Health Plan, Inc. will transition from US Script to CVS/caremark. All claims for Peach State Health Plan, Inc. will now be reimbursed according to your CVS/caremark Network Enrollment Forms and will be paid according to CVS/caremark processing rules and payment cycles, which will appear on your CVS/caremark 835 or remittance advice. New Member ID cards will be issued to Members. Please update your system with these claims processing changes: RXBIN: 004336 RXPCN: MCAIDADV RXGRP: RX5439 This transition will impact all US Script pharmacy networks. As a reminder, continue to process claims to US Script under BIN: 008019 until the above effective date. After such time claims will reject and should be processed under the CVS/caremark RXBIN, RXPCN, RXGRP provided or refer to the CVS/caremark New Implementation Notice. If you have any questions for US Script, please email your inquiry to pharmacynetworkteam@usscript.com or call provider services at 844-297-0513.

30

Aug

2016

US Script: US Script and CVS/caremark Network Transition ALERT – IMPORTANT CLAIMS PROCESSING NOTIFICATION

Effective: September 1, 2016

Effective September 1, 2016 - pharmacy claims processing for IlliniCare Health Plan, Inc. will transition from US Script to CVS/caremark. All claims for IlliniCare Health Plan, Inc. will now be reimbursed according to your CVS/caremark Network Enrollment Forms and will be paid according to CVS/caremark processing rules and payment cycles, which will appear on your CVS/caremark 835 or remittance advice. New Member ID cards will be issued to Members. Please update your system with these claims processing changes: RXBIN: 004336 RXPCN: MCAIDADV RXGRP: RX5437 This transition will impact all US Script pharmacy networks. As a reminder, continue to process claims to US Script under BIN: 008019 until the above effective date. After such time claims will reject and should be processed under the CVS/caremark RXBIN, RXPCN, RXGRP provided or refer to the CVS/caremark New Implementation Notice. If you have any questions for US Script, please email your inquiry to pharmacynetworkteam@usscript.com or call provider services at 844-276-1408.

30

Aug

2016

US Script: US Script and CVS/caremark Network Transition ALERT – IMPORTANT CLAIMS PROCESSING NOTIFICATION

Effective: September 1, 2016

Effective September 1, 2016 - pharmacy claims processing for Buckeye Health Plan will transition from US Script to CVS/caremark. All claims for Buckeye Health Plan will now be reimbursed according to your CVS/caremark Network Enrollment Forms and will be paid according to CVS/caremark processing rules and payment cycles, which will appear on your CVS/caremark 835 or remittance advice. New Member ID cards will be issued to Members. Please update your system with these claims processing changes: RXBIN: 004336 RXPCN: MCAIDOH RXGRP: RX5434 This transition will impact all US Script pharmacy networks. As a reminder, continue to process claims to US Script under BIN: 008019 until the above effective date. After such time claims will reject and should be processed under the CVS/caremark RXBIN, RXPCN, RXGRP provided or refer to the CVS/caremark New Implementation Notice. If you have any questions for US Script, please email your inquiry to pharmacynetworkteam@usscript.com or call provider services at 844-297-0511.

30

Aug

2016

CVS/Caremark: Amendment to 2016 Caremark Provider Manual- Nondiscrimination in Health Programs and Activities

Effective: July 18, 2016

In the Federal and State Laws and Regulations section of the Provider Manual (on page 69), a new section is added after the Patients’ Bill of Rights sub-section, as follows: Nondiscrimination in Health Programs and Activities Pursuant to Section 1557 of the Patient Protection and Affordable Care Act (42 U.S.C. 18116) which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities, and as a health care provider of Pharmacy Services for covered entities subject to 45 CFR Part 92 "Nondiscrimination on the Basis of Race, Color, National Origin, Sex, Age, or Disability in Health Programs or Activities Receiving Financial Assistance and Health Programs or Activities Administered by the Department of Health and Human Services or Entities Established Under Title I of the Patient Protection and Affordable Care Act," Provider agrees to comply with 45 CFR Part 92 to the extent applicable to Pharmacy Services provided to covered entities’ Eligible Persons. Such compliance shall include, but is not limited to, nondiscrimination under 45 CFR 92.101, providing meaningful access for individuals with limited English proficiency under 45 CFR 92.201, providing effective communication for individuals with disabilities under 45 CFR 92.202, meeting accessibility standards for buildings and facilities under 92.203, and providing equal access on the basis of sex under 45 CFR 92.206. This communication and any attachments may contain confidential information. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution, or copying of it or its contents, is prohibited. If you have received this communication in error, please notify the sender immediately by telephone and destroy all copies of this communication and any attachments. This communication is a Caremark Document within the meaning of the Provider Manual. Page 1

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