Express Scripts is updating the process for submitting Florida Informed Consent Medicaid claims effective January 1, 2017. Pharmacies will need to submit Clarification Code 11 "Certification on File" in order for these claims to process. Please note impacted claims will have the secondary message "UNDER 13, RESUBMIT SCC 11, CERT ON FILE" as a reminder.

Currently pharmacies need to enter Prior Authorization (PA) type code 2 to identify they have the Florida Informed Consent on file and override reject 60 "Product/Service Not Covered for Patient Age."

Effective January 1, 2017, Aetna Better Health of Illinois will be applying two new safety Drug Utilization Review (DUR) edits to improve patient safety.

*Please see the attached PDF for more information.

Effective January 1, 2017, CVS Caremark® will begin to administer the prescription benefits for CareSource, Indiana Medicaid program. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS Caremark.

*Please see attached PDF for more information.

RXBIN: 004336

RXPCN: MEDDADV

RXGRP: RX7816

VIVA Health, Inc. is a current Plan Sponsor with CVS Caremark®. Effective January 1, 2017, please continue to process claims for Medicare Part D to CVS Caremark using the claims processing information above. CVS Caremark will no longer process claims for VIVA commercial plans.

Effective January 1, 2017, Aetna Better Health of Ohio will be applying two new safety Drug Utilization Review (DUR) edits to improve patient safety.

*Please see attached PDF for more information.