APCI and Becton Dickinson are happy to announce a new partnership for our members between APCI and BD, the expert in diabetes injections. This exciting new partnership will officially begin in November and will provide APCI members with special membership discounted prices and access to high quality diabetes injection products. This partnership may enable you to provide your customers with increased quality care in addition to increasing your bottom line.

Effective January 1, 2016, Navitus Health Solutions will begin processing claims for FirstCare Health Plan Commercial, Self-Funded, Exchange and Medicare lines. This client has members in Texas. There are no changes to the current Medicaid processing information.

UNIQUE BIN/PCN INFORMATION

The following tables contain RXBIN, RXPCN, and RXGRP information for primary and dual demo plans adjudicated through CVS/Caremark. Please review and update plan member profiles appropriately.

In the "Iowa Addendum to Caremark Provider Agreement" (beginning on page 133), a new section is added to read as follows, right after section 6:

To the extent that Provider provides Pharmacy Services to Eligible Persons enrolled in Managed Care Organizations ("Plan Sponsor") contracting with the Iowa Medicaid Managed Care Program, Provider agrees to the following provisions, if applicable:

Title: Hoosier Care Connect Members Will Have Copays in 2016

Beginning January 1, 2016, all Hoosier Care Connect members will be responsible for paying a copayment for certain medical and pharmacy services, regardless of health plan selection. Members are responsible for copayments for transportation, non-emergent Emergency Room visits and pharmacy services at the time of service.

Copay Amounts

The following services will have a copay in 2016:

• Transportation - $1 one way/$2 round trip
• Prescription medication – $3 (per prescription)
• Non-emergent Emergency Room Visit – $3 (this means using the ER for non-emergency purposes)

Copay Exceptions

• Members who are pregnant, of Native American descent, less than 18 years of age or have already met their 5% cost sharing max will be exempt from copays.
• Medications for family planning will be exempt from copays.
• Transportation copays will be waived when transportation services are for an MHS education events or Member Advisory Council (MAC) meetings.

A Medicaid provider cannot deny care or services to an individual due to failure of payment.

Learn more about member copays in the MHS Provider Manual.