Accredo – EmblemHealth’s New Specialty Pharmacy
Starting January 1, 2019, Accredo, an Express Scripts subsidiary, will be EmblemHealth’s preferred specialty pharmacy vendor. (Magellan is the current specialty pharmacy vendor). Prescriptions will transfer to Accredo to avoid your patients missing remaining refills. To order medications, contact Accredo using accredo.com; or call them at 855-216-2166.
EmblemHealth to Manage Injectable Drug Utilization
Starting January 1, 2019, submit prior approval requests for injectable drugs to EmblemHealth by fax at 877-243-4812 or by calling 888-447-0295.
Click here to see all formularies.
New Medicare Part D Prescription Opioid Policies for 2019
Beginning January 1, 2019, EmblemHealth will implement new strategies to help prevent and combat opioid overuse. The new strategies include improved safety alerts when opioid prescriptions are dispensed at the pharmacy, and drug management programs to better coordinate care when chronic high-risk opioid use is present.
Prescribers will be expected to respond to pharmacy outreach related to opioid safety alerts in a timely manner and give the appropriate training to on-call prescribers when necessary. The criteria used to identify potentially at-risk beneficiaries for drug management programs or point-of-sale safety alerts are not intended as prescribing limits. The goal is to prevent overutilization of frequently abused drugs while maintaining access to medically necessary drugs. You can find additional details on CMS’s site Improving Drug Utilization Review Controls in Part D.