Effective January 1, 2016, Prime Therapeutics (Prime) will begin processing Medicare Part D and Part B claims for Covered Persons of Alignment Health Plan. Processing Requirements To ensure uninterrupted service to Participating Pharmacies and Covered Persons, please use the following information to set up your system prior to January 1, 2016.

Please download attached PDF file for more information.

Commercial Effective December 1, 2015 • Glumetza is excluded from the prescription benefit. The physician will not be able to request a prior authorization for continued coverage. • Capsaicin and menthol containing patches are excluded from the prescription benefit. The physician will not be able to request a prior authorization for continued coverage. • Specialty medications are limited to up to a 31 day supply fill. The physician will not be able to request a prior authorization for a larger day supply.

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 ensure that it is up to date.

To whom it may Concern-   Attached is the New 2016 Sponsor list for TrueRx. This list includes any updates or changes of Groups, PCNs and BIN numbers. Please make these updates in your system as of 1/1/2016. If you have any questions regarding these changes, please feel free to contact Benefits@pdmi.com.   Thank you, PDMI 1170 E. Western Reserve rd. Poland, Ohio 44514 800.800.7364