Please review the attached memo from CMS, related to upcoming changes to the Eligibility Verification (E1) transaction responses from the Transaction Facilitator (RelayHealth).

Pharmacies are required to complete the credentialing and re-credentialing process as well as keep updated documentation on file at all times in order to participate in the MeridianRx Pharmacy Network.  

Starting in February 2018, OptumRx, the pharmacy benefit manager for UnitedHealthcare Employer and Individual, will now allow an approved diagnosis code (ICD10) to be entered at the Point of Sale for select medications that require Prior Authorization.

Starting February 19, 2018, you’ll be able to complete comprehensive medication reviews and medication therapy management (MTM) services through OutcomesMTM® for eligible UnitedHealthcare Medicare Advantage benefit plan members who have Medicare Part D coverage.