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.

4

Nov

2016

CVS Caremark: INTotal Health - ADHD Denials

RXBIN: 004336

RXPCN: ADV

RXGRP: RX4037

It has recently come to our attention that many members who had previously been approved and established on specific medications for ADHD were denied continuation of their medication through the prior authorization process. These denials occurred secondary to a change in the prior authorization review process, implemented to provide more efficient and timely responses to prior authorization requests, and were unforeseen consequences of this change. At this time, INTotal Health has extended all prior authorization and step therapy medications for members previously established on Ritalin LA, Concerta, Vyvanse, and Focalin XR. We are also in the process of updating and simplifying our ADHD formulary for January 1, 2017.

Members previously established on these medications should now be able to fill new prescriptions for these medications. We apologize for the additional efforts and disruption you may have incurred during this time.

If you have additional questions or concerns regarding this issue, please feel free to contact Kristi Fowler, Managed Care Clinical Pharmacist, with INTotal Health via email Kristi.Fowler@inova.org.

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4

Nov

2016

Prime Therapeutics: Blue Cross and Blue Shield of Texas STAR Kids Medicaid Program

Effective November 1st 2016

Effective November 1, 2016, Prime Therapeutics (Prime) began processing pharmacy claims for eligible BCBSTX STAR Kids Covered Persons.

Processing Requirements

To ensure uninterrupted service to Participating Pharmacies and Covered Persons, please use the following information to setup your system prior to the effective date of 11/1/2016.

*Please see attached PDF for more information.

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3

Nov

2016

Generic News 11.3.16

This week's Generic News includes a NEW Generics Campaign, several new launches, and a promotion from Allison Medical.

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3

Nov

2016

CVS Caremark®: Covanta

Effective January 1st 2017

Effective January 1, 2017, CVS Caremark® will begin to administer the prescription benefits for Covanta. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS Caremark.

*Please see attached PDF for more information.

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3

Nov

2016

Prime Therapeutics: Blue Cross and Blue Shield of Texas - Claims Processing Issue

BIN: 011552 PCN: BCTX

Dear Valued Provider,

Participating Pharmacies may be experiencing claim rejections when trying to process claims for Covered Persons of Blue Cross and Blue Shield of Texas (BCBSTX).

Action Required:

Eligibility for these Covered Persons is currently being updated and expected to be corrected this evening. If you have a Covered Person with an urgent claim to be processed, please advise the Covered Person to call the Customer Service number on the back of their ID card.

Please communicate this information to your pharmacies to prevent further disruption of service for these Covered Persons.

Sincerely,

Pharmacy Network Management

Prime Therapeutics LLC

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