Reprint Original Email
From: Brett Thomas
[mailto:Brett.Thomas@gov.ok.gov]
Sent: Monday, November 07, 2011
2:04 PM
To: Rob
Standridge
Subject: RE:
OSEEGIB
November 7, 2011
Dear Rob Standridge:
Thank you for contacting the office of
Governor Mary Fallin concerning the
upcoming changes in the Oklahoma State and
Education Employees Group
Insurance Board (OSEEGIB) prescription
benefits.
The mail-order program that will go into
effect January 1, 2012 has been
considered by OSEEGIB for the last several
years. Many private and public sector
prescription plans have been using a
mandatory mail order program for some
time as a cost saving measure. The change
was considered and voted on in public
meetings on both July 22 and August 19,
and the Board determined that the
savings for the state of Oklahoma and its
employees was especially important
during this difficult economic time.
The Board also met on October 28 and
revisited the pharmacy maintenance
network/mail service program and voted to
make two changes to the original
proposal. First, members will be allowed to
fill three prescriptions at a 30 day
supply at all retail locations. After the
third fill, the member would need to use
a maintenance network pharmacy or Medco
mail service to obtain up to a 90 day
supply at the network copay. If the
member chooses to continue to fill the script
at a non network retail pharmacy,
the member will be able to get up to a 90 day
supply at retail, but will incur
the cost of the copay, plus the cost difference
between network and non network
contracted rates, estimated to be approximately
8-10% higher than what a member
would pay at an in network pharmacy.
Additionally, Medco will offer a higher
reimbursement for pharmacies to join
the maintenance network, if those
pharmacies are located more than fifteen miles
from a maintenance network
pharmacy to ensure adequate access.
The new mail order program is for
maintenance medications only and all
pharmacists will be allowed to
participate. Oklahoma pharmacies that participate
in the HealthChoice network
for maintenance medications will receive
reimbursement set at a fair market
price. Routine medications will stay the same
as today, with the same reimbursement to all pharmacies. If a member chooses
to fill a maintenance
prescription at a local out of network pharmacy they may
still do so, but will
incur a slightly higher cost.
Again, thank you for contacting Governor
Mary Fallin to voice your
concerns. As we continue to work together to address
the many challenges
facing our state, we hope you will continue to do so.
Sincerely,
Brett Thomas
Public Affairs Liaison
Reprint Original Email
From: Brett Thomas
[mailto:Brett.Thomas@gov.ok.gov]
Sent: Monday, November 07, 2011
2:04 PM
To: Rob
Standridge
Subject: RE:
OSEEGIB
November 7, 2011
Dear Rob Standridge:
Thank you for contacting the office of
Governor Mary Fallin concerning the
upcoming changes in the Oklahoma State and
Education Employees Group
Insurance Board (OSEEGIB) prescription
benefits.
The mail-order program that will go into
effect January 1, 2012 has been
considered by OSEEGIB for the last several
years. Many private and public sector
prescription plans have been using a
mandatory mail order program for some
time as a cost saving measure. The change
was considered and voted on in public
meetings on both July 22 and August 19,
and the Board determined that the
savings for the state of Oklahoma and its
employees was especially important
during this difficult economic time.
The Board also met on October 28 and
revisited the pharmacy maintenance
network/mail service program and voted to
make two changes to the original
proposal. First, members will be allowed to
fill three prescriptions at a 30 day
supply at all retail locations. After the
third fill, the member would need to use
a maintenance network pharmacy or Medco
mail service to obtain up to a 90 day
supply at the network copay. If the
member chooses to continue to fill the script
at a non network retail pharmacy,
the member will be able to get up to a 90 day
supply at retail, but will incur
the cost of the copay, plus the cost difference
between network and non network
contracted rates, estimated to be approximately
8-10% higher than what a member
would pay at an in network pharmacy.
Additionally, Medco will offer a higher
reimbursement for pharmacies to join
the maintenance network, if those
pharmacies are located more than fifteen miles
from a maintenance network
pharmacy to ensure adequate access.
The new mail order program is for
maintenance medications only and all
pharmacists will be allowed to
participate. Oklahoma pharmacies that participate
in the HealthChoice network
for maintenance medications will receive
reimbursement set at a fair market
price. Routine medications will stay the same
as today, with the same reimbursement to all pharmacies. If a member chooses
to fill a maintenance
prescription at a local out of network pharmacy they may
still do so, but will
incur a slightly higher cost.
Again, thank you for contacting Governor
Mary Fallin to voice your
concerns. As we continue to work together to address
the many challenges
facing our state, we hope you will continue to do so.
Sincerely,
Brett Thomas
Public Affairs Liaison