Peach State Health Plan Blog

January 24, 2011

Dear Peach State Provider:

 Peach State Health Plan (Peach State) is making some important changes to our Preferred Drug List, and we are writing to communicate the changes to you. Beginning March 1, 2011, the changes described below will be made.

1. Patients receiving a new prescription for an aromatase inhibitor will be required to try generic Anastrozole prior to taking a branded drug in the same class (Femara or Aromasin). Patients already on therapy with a branded aromatase inhibitor will be allowed to remain on the current therapy, but will be required to try Anastrozole if a change in medication is needed.

If you, as a physician, feel that a patient will require medication therapy outside of the above guidelines, you can submit a prior authorization request to US Script, the pharmacy benefit manager for Peach State Health Plan. The Medication Prior Authorization Request Form is available on the Peach State website, www.pshp.com, under the Provider Forms section. This form can be faxed to US Script at 1-866-399-0929.

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.

                                                                                                                            MEDIA CONTACT

                                                                                                                                                                                         Robert Clarke

                  (404) 446-1670

rclarke@duffey.com

FOR IMMEDIATE RELEASE                                           

PEACH STATE HEALTH PLAN PARTNERS WITH

MEMORIAL UNIVERSITY MEDICAL CENTER

FOR INFORMATIVE TEEN PREGNANCY PREVENTION SYMPOSIUM

 ATLANTA, GA (January 19, 2011) — On Dec. 3, Peach State Health Plan^™ (Peach State), in partnership with Memorial University Medical Center in Savannah, GA., hosted a symposium and panel discussion on teen pregnancy prevention. Headlined by Michele Ozumba – President and CEO of the Georgia Campaign for Adolescent Pregnancy Prevention – the symposium and panel covered a wide range of topics around teen pregnancy including sex education for teens, unplanned pregnancy, teen drug use during pregnancy and abused teens.

“Adolescent pregnancy is a serious problem in the United States, and Georgia has one of the highest rates of teen pregnancy in the country,” says Patrick Healy, president and CEO of Peach State. “It is critical that we address this problem head on and provide our youth with the knowledge to make appropriate decisions.”

Peach State awarded two 2010 Excellence in Teen Pregnancy Prevention Awards to Pamela Gallup, MD and the Chatham County Board of Health in recognition for their efforts in teen pregnancy prevention outreach and education. According to Georgia Campaign for Adolescent Pregnancy Prevention, Georgia has the eighth highest teen birth rate in the nation. Over 22,500 teen pregnancies occur each year in Georgia. That amount equals 62 new teen pregnancies each day – or more than two teen pregnancies an hour. In addition, adolescent pregnancy prevention is an effective poverty reduction strategy.

 “It is important to remember that the poverty rate for children to teen mothers who have never married and have not graduated from high school is 78 percent in Georgia,” says J. Dean Greeson, MD, VP, Medical Affairs for Peach State. “Adolescent pregnancy is an issue that affects everyone in the state of Georgia, and we are trying to help solve the problem in whatever way we can.”

Peach State distributed copies of the award winning teen book, “Off the Chain” during the ceremony to the attendees and participants. The book’s author, Michelle Bain wrote the book in efforts to answer many of the questions teens have about life’s important issues.

 About Peach State Health Plan

Peach State Health Plan (Peach State) is a Care Management Organization that serves the Medicaid and PeachCare for Kids ^™ population in partnership with Georgia Families. Peach State is a wholly owned subsidiary of Centene Corporation, a leading multi-line healthcare enterprise offering both core Medicaid and specialty services. Information regarding Peach State is available via the Internet at www.pshp.com.

About Centene Corporation

Centene Corporation, a Fortune 500 company, is a leading multi-line healthcare enterprise that provides programs and related services to the rising number of under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the Children’s Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and long-term care, in addition to other state-sponsored programs, and Medicare (Special Needs Plans). Centene’s CeltiCare subsidiary offers states unique “exchange-based” and other cost-effective coverage solutions for low-income populations. The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health, life and health management, managed vision, telehealth services, and pharmacy benefits management. More information regarding Centene is available at www.centene.com. 

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Quality Symposium _ Teen Pregnancy Prevention News Release.doc

This entry is filed under News.

Dear Provider,

In an effort to better serve our members, Peach State Health Plan™ (Peach State) is making updates to the Prior Authorization Process for Specialty medications. Please review the new procedure, as we feel it will streamline the process in your office and here at the plan. This change will be effective on 01/17/2011.

In the past, we have asked providers to send requests for medications provided by Caremark directly to Caremark for processing and to send requests for medications provided out of office stock directly to Peach State’s Pharmacy Department.

Although Caremark will continue to be Peach State’s preferred Specialty Pharmacy vendor and will ship medication to our members, prior authorization requests should no longer be sent to Caremark for review. All requests for specialty medications supplied by Caremark, and out of office stock, should be sent directly to Peach State’s Pharmacy Department. We expect that having one fax number for all specialty medication requests will simplify the prior authorization process. The attached prior authorization form has been created for your convenience. It contains most of the information we need for processing a medication request, as well as the Peach State’s Pharmacy Department phone and fax number. Be sure to indicate in the top section of the prior authorization form whether your request is for a product that will be shipped by Caremark or for a product that will be dispensed out of your Office Stock.

It is very important to remember that prior authorization forms do not include all the information needed for a proper review. You must send in clinical documentation that supports the diagnosis and use of the requested medication (for example; labs, chart notes, radiology reports, etc…)

US Script will continue to receive and process all retail pharmacy prior authorization requests. Retail Pharmacy medications would include oral or topical preparations that are self-administered and available at most local pharmacies. Those requests should be sent to US Script using the appropriate form and fax number found on our website.

We expect that this new process will be more convenient for you as there are now only two options, retail pharmacy/US Script or specialty medication/Peach State. If you have any questions that arise while preparing or processing a request, please call the Peach State Pharmacy Department at 800-514-0073 option 2.

Thank you,

Wendy Bailey, R.Ph and Robyn Lorys, Pharm. D.

Peach State’s Pharmacy Department

This entry is filed under News.

Dear Provider:

Please select the link below to review the Provider Communication Tip Sheet. This resource tool has been developed to provide  updates regarding Peach State’s programs and services. For questions or concerns, call the Provider Solutions Department, 1-866-874-0633, Monday – Friday, 7 am-7 pm.

Provider Communication Tip Sheet

Thank you~

This entry is filed under Blog, News.

Dear Provider:

Attached is the latest information regarding enhancements to Peach State’s website. Please select the link below to read this issue. For questions, contact Peach State’s Provider Department at 866-874-0633, Monday-Friday, 7am-7pm.

Provider Watch – December 2010

This entry is filed under Blog, News.