Effective January 1, 2014, OptumRx will accept Patient Residence Code (PRC) 01 and Pharmacy Service Type (PST) 01 on Medicare Part D claims. The following chart lists the PRCs OptumRx will accept based on the patient setting.

Cigna recently decided it will not transition its commercial customers to the RxClaim processing platform. Accordingly, the 15 Cigna commercial clients currently on RxClaim will transition to Argus as of June 1, 2015.

Health Partners Medicare allows their members to receive up to a 90 days’ supply of medications at participating retail pharmacies. Members can receive a 3 month supply of medication and only be charged two copays.

Please see attached reminder of the MedImpact Medicare Part D Plans for 2015.

TEMPORARILY your pharmacy was able to process claims for all Aetna Part D plans at CVS/Caremark Medicare Part D Network 12 and CVS/Caremark Medicare Part D Extended Days Supply Network 12 in network reimbursement rates. TEMPORARY ACCESS was effective for claims dating back to January 1, 2015. Please be advised that your TEMPORARY ACCESS for certain plans is through March 31, 2015.

This means that effective April 1, 2015 your pharmacy will receive Reject 40 (out-of-network) notices for claims submitted for the Standard and Standard Preferred Networks (Please download the PDF file listed below for more details).