Catamaran, an Optum Rx Company, will manage claims processing for members of Popular Community Bank. Please note:  All members of Popular Community Bank will receive a new member identification (ID) card as shown below.  Please process prescriptions online using the Popular Community Bank ID card information.

Catamaran, an Optum Rx Company, will manage claims processing for members of Health Alliance Medicare. Please note:  All members of Health Alliance Medicare will receive a new member identification (ID) card as shown below.  Please process prescriptions online using the Health Alliance Medicare ID card information.

Effective January 1, 2016 This notice is to provide you with information on the actions taken by OptumRx to implement Maximum Allowable Cost (MAC) pricing and disclosure requirements that are effective beginning January 1, 2016. On April 6, 2015, CMS issued “Announcement of Calendar Year (CY) 2016 Medicare Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter.” In the Final Call Letter, CMS codified the MAC pricing requirements included in CMS-4159-F (final rule). The final rule added MAC pricing to existing prescription drug pricing standards, which requires pharmacy drug cost pricing to be updated at least every seven calendar days. Sponsors are also required now to disclose MAC prices to applicable pharmacies in advance of their use for reimbursement. The portion of the Final Call Letter that speaks to the MAC pricing disclosure requirement is below:

OptumRx will assume responsibility for claims processing for members of Advocate Health Care Network. Please Note:  All plan participants of Advocate Health Care Network will receive a new member identification (ID) card. Please refer to the sample of the new ID card below.  Prescriptions need to be processed on-line using the Advocate Health Care Network ID card information.

Effective 01/01/2016 OptumRx will assume responsibility for claims processing for members of Samsung C&T America, Inc. Please Note:  All plan participants of Samsung C&T America, Inc. will receive a new member identification (ID) card. Please refer to the sample of the new ID card below.  Prescriptions need to be processed on-line using the Samsung C&T America, Inc. ID card information.