A statewide series of 15 provider forums will be held in February and March for physicians, hospital officials and other interested healthcare professionals who want to learn more about how the Agency’s implementation of Regional Care Organizations will impact them.

With Alabama’s 2016 regular session set to begin on Tuesday, February 2nd, I thought I might give a little preview of what we might expect or not expect.

The governors of Alabama, Illinois, Georgia, Missouri, New Mexico and Texas have declared States of Emergency due to Storm Goliath. Due to this issuance, Express Scripts has implemented Emergency Refill Too Soon procedures in the states of Alabama, Illinois, Georgia, Missouri, New Mexico and Texas for Part D and Medicare Advantage plans. Effective immediately, if a patient from the disaster area attempts to fill a prescription for lost or damaged medication resulting from the disaster, and the claim rejects with NCPDP Reject 79 "Refill Too Soon," the pharmacy should enter override code 91100000001 in NCPDP vD.0 field 462-EV "Prior Auth Number Submitted."

Dear Valued Provider, Effective January 1, 2016, Blue Cross and Blue Shield of Alabama is adding a new definition to their prescription drug guidelines for Commercial and Health Insurance Marketplace (HIM) plans. This definition clarifies coverage of prescription products approved by the Food and Drug Administration (FDA). Prescriptions for products not approved by the FDA are not covered. FDA-approved drug coverage will be defined as follows: coverage is limited to prescription products approved by the Food and Drug Administration (FDA) as evidenced by a New Drug Application (NDA), Abbreviated New Drug Application (ANDA), or Biologics License Application (BLA) on file. Any legal requirements or group specific benefits for coverage will supersede this (e.g., preventive drugs per the Affordable Care Act).