BlueCross BlueShield of South Carolina

Specialty Pharmacy Enhancements

February 22, 2012

BlueCross BlueShield of South Carolina is pleased to announce that we have selected CuraScript to handle the specialty pharmacy needs of our members.

Effective April 1, 2012, CuraScript Specialty Pharmacy will dispense and manage the oral and self-administered specialty drug portion of the prescription drug benefit. CuraScript is an independent company that provides specialty pharmacy services and will assist in the administration of the specialty pharmacy program on behalf of BlueCross. BlueCross is working diligently to ensure a seamless transition for our members.

CuraScript offers members the following benefits:

• Confidential and convenient delivery of their specialty drug to the location of their choice — when they need it and at no additional charge
• Personal attention from patient care advocates and easy access to pharmacists and other health experts 24 hours a day, seven days a week
• Help with refilling prescriptions, filing claims and any prior authorizations

What is the Transition Plan?

All active specialty drug prescriptions with remaining refills at Caremark’s Specialty Pharmacy will be transferred to CuraScript on April 1, 2012. After March 31, Caremark Specialty Pharmacy will be out of network and will not be covered. On behalf of your health plan, Caremark has assisted in the administration of the program. Caremark is an independent company that provides pharmacy benefits management.

Members who have prescriptions transferred to CuraScript will receive a:

• Letter from BlueCross explaining the specialty pharmacy changes and how to contact CuraScript
• Welcome packet from CuraScript
• Phone call from a CuraScript patient care advocate who will answer their questions and assist them with their prescription refills

Are Specialty Pharmacy Benefits Changing?

It is important to note that the specialty pharmacy benefits will not change; only the vendor will change.Prescriptions for non-specialty drugs (those on the Preferred Drug List) will continue to be available from a participating retail or mail-order pharmacy as indicated in the member’s benefit plan.

Specialty Pharmacy Utilization Management

Also effective April 1, 2012, BlueCross will use Care Continuum for specialty pharmacy utilization management. Currently, Caremark handles this service for us. Care Continuum is an independent company that provides utilization management services. On behalf of BlueCross, Care Continuum will assist in the administration of the utilization management program including specialty drug prior authorization processes.

What Does This Mean?

Today, if members’ benefits for specialty drug prescriptions are rejected for any reason, they are told to call Caremark. On or after April 1, 2012, members that have specialty drug prescriptions rejected will be told to call Care Continuum.

Communications

We will email group benefit coordinators a notice they can distribute to their employees. If we do not have an email address for a group, we will mail the notice to them. Individual members affected by the change will receive a notice from BlueCross.

View the printer-friendly version of this bulletin.