Kaiser Permanente

Medicare Prior Authorization rejections

and

Medicare opioid high dose alter DUR rejections

Effective 1/1/2017, Cigna has made formulary changes that may impact customers at your pharmacy. Cigna will limit the number of preferred drugs in certain drug classes within our formularies. Some drug classes will feature one or a select set of preferred brand name drugs, and other brand name equivalent drugs will only be covered by going through Cigna’s medical necessity review process. We have included a list of drugs – by drug class – that will be considered non-covered or non-preferred brand as of 1/1/17 and their covered alternatives. We sent letters to the customers and prescribers explaining the impact, based on their current medications.

*Please see the attached PDF for more information.

This week's Generic News includes the most recent Generics Campaign, items with pricing concerns, and more!

Dear Pharmacy Provider:

In accordance with Texas Labor Code §408.0281, OptumRX (formerly Catamaran) and Tech Health, Inc. are providing the following notification to network healthcare providers in the state of Texas.

Pursuant to the sixty (60) month agreement beginning October 1st 2011 OptumRX provides Tech Health with access to its network of providers at the discounted fee rate previously established by OptumRX and its providers. In an effort to comply with this Texas law, we are attaching a list of Tech Health clients who may access our pharmacy network.