Effective January 1, 2015, the preferred short and intermediate acting insulin will be Novolin and Novolog for Commercial and Exchange Market formularies.

Humulin, Humalog, and Apidra will be non-preferred, and in most cases, will require a Prior Authorization (PA) or be excluded entirely from the Covered Person’s formulary.

To ensure a smooth transition for impacted Covered Persons, Participating Pharmacies are encouraged to assist their Covered Persons to get a new prescription from their Prescribing Provider.

Effective January 1, 2015, Blue Cross and Blue Shield of North Carolina (BCBSNC) Covered Person(s) compound claims that are submitted with bulk chemical ingredients (e.g. liquids, powders) will no longer be covered. This change is based on bulk chemical ingredients not being approved by the U.S. Food and Drug Administration (FDA). As a reminder, Covered Persons do not have benefits for drugs not approved by the FDA and these drugs are not eligible for review under our utilization management program.

Inside this issue:

QLL for MEqD…………..….……….………2

Georgia DCH 2015 Plans………….2-3

2015 Med D EGWPs…………….…..4-6

Inside this issue:

Med D Compounds Management……...2

Express Scripts Formulary Changes..2-4

BCBSMA Formulary Update……………4-6

Amerigroup Change Reminder………….6

Effective January 1, 2015, the Mississippi Medicaid (MSCAN) and Children’s Health Insurance Program (CHIP) is moving to a common Preferred Drug List (PDL).

• UnitedHealthcare Community Plan member identification (ID) cards will not change.

• Be sure to include the member’s ID number, date of birth and gender when submitting claims.

• Please process prescriptions online using the following processor information:

Name of Processor: OptumRx

Bank Identification Number: 610494

Processor Control Number: 9999

Submitted Group: ACUMS