The Sav-Mor Office would like to extend our best wishes to Anthony and his wife Bethany as they welcomed their first child on Friday morning. Baby boy and mom are all doing well. Congratulations!

"New Year - New Rules" - See below for changes in 2023!

*REMINDER* Pharmacy Changes Effective January 1, 2023

• Increases in payment of Medicare Part B vaccine administration and monoclonal antibodies fees:
• $31.14 for administering influenza and pneumococcal vaccines for all Part B beneficiaries, and for hepatitis B vaccine to patients with medium or high risk for hepatitis B;
• $41.52/shot for COVID-19 vaccines1; and
• $36.85/shot additional payment when the COVID-19 vaccine is administered in a home setting.
• For monoclonal antibodies for pre-exposure prophylaxis (i.e., Evusheld), CMS will pay:
• $150.50 for an injection in a healthcare setting and $250.50 for an injection at home.

• Adult vaccine copays are eliminated. Under Medicare Part D, adult vaccines covered and recommended by the Advisory Committee on Immunization Practices (ACIP) will be covered with no cost sharing. Under state Medicaid and CHIP programs, all approved adult vaccines recommended by the ACIP will be covered without cost sharing.

• All Insulin copays are capped. Monthly copayment spent on insulin is capped at $35 for plan years 2023, 2024, and 2025 for those drugs covered in Medicare Part D and Medicare Advantage.
• *Important* Medicare Part D plans have a 90-day grace period in 2023 to implement the insulin copay cap; excess copays collected at the pharmacy counter during this grace period must be refunded BY THE PLAN to the patient. Insulin furnished through durable medical equipment under Medicare Part B will also have a monthly copayment cap at $35, with no deductible, beginning July 1,2023.

January Brand Name AWP Update

As a reminder, typically during the month of January, Brand manufacturers update their Average Wholesale Prices (AWPs). You may notice certain brand claims being underpaid – this is because of the AWP update. So far, the Sav-Mor Team has been able to resubmit 91 claims for a total increased reimbursement of $4,842!

Here are some examples of drugs we have seen so far that have increased in reimbursement due to AWP Increases:

**If your pharmacy would like Sav-Mor to help process claims with higher AWP's, please reach out to Anthony.Codrean@sav-mor.com

Pharmacies already participating in this service, detailed reporting is included in your monthly aging report titled "AWP Resubmits".**

Update for Rx30/ComputerRx Users - Network Management (Elevated MSP)

TDS has announced that Elevated MSP is the new partner for providing network management services to clients. This is a replacement for the NetProtect program that TDS previously offered. Elevated MSP took over all invoicing and support of clients who were paying for NetProtect or legacy SonicWall support. Clients who are enrolled in the NetProtect program will be receiving an update from Elevate regarding invoicing and payment for this service 

Elevated MSP Contacts:

Support for existing clients: 800-444-9484, opt 0 | support@elevatedmsp.com | www.elevatedmsp.com/support

Sales for new clients: 800-444-9484, opt 2 | sales@elevatedmsp.com

Pharmacy Tips/Updates from Core Members

See below for tips/updates/reminders from various members - please continue to share!

• Sign up for AssistRx - Patient Pay Assistance or Gilead Co-Pay Program

• Review the MI Medicaid 2/1/2023 PDL Changes Here!

• Check out the recorded webinar from NCPA "Don’t Say We Didn’t Warn You: Preparing for the DIR Hangover, DSCSA, and Other Regulatory Items That Should Be On Your 2023 Pharmacy Checklist"

• Aetna of Michigan Lancets - Preferred Products for 2023 will be One Touch!

• Make sure your pharmacy is displaying the most up-to-date CMS-10147 Form!

• Starting 1/1/2023, Humana will be resuming on-site audit visits.

• Michigan Electronic Prescribing enforcement starts 1/1/2023. Check the FAQ!

• CVS/Caremark Onsite Audits - *Be aware* the auditor will provide a list of 25 Drugs that require a visual count during the onsite visit.

• Outcomes MTM's - Better for TIP cases to expire than put a "negative result" as those results "couldn't reach patient, etc.." hurt your ratings whereas the expiration does not. Aetna MAPD will be offering an additional $50 bonus payment for completed CMR's.

• Michigan Pharmacist Association (MPA) Renewal Discount Code: Use code: SAV2023 to save 30% off when renewing your membership!

FDA Updates Mifepristone REMS Program

FDA has updated its risk evaluation and mitigation strategy (REMS) on dispensing mifepristone that must be followed for mifepristone for medical termination of pregnancy through ten weeks gestation. Under the Mifepristone REMS Program, mifepristone must be dispensed by or under the supervision of a certified prescriber or by certified pharmacies for prescriptions issued by certified prescribers. Under the Mifepristone REMS Program, mifepristone may be dispensed in-person or by mail.

PBM/Third-Party Updates

If you are interested in placing an order for popular summer items for please see the attachment below.