December 12, 2019
Pharmacy Network Changes

Applicable to: Mercy Care Complete Care, Mercy Care RBHA, Mercy Care Long Term Care and Mercy Care DD 

Mercy Care is implementing changes to the retail and specialty pharmacy networks for Mercy Care's Medicaid lines of business.

Mercy Care will be sending letters to members in December. CVS Specialty Pharmacy will be contacting members via telephone starting 5-7 days after the letters are sent to facilitate the specialty prescription transfer process. Members can contact Member Services or work with their Care Manager to assist in finding an in-network pharmacy and transferring their prescriptions. Members can also contact in network pharmacies to initiate prescription transfers.

Important note: This change only impacts members who are filling their medications using their Mercy Care Medicaid plan coverage.

Additional information can also be found at the following links: 

Dual eligible members who fill their medications using their Medicare Advantage Prescription Drug plan coverage provided either through Mercy Care Advantage or another Medicare health plan are not affected by this change.

Medicare members can continue to use their Part D prescription drug benefit to fill covered medications at their current pharmacy in 2020.

We are alerting our provider network now so that you can assist your patients through further communication and in transferring their prescriptions to a network pharmacy.  Before February 3, 2020   Mercy Care members impacted by this change must transition their prescriptions to a participating network pharmacy for their medications to be covered beginning February 3, 2020 . We recommend that members identify and begin using the new pharmacy prior to  Monday, February 3, 2020, to help assure a smooth transition.

How to transfer your prescriptions to a new network pharmacy 
  • Call or visit your the new pharmacy with current prescription label in hand. 
  • All the information needed to transfer your prescription is on the label.

How to request an emergency supply of your medication
If you need an emergency supply of your medication, choose one of the options below:
  1. Call Member Services and explain that you need an emergency supply. They will work with our pharmacy team to get a one-time override. 
  2. Ask your pharmacy to contact the CVS Pharmacy Help Desk and request a one-time override.  

A robust campaign to alert members of this change is underway.

As always, don't hesitate to contact your Mercy Care Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website.

We appreciate your continued assistance, support and cooperation!