As stated in previous notices, the Centers for Medicare and Medicaid Services requires all Medicaid providers’ enrollments to be revalidated by September 24, 2016. The Department strongly recommends that all provider enrollments be submitted in IMPACT by August 31, 2016 in order for staff to review and approve the enrollments prior to the revalidation deadline. Failure to submit a provider’s enrollment for revalidation and approval will result in disenrollment from Illinois Medicaid on September 25, 2016. Therefore, prior to providing any future Medicaid services and submitting claims, the provider must re-enroll as a new provider into the program and retroactive requests will not be allowed. More information on the IMPACT system plus frequently asked questions, webinars and other training guides are available at the IMPACT website: http://www.illinois.gov/hfs/impact/Pages/default.aspx. If you have any additional questions or need assistance, please contact the IMPACT Help Desk:  By email: IMPACT.HELP@illinois.gov  By phone: (877) 782-5565, option #1 For questions regarding this communication or other pharmacy related claims processing issues call: Provider Relations (877) 633-4701 or e-mail provider.relations@optum.com Please distribute immediately.

On June 1, 2016 the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin about Medicaid benefits available for the prevention, detection, and response to the Zika virus. Zika can cause severe birth defects in unborn children whose mothers are infected while pregnant. Because there is not a vaccine to prevent the disease or medicine to treat it, it is important for women to use repellent to protect themselves and unborn babies. Starting August 12, 2016, Sendero Health Plans will cover select mosquito repellents for its IdealCare clients. The following information describes the benefit details, including eligibility, benefit specifics and claims processing, and information about Zika virus.

On June 1, 2016 the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin about Medicaid benefits available for the prevention, detection, and response to the Zika virus. Zika can cause severe birth defects in unborn children whose mothers are infected while pregnant. Because there is not a vaccine to prevent the disease or medicine to treat it, it is important for women to use repellent to protect themselves and unborn babies.

Starting August 9, 2016, Texas will cover select mosquito repellents under the Medicaid Fee For Service (FFS) and managed care organizations (MCO), Children's Health Insurance Plan (CHIP) and Healthy Texas Women programs. Neither the Kidney Health Care (KHC) nor Children with Special Health Care Needs (CSHCN) Services programs will cover these products. The following describes the benefit details, eligibility, benefit specifics, and claims processing for mosquito repellent, and information about Zika virus.

Appropriate Billing of Medications

Purpose of communication: The CVS Caremark® Pharmacy Audit Department is providing network pharmacies with basic information on the appropriate billing of nasal spray medications to help prevent audit discrepancies and non-compliance with the CVS Caremark Provider Manual and Centers for Medicare and Medicaid Services (CMS) requirements.

This message is to remind the authorized individual at your pharmacy to ensure that your pharmacy’s NCPDP profile is up to date and accurate. Your pharmacy’s profile can be accessed at https://accessonline.ncpdp.org. Medicare beneficiaries use pharmacy directories to make decisions about their choice of pharmacy, and information in your pharmacy’s NCPDP profile informs those directories. CMS expects information in pharmacy directories to be accurate, and requires Medicare Plan sponsors to communicate with contracted pharmacies on a quarterly basis to verify that information. This message does not imply that your pharmacy’s information on file with NCPDP is necessarily inaccurate, but rather serves as a reminder to ensure that it is up to date.