About APCI

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Since 1984, APCI has been the ‘united voice of independent pharmacy’

APCI began as a small buying group for a limited number of independent pharmacies in central Alabama. Since that time, the cooperative has grown to more than 1,800 members pharmacies in 26 states, and provides its members with a wide range of products and services.

Our mission is to represent the economic and professional interests of independent pharmacies by providing leadership, vision, and a collective voice for our members in the healthcare marketplace. Our goal is to level the playing field for our member pharmacies by providing innovative, targeted programs to benefit our entire membership.

30

Aug

2016

CVS/caremark: New Implementation for South Carolina Medicaid Absolute Total Care Inc.

Effective: September 1, 2016

South Carolina MedicaidAbsolute Total Care, Inc. Note: Updated information is included on page two. As previously communicated by US Script and CVS Caremark®, Absolute Total Care began using the CVS Caremark pharmacy network on May 2, 2016, while claims processing and payment remained with US Script. This notice is to inform you that effective September 1, 2016, CVS Caremark will begin to process claims for Absolute Total Care. All claims for Absolute Total Care will now be reimbursed according to your CVS Caremark Network Enrollment Forms and be paid according to CVS Caremark processing rules and payment cycles, which will appear on your CVS Caremark 835 or remittance advice. Please update or create plan member profiles to reflect the claims processing changes and note new phone numbers included in this communication. RXBIN: 004336 RXPCN: MCAIDADV RXGROUP: RX5433 Member ID Format: 10 digits, numeric

30

Aug

2016

CVS/caremark: New Implementation for Illinois Medicaid IlliniCare Health

Effective: September 1, 2016

Illinois Medicaid IlliniCare Health Note: Additional information is included on page two. As previously communicated by US Script and CVS Caremark®, IlliniCare Health began using the CVS Caremark pharmacy network on April 13, 2016, while claims processing and payment remained with US Script. This notice is to inform you that effective September 1, 2016, CVS Caremark will begin to process claims for IlliniCare Health. All claims for IlliniCare Health will now be reimbursed according to your CVS Caremark Network Enrollment Forms and be paid according to CVS Caremark processing rules and payment cycles, which will appear on your CVS Caremark 835 or remittance advice. Please update or create plan member profiles to reflect the claims processing changes and note new phone numbers included in this communication. RXBIN: 004336 RXPCN: MCAIDADV RXGRP: RX5437 Member ID Format: 9 digits, numeric

26

Aug

2016

Medimpact: Amendment to MedCare® Pharmacy Network Agreement/ Policies and Procedures Manual

August 25, 2016

The MedCare® Pharmacy Networks Policies and Procedures Manual (“P&P Manual”) has been updated and is available on the MedImpact website under the Pharmacy Portal at: https://mp.medimpact.com/pharmacyportal/public/Frameset.jsp?forwardUrl=/pharmacyportal/public/PoliciesProcedures.jsp

26

Aug

2016

Argus: Louisiana 10-cent Provider Fee

Effective: September 29, 2016

 Date: August 26, 2016 Effective Date: September 29, 2016 Summary The Louisiana Provider Fee, when applicable, must be populated in the Flat Sales Tax Submitted (NCPDP field 481-HA). Any applicable sales tax must be submitted in the Percentage Sales Tax Amount Submitted (NCPDP field 482-GE). The amounts must not be combined and each amount must be individually submitted in the correct corresponding field. Argus will install claims processing logic on September 29, 2016, that will address reimbursement of the Louisiana 10-cent Provider Fee for applicable claims when the amount is submitted as described above. NOTE: The Universal Claim Form (UCF) includes only one sales tax field. When an amount is submitted in the UCF Sales Tax field for applicable Louisiana claims, Argus will calculate a $0.10 Provider Fee in addition to any applicable sales tax. Action Required If you have any questions concerning this bulletin or would like further information, please use the contact information provided on the customer specific payer sheet.

26

Aug

2016

Magellan: All TennCare Ambulatory Pharmacy Network Providers

August 24, 2016

To: All TennCare Ambulatory Pharmacy Network Providers Re: Coverage of up to a 91-day supply of insulin products The purpose of this notice to TennCare pharmacy providers is to clarify the intent of the coverage of up to a 91-day supply of insulin products. On March 29, 2016, Tennessee Code Annotated, Title 63, Chapter 10, Part 2 was amended allowing a pharmacist to "exercise professional judgment to dispense varying quantities of medication per fill up to the total number of dosage units as authorized by the prescriber on the original prescription including any refills, so long as the units dispensed do not exceed a ninety-day supply". Although pharmacists are allowed by Tennessee Law to fill prescriptions for maintenance medications up to a 90-day supply, TennCare still only covers 31 days supply due to the frequent change in eligibility status of our enrollees. For insulin products, please note that we allow up to a 91-day supply because of the fact that insulin doses and regimens are individualized, and in many cases, a single bottle of insulin cannot be used by a patient within a 31- day timeframe. Due to individualized dosing, and the inability to break a 10ml vial package, we allow up to a 91- day supply. At the same time, pharmacists should not automatically provide a 90-day supply simply because the law allows this. TennCare still covers only the least costly amount of the drug necessary to meet the doctor’s prescription.

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