FutureScripts® will manage claims processing for members of AmeriHealth Administrators, Independence Administrators and Inter-County Health Plan.

IMPORTANT INFORMATION REGARDING

Recall of Amikacin Injection by Teva Pharmaceuticals

During a review of 2015 and 2016 claims processing of DEA schedule II (CII) prescription drug claims, PerformRx noticed an increase in the number of schedule II (CII) drugs being incorrectly billed as refills at the point of sale (POS). While this may have been due to an error in entering and submitting prescription claim information to PerformRx, efforts need to continually be made to prevent these types of errors as they can signal potential fraud, waste or abuse incorrectly. Pursuant to 21 U.S.C. § 829(a), refills of medications with a DEA schedule II (CII) designation are prohibited at POS.

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

Please see attached PDF file for more information.