Dear Valued Provider, Effective April 1, 2016, Blue Cross and Blue Shield of Alabama is updating the buprenorphine and buprenorphine/naloxone for opioid dependence Prior Authorization (PA) policy for Commercial and Health Insurance Marketplace (HIM) plans. There is no coverage provided for these products when used for the treatment of acute or chronic pain.

Beginning April 1, 2016, Express Scripts will be the pharmacy benefits manager (PBM) for Amerigroup Iowa Medicaid members. Following are some important updates about the pharmacy benefit for these members. Member

Vistana Effective April 1, 2016, CVS/caremark will begin to administer the prescription benefits for Vistana. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS/caremark. RXBIN: 004336 RXPCN: ADV RXGRP: RX0144 Member ID Format: 9 digits, alphanumeric Person Code : 2 digits

On March 13, 2016 from 12:00 a.m. ET to 5:00 a.m. ET, the CVS Caremark® claims adjudication system will be unavailable while maintenance is conducted. The following or similar reject will occur during this time: << HOST UNAVAILABLE >>. Providers must resubmit claims after maintenance is completed. As stated in the CVS Caremark Provider Manual, unscheduled system maintenance or other circumstances may occur when the adjudication platform(s) may not be available to adjudicate claims for a limited time. At any time, a Provider may contact the Pharmacy Help Desk for assistance or information regarding any claim processing related question. Pharmacy Help Desk Representatives are available 24 hours a day, 7 days a week. Note: Providers are reminded that, pursuant to the Provider Agreement, Providers must render services unless professional judgment dictates otherwise.

Dear Pharmacy Provider, The purpose of this letter is to notify you that, effective April 1, 2016; PerformRx will be providing pharmacy benefit management services to Partners Health Plan. Your provision of Pharmacy Services to Partners Health Plan members will be governed by the terms and conditions of your PerformRx Participating Pharmacy Agreement. The fee schedule for Partners Health Plan is the same as the fee schedule in the national agreement(s).