Specialty Pharmacy Notice

Specialty Pharmacy Notice

Should a member wish to receive a specialty pharmacy drug from an in-network retail pharmacy rather than US Bioservices Specialty Mail Order pharmacy, they may choose any pharmacy in the plan's retail network as long as that retail pharmacy is willing to accept comparable pricing. If a member selects a retail pharmacy that has not requested to be in the plan's Specialty Pharmacy Network, and has not accepted comparable pricing, then the pharmacy should still attempt to adjudicate the claim. If the pharmacist is having difficulty processing a claim at the point-of-sale transaction, they should use the telephone number indicated on the reject message for further processing of the point-of-sale transaction. For a complete list of VNSNY CHOICE SelectHealth formulary drugs, please refer to the VNSNY CHOICE SelectHealth Formulary and VNSNY CHOICE SelectHealth Formulary Changes.  
 
In-network retail pharmacies interested in applying to the Specialty Pharmacy Network must submit a request by contacting MedImpact Healthcare Systems, Inc. at 1-888-678-7741 or specialtycontracts@medimpact.com. To use your retail pharmacy for accessing specialty pharmacy drugs, please provide contact information, NPI, the name of the health plan you wish to join for specialty pharmacy networks and information regarding the member making the request.
 
Electronic messaging is provided to pharmacies to help redirect and resolve rejects through the MedImpact Healthcare Systems, Inc. adjudication system. 
 
Last updated 10/1/2016

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