In March 2024 we shared that several states, including Florida, Arkansas, Oklahoma, Tennessee, and West Virginia, introduced new regulations that may impact groups with pharmacy coverage and pricing arrangements with CarelonRx. The mandated changes apply to claims processed by pharmacies in these states and to members residing in these states, regardless of where the plan, and in some instances the pharmacy, is located. You can review the article that summarizes the changes here.
As of October 14, 2024, we have notified all clients who may have members impacted by these state-mandated regulations. In this notice, we asked clients to contact their Pharmacy Account Manager within 3 weeks of receiving the notice if they disagree with the changes. If we do not hear from clients within this timeframe, the changes outlined in the notice will go into effect and we will provide an updated amendment to our agreement.