Thursday, May 30, 2013

Changes to Medicaid pharmacy benefit manager

Family Voices Indiana has been receiving calls from families who have recently had issues with obtaining prescriptions under Medicaid. According to a recent IHCP bulletin: "Catamaran Corporation will serve as the new Pharmacy Benefit Manager
(PBM) and pharmacy claims processor for the Indiana Health Coverage Programs (IHCP). This change is targeted for an effective date in late May 2013."

As of last week, this change took place. However, the bulletin further states: "The PBM transition does not change any existing coverage policies or rules that govern IHCP pharmacy benefits. For  example, claim filing limits, pricing, Preferred Drug List (PDL) content, utilization and step therapy edits, and quantity limits are not changing as a result of this transition. The PDL and OTC Drug Formularies are not changing as a result of this transition. Criteria used in PA determinations will not change as a result of the transition."

Families have still reported issues when trying to obtain medications via certain pharmacies. The bulletin includes this information about a call center to address any issues:
The Catamaran Clinical/Technical Help Desk will be functional on the implementation date, and will be open 24 hours a day, seven days a week. Calls related to provider enrollment, physician-administered drugs, Web interChange, and all other nonpharmacy calls will continue to be handled by HP. The Catamaran Clinical/Technical Help Desk number is (toll free) 1-855-577-6317.  

If the call center does not resolve your issues, please feel free to contact us. 317 944 8982

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