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Community CCRx SM PDP 2010 Plan Year – Town Hall Update

Community CCRx SM PDP 2010 Plan Year – Town Hall Update. Speakers: Michael Bukach, RPh, SVP Pharmacy Relations Amber Jones, RPh, Senior Manager Network Operations Marc Bralts, Vice President, Network Operations. 1. 2010 Operational Changes Member movement / LIS lives

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Community CCRx SM PDP 2010 Plan Year – Town Hall Update

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  1. Community CCRxSM PDP2010 Plan Year – Town Hall Update Speakers: Michael Bukach, RPh, SVP Pharmacy Relations Amber Jones, RPh, Senior Manager Network Operations Marc Bralts, Vice President, Network Operations 1

  2. 2010 Operational Changes Member movement / LIS lives AEP – Agents and Enrollment activity Additional Targeted Medication Review Cases available in 2009 2010 Pharmacy Medication Management Incentive Program Topics for Today’s Program

  3. 2010 Operational Changes • Quick Reference Guide to be delivered early December- handy reference guide for new plan year changes • Prescription Origin Code – POC is required starting 1/1/2010 • FDA Non-Matched List to take effect on 1/1/2010 • Claims will reject at point-of-sale • Exceptions will not be granted

  4. 2010 Pharmacy Reimbursement • No changes to core reimbursement • Mail Order – no mail order for Community CCRx in 2010 • Help us keep mail out- migrate patients to maintenance supplies • Prompt Pay legislation requires payment of Part D claims within 14 days of a clean claim • EFT is available for faster receipt of funds (Paymode) • Community CCRx including LTC in Prompt Payment

  5. Member movement / LIS • More than 1.8 million LIS lives are in plans that will be over the benchmark in 2010 and WILL NOT automatically be moved • These members will be notified via a TAN notice by early November • Community CCRx LIS benchmark status for 2010: • Under LIS benchmark in all regions where under 2009 except NM • Back under benchmark: MA, RI, VT, CT, UT, ID • New under benchmark for 2010: AZ, NV • LIS lives by Region, and plans where there will be a premium in 2010 is available on-line @ www.mhrx.com

  6. Annual Election Period Activities • For patients with questions on selecting a Community CCRx℠ PDP plan that’s right for them, have them call 1-877-545-3815 • To request a Pharmacy Education Kit with information to provide your patients, please contact the PTC or email us at experts@mhrx.com

  7. Additional 2009 TMR Cases • Focus is on Therapeutic Interchange • Flat fee paid for completing case • Approximately 47,000 cases releasing nationwide • Planned to be released by November 23 • Cases must be completed in 30 days to receive reimbursement

  8. 2010 Pharmacy Medication Management Incentive Program

  9. Communications • Website: www.mhrx.com • 2010 Formularies • 60 Day Formulary Notices • Formulary Disruption – 2010 Impacted Patient Look-up • Fraud Waste and Abuse Module • PA Forms • PA Criteria • PA Status Search • Pharmacy Scorecard

  10. 2010 Part D: Community CCRx Thank You for your continued Support. Questions & Answers

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