October 10, 2009

Dear Peach State Provider:

Peach State Health Plan (Peach State) gives a thirty (30) day notice prior to all policy changes to ensure that our providers have adequate time to comply with changes requested by the plan. We also want you to know that we listen to your feedback.

In September 2009, we sent a communication to you about our specialty drug policy. We informed you that we were changing our policy on October 1, 2009 to require all specialty drugs (with the exception of chemotherapy agents, Mirena, and ParaGard) to be obtained through Caremark.

Your valued feedback allowed us to understand potential challenges associated with this policy change. Some of these challenges were related to internal office procedures, especially when hospital based infusion centers were administering medications.

At this time, we are retracting our previous communication. We are asking that you continue to obtain specialty drugs and dispense them as you have done historically. We are making no changes to our list of drugs requiring prior authorization, only to the procedure for dispensing the drugs.

The Specialty Drug Prior Authorization Request Forms are available on the Peach State website, www.pshp.com, under the Provider Forms section. These forms should be completed and faxed with appropriate clinical information to Caremark at 1-800-323-2445 if you need Caremark to ship the drug to your office. You can fax the form directly to Peach State at 1-866-374-1579 if you would like to supply the drug out of your office stock.

If you have any questions about this information, please contact the Peach State Health Plan Pharmacy Department at 1-800-514-0083 option 2.

Thank you,

Wendy D. Bailey, RPh.            Robyn A. Lorys, Pharm. D.

Director of Pharmacy               Director of Clinical Pharmacy

Peach State Health Plan           Peach State Health Plan

This entry is filed under News.