14

Apr

2015

OptumRx: Notification- Maximum Allowable Cost (MAC) Pricing, Review and Appeals, MAC State-Specific-MI 3.2715

The below MAC Appeal process supersedes appeal resolution timing as described in Section IV, Subsection I (Pages 42 - 45) of the 2015 Pharmacy Manual:

7

Jan

2015

Tmesys MAC Reimbursement

This is to make you aware that between January 1 and January 6,  MAC transactions processed through Tmesys were pricing at an incorrect MAC rate.  Many pharmacies received reimbursements far below cost or previous MAC prices.  This pricing issue has been corrected as of 11:30 am EST and all MAC drugs are now pricing correctly.  We are in the process of reviewing all transactions that were affected and re-pricing these at the correct MAC rate.

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