Dear Valued Service Provider: Please be alerted that beginning on March 4, 2016, at 11:00 p.m. CST until 11:45 p.m. CST on March 4, 2016 Optum Rx will experience a Point of Sale Claims Processing Outage on a portion of our business. The outage is due to an Optum Rx scheduled system enhancement. Please reprocess claims after 11:45 p.m. CST on March 4, 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. Optum Rx apologizes for any inconvenience this may cause. Optum Rx strives to prevent system processing outages. Your assistance in servicing patients and resubmitting claims is greatly appreciated.

On March 1, 2016, Sagent Pharmaceuticals announced a recall of one lot of fluconazole injection (in 0.9% sodium chloride), 200 mg/100 mL because of the presence of an impurity identified as metronidazole. Per Sagent Pharmaceuticals, an elevated impurity has the potential to decrease the effectiveness of the recalled fluconazole. Patients receiving the recalled product and concomitant metronidazole may receive an increased dose of metronidazole. Catamaran, an OptumRx Company, notified members who may be affected by this recall. These members were provided information to help them identify if their medication is being recalled. In the future, these members may inquire about the fluconazole injection prescription(s) you dispensed. If you have any questions, please call Sagent Pharmaceuticals at 866-625-1618 (8:00 am – 7:00 pm CST, Monday through Friday) for more information about this recall.

US Script and CVS/caremark are pleased to announce that beginning on or after April 1, 2016, select US Script plans (noted on left) will begin utilizing CVS/caremark’s provider agreements, which includes CVS/caremark’s pharmacy networks and reimbursement terms, except as may otherwise be communicated by US Script. However, claims processing and payment processing will remain the same (via US Script).

CVS Caremark manages multiple drug lists. Within the therapeutic categories represented, identification of preferred drugs may help optimize clinical results and economic value for your patients. The drug lists include preferred products within 80% to 90% of the top therapeutic categories that affect our clients’ prescription drug spend. Updates or changes to these lists may affect cost share for your patients. CVS Caremark may add or remove drugs from our Performance Drug List during the year. If we add/remove drugs from our drug list, we will notify you of the change(s) quarterly. However, if the U.S. Food and Drug Administration deems a drug to be unsafe or the drug’s manufacturer removes the drug from the market, we will immediately remove the drug from our drug list. This letter highlights changes to the Performance Drug List effective April 1, 2016.

As a reminder, effective January 1, 2016, Coventry Health Care/First Health began using new claims processing information for Medicare Part D members. RXBIN: 610502 RXPCN: MEDDAET RXGRP: RXAETD Effective April 1, 2016, the above RXBIN, RXPCN and RXGRP must be submitted for all Aetna and Coventry Health Care/First Health Medicare Part D claims. Claims that are NOT submitted using the correct RXGRP will result in the following or similar reject: Reject 06: <Missing/Invalid Group ID>