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Express Scripts Incorporated (ESI) is sending out a Medicare Part D network enrollment alert via fax to some of our members. ESI will automatically enroll your store in the network unless you decline by the deadline. However, faxed alerts do not specify the deadline. The deadline may be as little as ten (10) days from the date of the fax. Review your ESI contract or contact ESI to determine the deadline applicable to you.
The faxed notification describes the “average” rates of reimbursement for both generic and brand drugs for 2024 and subsequent years. Please be sure to review these figures and terms carefully to ascertain whether you wish to participate in the Medicare Part D network for 2024. This network will be used for most ESI Med D networks, including Prime Therapeutics and Centene. Some of our members report that the proposed ESI reimbursement rates are oppressively low.
The network also includes a feature that may violate CMS’ new Part D Rules by requiring network pharmacies to contribute to a bonus pool that the pharmacy may not receive back after an evaluation period. You should quickly and carefully evaluate the offer and make your own conclusion. A failure to act quickly will result in automatic enrolment.
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