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Part D Issues Update
CMS Corrects Network Status for Elevate in 2 Plans; Silverscript Site Still Steers Users to CVS Pharmacies
CMS has corrected its plan listings in the online Medicare Part D Plan Finder at Medicare.gov, but pro-CVS bias remains in online plan listings at silverscript.com.
An APRx member pharmacy filed a complaint two weeks ago with CMS over its erroneous listing of the pharmacy as non-preferred in the SilverScript Plus and SilverScript Allure plans in Medicare Part D. Our own check of a large random sample of 20+ APRx member pharmacies from ZIP codes in seven different areas of the state confirmed that every APRx (Elevate) pharmacy was listed as "Standard Cost-Sharing" on medicare.gov instead of the correct "Preferred Cost-Sharing" for both the SilverScript Plus and SilverScript Allure plans. That problem has apparently been corrected, as another random sampling yesterday of different Texas ZIP codes showed all APRx pharmacies correctly listed as "Preferred" in the two Silverscript plans.
 However, Caremark is still trying to to steer enrolling patients to a default CVS pharmacy at silverscript.com. APRx tested the drug-pricing function for Silverscript plans at the Silverscript.com website using 20 different addresses/ZIP codes from seven different parts of the state. I
n every instance, a CVS pharmacy came up as the default pharmacy. In some cases, the default CVS pharmacy listed is not even in the same ZIP Code that we entered for our pharmacy search. We had to click on the rather small, red "edit" link below it to choose another pharmacy (see illustration at right). That inequity has not changed and calls to Caremark on the issue have so far not been productive.
We continue to encourage all member pharmacies to file a complaint with CMS over the CVS steering issue with Caremark's Silverscript plans.
Before submitting a complaint, please use the "Pharmacy Locator Tool" and the "Drug Price Quote Tool" at silverscript.com to verify that the site steers patients/enrollees to a default CVS pharmacy
and away from your independent pharmacy. (You can click here to see how Norman's Pharmacy went through this process).
If yes, then you should submit a formal complaint to CMS using this template as a guide. The subject line of your complaint email should read "Complaint Against Silverscript PDP by (insert name of your pharmacy/pharmacies)." You can send the complaint to: PartDComplaints_RO6@cms.hhs.gov. Please
send a copy of your CMS complaint to rgoebel@aprx.org so we can monitor the level of engagement on this issue.
You can direct patients to these websites if they need more support:
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Your APRx Board
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Mike Muecke, R.Ph.
Chairman
Alton Kanak, R.Ph.
Vice Chairman
Joe Ochoa, R.Ph.
Secretary/Treasurer
Lynn Everett, R.Ph.
Steve Hoffart, Pharm.D.
Vance Oglesbee, R.Ph.
Bruce Rogers, R.Ph.
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