Amendment to 2016 Caremark Provider Manual:

In the West Virginia Addendum to Caremark Provider Agreement a new section is added beginning on page 260.

*Please see attached PDF for more information

Effective 1/1/2017, Cigna will be making 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 attached PDF for more information.

On October 1st, 2016, generic Vagifem (estradiol vaginal tablets) will become available to the market. Estradiol vaginal tablets will require a Prior Authorization by Florida Blue until multiple manufacturers become available or the price decreases. The innovator product Vagifem will continue to be covered*.

On October 01, 2016, generic Vagifem (estradiol vaginal tablets) will become available to the market. Estradiol vaginal tablets will not be covered by Blue Cross and Blue Shield of Kansas (BCBSKS) until multiple generic manufacturers become available or the price decreases. The innovator product, Vagifem, will continue to be covered*.

Effective Immediately for the 2016-2017 Flu Season, AmeriHealth Caritas Pennsylvania (ACPA) will reimburse pharmacies for administration of the injectable seasonal flu vaccine to all its members 19 years of age or older. AmeriHealth Caritas Pennsylvania (ACPA) members have a $0 copay for the flu vaccine.

*Please see attached PDF for more information.