Dear Pharmacy Provider,

The purpose of this letter is to notify you that, effective December 1, 2016; PerformRx will be providing pharmacy benefit management services to Prestige Health Choice Plan. Your provision of Pharmacy Services to Prestige Health Choice Plan members will be governed by the terms and conditions of your PerformRx Participating Pharmacy Agreement under your Prestige Health Choice amendment.

*Please see attached PDF for more information.

Since you have already agreed to participate with MedImpact, there will be no information for you to return.

*Please see attached PDF for more information.

Effective November 1, 2016, Texas STAR Kids will go live with Aetna Better Health of Texas. Please be aware that during the transition new members may not have received their new ID cards or they may not have them available when they present a prescription at the pharmacy. These members are active as of November 1, 2016, and eligible in the system. CVS Caremark Pharmacy Help Desk will be able to assist your pharmacy staff with missing ID numbers. Please contact 1-877-874-3317 and use option 5 for Texas STAR Kids.

*Please see attached PDF for more information.

Effective 12/12/2016

For most members in the following plans:

• AARP® MedicareRx
• AARP® MedicareComplete®
• UnitedHealthcare® MedicareComplete Plans
• United MedicareRx
• UnitedHealthcare MedicareRx Plans

Upon the release of the generic for the brand medication Zetia, the brand name version of Zetia will continue to be the preferred product. The generic Ezetimide will be a non-covered/non formulary drug.

Please continue to process claims for brand Zetia as it will process without any need of a prior authorization. The generic Ezetimide will be not be a covered drug and should reject as a non-covered/non formulary drug, if you get this reject, changing the drug back to brand Zetia will allow the drug to process.

In addition, if you get a paid claim for generic Ezetimide, please reverse the claim and continue to process for brand Zetia. You will see that as the brand Zetia is on the preferred tier, it will produce a lower copay amount for the member than processing the generic even if the generic pays.

TO REDUCE PROCESSING ERRORS, PLEASE CONFIRM THE INFORMATION ON MEMBER’S ID CARD PRIOR TO SUBMITTING PRESCRIPTION CLAIMS.