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). These changes will go into effect in 60 days coinciding with CMS required 60 days notice to Beneficiaries of any negative formulary changes.

*Please see attached PDF for more information.

As previously communicated by US Script and CVS Caremark®, Ambetter from Superior HealthPlan began using the CVS Caremark pharmacy network on July 19, 2016, while claims processing and payment remained with US Script. This notice is to inform you that effective January 1, 2017, CVS Caremark will begin to process claims for Ambetter from Superior HealthPlan. All claims for Ambetter from Superior HealthPlan will now be reimbursed according to your CVS Caremark Network Enrollment Forms and be paid according to CVS Caremark processing rules and payment cycles, which will appear on your CVS Caremark 835 or remittance advice.

*Please see attached PDF for more information.

DATE: 9/30/16

TO: Third Party/Pharmacy

FROM: Pharmacy Network Management PHONE: (800) 788-2949 MedImpact Healthcare Systems

Subject: Reminder - please update your NCPDP profile information

This message is to remind the authorized individual at your pharmacy to ensure that your pharmacy’s NCPDP profile is up to date and accurate. Your pharmacy’s profile can be accessed at https://accessonline.ncpdp.org.

Medicare beneficiaries use pharmacy directories to make decisions about their choice of pharmacy, and information in your pharmacy’s NCPDP profile informs those directories. CMS expects information in pharmacy directories to be accurate, and requires Medicare Plan sponsors to communicate with contracted pharmacies on a quarterly basis to verify that information.

This message does not imply that your pharmacy’s information on file with NCPDP is necessarily inaccurate, but rather serves as a reminder to

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