About APCI

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(800) 532-2724

Since 1984, APCI has been the ‘united voice of independent pharmacy’

APCI began as a small buying group for a limited number of independent pharmacies in central Alabama. Since that time, the cooperative has grown to more than 1,800 members pharmacies in 26 states, and provides its members with a wide range of products and services.

Our mission is to represent the economic and professional interests of independent pharmacies by providing leadership, vision, and a collective voice for our members in the healthcare marketplace. Our goal is to level the playing field for our member pharmacies by providing innovative, targeted programs to benefit our entire membership.

16

Dec

2015

OptumRx: Point of Service Rejections for New England Health and Minuteman Health

Effective: January 1, 2016

Effective January 1, 2016, Health New England and Minuteman Health will no longer cover Absorica, Apidra, Doryx, Glumetza, Hydrocodone/Acetaminophen 7.5/300mg and 10/300mg, Levemir, Novolin, Novolog, and Doxycycline 40mg.

16

Dec

2015

Express Scripts: Claims Processing Update for Amerigroup Kansas Inc.

Effective: December 28, 2015

Effective December 28, 2015, Amerigroup will be adding drugs to their Prior Authorization (PA) program for Medicaid. The goal of this program is to ensure the medication is being used for FDA-approved indications for therapy. PA criteria for the drugs listed in the table on page two of this communication were reviewed and approved by the Kansas Drug Utilization Review Board.

16

Dec

2015

Prime Therapeutics: PrimeWest Health Transtions to new PBM

Effective: January 1, 2016

Dear Valued Provider, Effective January 1, 2016, PrimeWest Health will transition their Medicaid and Medicare Part D products from Prime Therapeutics to MedImpact. Participating Pharmacies will no longer be able to submit claims to Prime Therapeutics for Medicaid or Medicare Part D Covered Persons for dates of service after 12/31/15 for the following BIN and PCN combinations:

16

Dec

2015

PerformRx: MACRA Communication

Effective: January 1, 2016

11/13/2015 Dear Pharmacy Network Provider, Beginning January 1, 2016 all claims submitted to PerformRx must be submitted with a valid Prescriber National Prescriber Identifier (NPI) number. This is a result of MACRA Legislation which was passed April 16, 2015. Currently PerformRx accepts claims submitted with only a Drug Enforcement Agency (DEA) identifier for select customers. Beginning January 1, 2016, claims submitted with only a DEA number and identifier will deny at point-of-sale and reject with error 434 (Valid Prescriber Type 1 NPI Required), requiring the pharmacy to submit a valid Prescriber NPI number and qualifier.

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