New PBM Transition Targeted for Late May 2013

New PBM Transition Targeted for Late May 2013

As previously announced, Catamaran Corporation will serve as the new Pharmacy Benefit Manager (PBM) and pharmacy claims processor for the Indiana Health Coverage Programs (IHCP). This change is targeted for an effective date in late May, 2013. The exact implementation date will be published in an IHCP Bulletin at least 30 days prior to the actual transition. Additional IHCP publications will provide specific information about the roles and responsibilities of Catamaran and describe any changes that will affect providers. It is important to note that the PBM transition will not change any existing coverage policies or rules that govern IHCP pharmacy benefits. For example, claim filing limits, pricing, Preferred Drug List (PDL) content, utilization and step therapy edits, and quantity limits are not changing as a result of this transition.

The PBM transition will affect pharmacy services rendered under the fee-for-service and managed care delivery systems, including the Healthy Indiana Plan (HIP). As information is shared in future publications, IHCP providers should share the technical components of the transition with their software and/or switch vendors to ensure all pharmacy claims are routed appropriately to Catamaran beginning on the implementation date.