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.

Thank you,

MedImpact Healthcare Systems, Inc.

National Average Drug Acquisition Cost (NADAC) Pricing Methodology 90-Day Supply Enforcement Specialty Pharmacy Program Change Sunflower Health Plan, a subsidiary of Centene Corporation, currently provides pharmacy and health services throughout the state of Kansas for over 140,000 Kansas Medicaid members. We are writing today to alert you of three important changes that will take place as of April 1, 2016: The Kansas Department of Health & Environment (KDHE) is implementing the below requirements for Kansas State Medicaid pharmacy claims:  National Average Drug Acquisition Cost (NADAC) pricing methodology: o For all medications with an available NADAC rate, those claims will be reimbursed with NADAC ingredient cost basis with an enhanced dispensing (professional) fee of $10.50  For medications without an available NADAC rate, claims will be reimbursed at the applicable network rate with a $10.50 dispensing fee  An additional $0.50 will be added to dispensing fees for pharmacies meeting the Center for Pharmacy Practice Accreditation (CPPA) requirements and providing documentation to US Script regarding proof of accreditation being met

As a member of the US Script pharmacy network, you are contractually obligated to process claims for the members of Ambetter from Superior HealthPlan. Ambetter from Superior HealthPlan claims should be processed using BIN 008019. As a reminder, a PCN is not needed in order to process Ambetter from Superior HealthPlan claims. Please check with your corporate office if you have concerns or questions regarding your pharmacy contract.

OptumRx will assume responsibility for claims processing for members of Dish Network L.L.C. Please Note:  All plan participants of Dish Network L.L.C. will receive a new member identification (ID) card. Please refer to the sample of the new ID card below.  Prescriptions need to be processed on-line using the Dish Network L.L.C. ID card information.

Express Scripts administers the prescription drug benefit for Consolidated Nuclear Security LLC members. Some of these members are changing benefit groups on March 1, 2016 and will receive new ID cards with their new Rx Group. (Please note the member ID number is not changing.) However, these members may not have their new cards by the March 1 effective date. If a Nuclear Security LLC claim rejects with NCPDP Reject Code 51 (Non-Matched Group ID), please ask the member for his/her new ID card or contact the Express Scripts Pharmacy Services Help Desk at 800.922.1557.