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.

3

Dec

2015

OptumRx: Cigna Pricing Policy Change for Compound Prescriptions

Effective: January 1, 2016

Cigna COMPOUNDED DRUG POLICY UPDATED TO IMPROVE SAFETY, LOWER COSTS

To help protect the health and well-being of our customers’, as well as manage the significant costs associated with compound drugs, Cigna is further enhancing the management of these products. For reasons related to safety and clinical effectiveness, Cigna's pharmacy benefit will only cover FDA approved drugs.

Beginning January 1, 2016, Cigna will apply this guideline to compounded medications.*

Cigna pharmacy benefit plans will no longer reimburse pharmacies for:

• Non-FDA approved bulk chemicals or other non-covered pharmaceuticals that typically make up the majority of many compounded drugs.

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3

Dec

2015

Prime Therapeutics: Claims Processing Outage Notification

Effective: December 5-6, 2015

Dear Valued Provider,


Due to system maintenance at Prime Therapeutics, our claims processing system will be unavailable for claims adjudication during the time frame listed below.

Saturday December 5, 2015 11:00 p.m. to Sunday December 6, 2015 4:00 a.m. (Central Time)


During this downtime, claims will not be processed.  Please communicate this information to your pharmacies.

If you have any questions regarding processing claims, please call the Prime Contact Center at 800.821.4795.


Thank you,

Pharmacy Network Management
Prime Therapeutics LLC
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2

Dec

2015

Medimpact: Provider Pharmacy Notification of Medicare Part D Formularies

Effective: November 1, 2015

This notification is to advise pharmacy providers of future formulary changes in the MedImpact Healthcare Systems, Inc. Medicare Part D Formularies. A list of drugs along with the description of the change and effective date is included in the formulary change portion of this notification which is available on the ChainDrugStore.net network (www.chaindrugstore.net).

Thank you,

MedImpact Healthcare Systems, Inc.

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2

Dec

2015

CVS/caremark: New Implementation for Wellmark Blue Cross and Blue Shield of Iowa and South Dakota

Effective: January 1, 2016

Wellmark Blue Cross and Blue Shield of Iowa and South Dakota

Effective Jan. 1, 2016, CVS/caremark will begin to administer the prescription benefits for Wellmark Blue Cross and Blue Shield of Iowa and South Dakota. 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: RX1021

Member ID Format: 3 alpha characters, then 9 numeric digits

Person Code : not required

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2

Dec

2015

CVS/caremark: New Implementation for Southwest Airlines

Effective: January 1, 2016

Help Improve Member Adherence

Effective December 1, 2015 - Sunshine Health is relaxing quantity edits on select maintenance medications for our Medicaid

members to help improve member adherence and outcomes. Pharmacies may fill up to a three month supply (up to 100

day supplies) of generic medications on the Medicaid PDL in the following classes.

• Generic Oral Diabetes Medications

• Generic ACE-Inhibitors

• Generic ARBs

• Generic Statins

In addition, participating pharmacies in our Ambetter and Sunshine Advantage pharmacy n

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