Non-specialty pharmacy

A new preferred home delivery pharmacy and/or a new option for certain member’s maintenance medication needs is being changed from Alliance to Express Scripts Pharmacy®.

Existing, non-expired, maintenance medication prescriptions for patients in commercial plans will automatically be transferred to Express Scripts by 1 de janeiro, 2022. Any open prior authorizations for drugs continuing to be covered on the formulary will be carried over to Express Scripts. After 1 de janeiro, 2022, you will need to send any new prescriptions to Express Scripts if these patients want to continue to use a home delivery service.

Some prescriptions will not be automatically moved, and you will need to send a new prescription to Express Scripts on or after 1 de janeiro, 2022. These include:

• Controlled substances
• Medicines regulated by a risk evaluation and mitigation strategy (REMS) program
• Prescriptions that will expire before 1 de janeiro, 2022
• Prescriptions that have no refills left on 1 de janeiro, 2022
• New prescriptions that have not been filled at AllianceRx Walgreens Prime

Prescriptions can easily be sent to Express Scripts Pharmacy using your EMR system by e-prescribing to Express Scripts Home Delivery. For questions on e-prescribing call 1-800-211-1456, option 5. For more information, visit https://www.express-scripts.com/rx.

If you have any questions, please call the Physician & Provider Service Center at (401) 274-4848 or 1-800-230-9050 for out-of-state providers. This information can also be found in the Pharmacy section of our monthly Provider Update at bcbsri.com/provider.

Specialty pharmacy

A new preferred home delivery pharmacy and/or a new option for certain member’s maintenance medication needs is being changed for specialty pharmacy from Alliance to Accredo*

There is no immediate action you need to take. Existing, non-expired prescriptions will automatically be transferred to Accredo by 1 de janeiro, 2022. Any open prior authorizations for drugs continuing to be covered on the formulary will be carried over to Accredo. After 1 de janeiro, 2022, you will need to send new specialty prescriptions for these patients to Accredo.

Some prescriptions will not be automatically moved, and you will need to send a new prescription to Accredo on or after 1 de janeiro, 2022. These include:

• Controlled substances
• Medicines regulated by a risk evaluation and mitigation strategy (REMS) program
• Prescriptions that will expire before 1 de janeiro, 2022
• Prescriptions that have no refills left on 1 de janeiro, 2022
• New prescriptions that have not been filled at AllianceRx Walgreens Prime

Accredo provides your patients access to their specialty medications and dedicated clinical resources to help them manage their health condition(s). Accredo has various tools available to you, including physician concierge, e-prescribe, ePA, and interoperability with EHRs. Once these patients are live with Accredo, you will have visibility to their status through Accredo’s provider portal at https://myAccredoPatients.com. For more information, visit https://www.accredo.com/prescribers.

*with the changes being made from Walgreens to Accredo, Accredo will not be contacting the prescribing provider for the prescription. It will be the providers responsibility to send over the prescription to Accredo once your determination letter is received from Prime

Fertility

Care New England Pharmacy and Freedom Fertility Pharmacy (referenced as Accredo in member letters) will be the new pharmacy options available for fertility drugs. Current Provider: Village Pharmacy.

If you have any questions, please call the Physician & Provider Service Center at (401) 274-4848 or 1-800-230-9050 for out-of-state providers. This information can also be found in the Pharmacy section of our monthly Provider Update at bcbsri.com/provider.