The chart on below describes the DUR reject edits and associated PPS codes that can be used to override rejects when applicable. Be sure to review the entire DUR message for instructions. This may require viewing additional screens in your software application. Additionally, a single claim may trigger more than one concurrent DUR reject. Pharmacists will need to enter the corresponding PPS codes documenting their action for each reject. Please note: Do NOT save PPS and Result of Service Codes on any prescriptions that have previously rejected for DUR. For an initial fill or any refills, pharmacies CANNOT pre-empt the reject by entering PPS Codes prior to the first submission of the claim. You must allow the reject to occur and then enter the appropriate PPS Codes on resubmission. Entering PPS Codes prior to allowing the claim to reject will cause the claim to continue to reject.

Dear Valued Provider, Due to the recent severe weather in Texas, Prime Therapeutics has implemented its Natural Disaster Relief protocol to assist our client and their Covered Persons in the affected areas in Texas. Covered Persons of Blue Cross and Blue Shield of Texas (BCBSTX) STAR and CHIP Medicaid Programs may experience difficulty obtaining new prescriptions or refills for lost medication or medications left behind when evacuating their homes.

December 28, 2015 Dear Valued Provider, Effective January 1, 2016, BlueCross BlueShield of New Mexico will no longer be handling prior authorizations for Blue Cross Community Centennial (NM Medicaid) Covered Persons. Prime Therapeutics will begin to review Prior Authorizations and enter claim overrides for Covered Persons of Blue Cross Community Centennial. If you have questions regarding claims processing, please call the Prime Contact Center at 800.821.4795. Sincerely, Pharmacy Network Management Prime Therapeutics LLC

Effective January 1, 2016, Prime Therapeutics (Prime) will begin processing a larger volume of Medicaid claims for BlueCross BlueShield BluePlus of Minnesota.

Processing Requirements

To ensure uninterrupted service to Participating Pharmacies and Covered Persons, please use the following information to set up your system prior to January 1, 2016.

Dear Valued Provider,

Effective January 1, 2016, Prime Therapeutics (Prime) will begin serving as the pharmacy benefit manager (PBM) for the Mississippi State and School Employees’ Health Insurance Plan. In preparation for this transition, a printing error occurred in producing the new ID cards which were recently mailed. Unfortunately, the RxBIN and RxPCN numbers were incorrectly printed on the cards. The ID number on the cards is correct, and is the same number as was used by Catamaran, the Plan’s previous PBM.