Medicaid narrow pharmacy network as of Dec. 1
Effective Dec. 1, 2017, the Medicaid product pharmacy benefit will be managed under a narrow network through Express Scripts Inc. (ESI).
The narrow pharmacy network in our west and southwest Michigan Medicaid regions includes many smaller/local pharmacies as well as those in large retail stores such as Walmart, Meijer and Walgreen's. Pharmacy chains no longer in network include Rite Aid, CVS and Family Fare.
We sent a letter in early October to all Medicaid members currently using a pharmacy that will be out of network.
In the letter, we provided information about their nearest contracted pharmacy and a link to the ESI website so members can search for the closest approved pharmacy.
We also included directions for how to get prescriptions transferred to an in-network pharmacy.
After December 1, should a member choose to fill prescriptions at a non-contracted pharmacy, they will be liable for the full cost of the drug.
While this is a change for your Medicaid patients there should be little impact on physician offices. Prescriptions should be transferred to an in-network pharmacy by Nov. 30, 2017, and patients have been instructed on how to make this happen.
Contact your Provider Performance Specialist.