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Weekly Update

Managed Care

January 21, 2008

Managed Care

USP to Hold Educational Training on General Chapter 797 Pharmaceutical Compounding – Sterile Preparations

The United States Pharmacopeia – National Formulary (USP– NF) will hold webinars and conferences to educate healthcare practitioners regarding the revisions of General Chapter 797.

During these educational sessions, participants will have the opportunity to have “real time” discussions with compounding experts. Participants are shown how to implement the new standards into their everyday working arena.

To view the schedule for the Webinar or conferences please visit USP Educational and Training Programs on 797 . Spaces are filled on first come basis and most sessions offer pharmacy CE credits.

If you would like to pre-register for any of the upcoming sessions, please send your contact information along with

program of interest to uspcaps@usp.org.

PBM and Plan Updates

Nationwide Updates


  • Effective immediately, Argus has added the Oct. 2007 out-of- network fees to the January out-of-network payment cycles. October out-of-network fees will be added to January’s out-of- network cycles until all three cycles (Oct. 10, Oct. 20, & Oct. 31) have been resolved. If you have questions regarding this matter please contact the Argus Recon Customer Service Department at

      • 866.211.9459

        or via email reconcustomerservice@argushealth.com

  • Reminder: LTC pharmacies, 3rd quarter (2007) rebate report is due January 31, 2008. Rebate reports must be submitted every quarter. Please submit your data on the Smith Premier website Premier LTC Submissions


  • Effective immediately, there have been changes to the DRAMS Clinical Help Desk phone prompts, please choose the correct prompt so that your call will be directed to the correct dedicated technician.

Reminder: April 1, 2008 - Deadline for Tamper- Resistant Medicaid Scripts Required

CMS has extended the deadline to April 1, 2008 for when at least one (1) tamper-resistant characteristic must be met for all non-electronic Medicaid prescriptions. All three (3) characteristics must be met by October 1, 2008. For more information on the tamper resistant requirements, please see Tamper Resistant Prescription Pads.

Type of Inquiry Medicare Part D prescription drug claim Nexium prior authorization or step therapy program Any other pharmacy related claim issue

Prompt #





  • Reminder: Caremark has activated several new counties under

the Nat’l Association of Counties (NACo). BIN #: 004336


  • Effective 02/01/08, Culinary Health Fund will be making changes

to their formulary.

Generic Launch

Cobalt Laboratories have now launched generic Altace 2.5mg. Altace is an ACE inhibitor used in the treatment of hypertension. Due to limited quantities this product will not automatically ship. Customers may start placing orders January 23, 2008.

Coventry Health Effective 01/24/08, Coventry Health will cover brand and generic forms of OTC Zyrtec® and Zyrtec-D®.

Effective 02/01/08, Coventry Health will no longer cover prescription forms of Zyrtec® and Zyrtec-D®.

Continued on Page 2 of this Managed Care Weekly Update

For questions and additional information, please contact the Managed Care Connection Help Desk at 877.292.3196

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