Effective 12/12/2016

For most members in the following plans:

• AARP® MedicareRx
• AARP® MedicareComplete®
• UnitedHealthcare® MedicareComplete Plans
• United MedicareRx
• UnitedHealthcare MedicareRx Plans

Upon the release of the generic for the brand medication Zetia, the brand name version of Zetia will continue to be the preferred product. The generic Ezetimide will be a non-covered/non formulary drug.

Please continue to process claims for brand Zetia as it will process without any need of a prior authorization. The generic Ezetimide will be not be a covered drug and should reject as a non-covered/non formulary drug, if you get this reject, changing the drug back to brand Zetia will allow the drug to process.

In addition, if you get a paid claim for generic Ezetimide, please reverse the claim and continue to process for brand Zetia. You will see that as the brand Zetia is on the preferred tier, it will produce a lower copay amount for the member than processing the generic even if the generic pays.

TO REDUCE PROCESSING ERRORS, PLEASE CONFIRM THE INFORMATION ON MEMBER’S ID CARD PRIOR TO SUBMITTING PRESCRIPTION CLAIMS.

Effective Date: 11/01/2016

Volt Information Sciences, Inc.

BIN: 610011; PCN: IRX; Group: VOLT

Please note:

• All members of Volt Information Sciences, Inc. will receive a new member identification (ID) card as shown below.
• Please process prescriptions online using the Volt Information Sciences, Inc. ID card information.

*Please see attached PDF for more information.

First Fills

First Fills may be for work place injuries. Due to the potential sensitivity of these injuries, it is imperative to have the medications for these patients reviewed, approved and processed as quickly as possible. If a medication requires authorization, please contact the Cypress Care/OptumRx Help Desk immediately at 800-419-7191.

Please make sure first fill prescriptions for Ascension are being processed electronically. Injured workers should not have to pay for work related injury medications out of pocket. Ascension injured workers should have a signed authorization form for their first fills.

Retail Plan

Some workers’ compensation medications may require authorization before being dispensed. Medications that require prior authorization should not be identified as a denied prescription. In the event a claim rejects, reasonable attempts must be made to retransmit the claim. If the retransmission fails, please contact the Cypress Care/OptumRx Help Desk at 800-419-7191.

*Please see attached PDF for more information.