Dear Valued Provider,

Please be advised that Flu and Pneumonia Vaccines are covered for Florida Blue Medicare Advantage Part B Covered Persons when administered at a Participating Pharmacy. Please see the attached PDF for further processing instructions.



If you have any questions about claims processing, please call the Prime Contact Center at 888.877.6323 for Commercial and 888.877.6420 for Medicare.  

Sincerely,

Pharmacy Network Management
Prime Therapeutics LLC

Prime Therapeutics Contracting Fax number: 877-823-6373

In this week's Generic News, there's a new Generics Campaign, as well as an updated list of FDA drug shortages, discontinuations, information from PruGen, and two new launches.

Dear Valued Provider,

Effective November 1, 2016, amphetamine-dextroamphetamine capsules extended release (i.e., generic Adderall XR) will become a preferred product. Please see the PDF for further processing instructions.

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

Sincerely,

Pharmacy Network Management
Prime Therapeutics LLC

Prime Therapeutics Contracting Fax number: 877.823.6373

Please be alerted that beginning on October 21, 2016, at 11:00 p.m. CST until 11:45 p.m. CST OptumRx Administrative Services, LLC, will experience a Point of Sale Claims Processing Outage on a portion of our business. The outage is due to an OptumRx scheduled system enhancement. Please reprocess claims after 11:45 pm CST on October 21, 2016.

Due to this maintenance we would like to remind you that there may be a delay in the posting of your 835 files by 1-2 business days for the affected pay cycle.

OptumRx apologizes for any inconvenience this may cause. OptumRx strives to prevent system processing outages. Your assistance in servicing patients and resubmitting claims is greatly appreciated.

On July 22, 2016, Express Scripts issued a communication indicating that the Louisiana State-imposed $0.10 provider fee on prescription drug claims did not apply to Medicare claims. This is a correction to that communication.

Express Scripts network pharmacies should not be submitting the $0.10 provider fee to Express Scripts for Medicare claims; however, pharmacies are still required to remit the $0.10 provider fee to the Louisiana taxing authority for all prescription drug claims, including Medicare claims.

Express Scripts reserves the right to recoup the $0.10 provider fee from network pharmacies if they have inappropriately charged the $0.10 fee on Medicare Part D claims after July 1, 2016.