drug-alerts

Pharmacy news and alerts

This page provides pharmacy-related safety alerts, drug recall and new generic drug announcements and other medication information.

Nuedexta to require prior authorization effective May 1, 2018

Effective May 1, 2018, Humana will add a prior authorization requirement to Nuedexta (dextromethorphan hydrobomide and quinidine sulfate) on its Medicare formularies.

Prescribers with patients currently taking Nuedexta will not be impacted by this change. Those patients will be able to continue taking the medication until the end of the plan year. On May 1, all patients with new prescriptions must have a prior authorization for Nuedexta for the claim to be covered.

Prescribers with questions regarding this change may call the Humana Clinical Pharmacy Review team at 1-800-555-CLIN (1-800-555-2546) Monday through Friday, 8 a.m. to 8 p.m. Eastern time.

Get information about 2018 Medicare formulary changes

Effective Jan. 1, 2018, certain drugs in the Humana Medicare formularies will have new limitations or will require utilization management for the 2018 plan year.

Humana to prefer brand-name Lialda on its Medicare, employer group and HumanaOne® formularies

Effectively immediately, for Medicare, brand-name Lialda is covered and can be filled for the member without a prior authorization, although generic Lialda is not covered. For employer group and HumanaOne®, generic Lialda isn’t covered in most cases or may require a step therapy.

Prescribers with questions regarding this change may call 1-800-555-CLIN (1-800-555-2546), Monday through Friday, 8 a.m. to 8 p.m. Eastern time. Prescribers in Puerto Rico should call 1-866-488-5991.

Generic Pataday is considered noncovered/nonformulary for certain formularies

Humana would like to notify network pharmacies that generic Pataday (olopatadine hydrochloride ophthalmic solution) is considered noncovered/nonformulary for all Medicare, employer group and HumanaOne formularies.

Generic Renvela is considered noncovered/nonformulary for certain formularies

Humana notified network pharmacies that generic Renvela (sevelamer carbonate) will be considered noncovered/nonformulary for all Humana Medicare and employer group formularies.

Opioid utilization program point-of-sale edit continues

Humana Pharmacy Solutions will continue the opioid utilization program point-of-sale edit. Pharmacists may continue to use Pharmacy Professional Service (PPS) codes for certain opioid thresholds.

Drug recall notice for EpiPen and EpiPen Jr Auto-Injector

We want to alert you to a recall of EpiPen and EpiPen Jr (epinephrine injections, USP), effective March 31, 2017.

Meridian Medical Technologies and Mylan voluntarily recalled EpiPen and EpiPen Jr (0.3 mg and 0.15 mg strengths) Auto-Injectors currently on the market. This recall was initiated due to reports of possible device malfunctions that could result in the devices failing to activate or requiring increased force to activate in an emergency or life-threatening situation.

The recall includes the NDC and lot numbers in the table below.

NDC Product Lot Expiration Configuration/Count

49502-501-02

49502-500-02

EpiPen Jr 2-Pak Auto-Injectors, 0.15 mg;

EpiPen 2-Pak Auto-Injectors, 0.3 mg

5GN767; 5GN773; 5GM631; 5GM640; 6GN215; 6GM082; 6GM072; 6GM081; 6GM088; 6GM199; 6GM091; 6GM198; 6GM087 April 2017 through October 2017 Dosage delivery

We want to alert you to a recall of EpiPen and EpiPen Jr (epinephrine injections, USP), effective March 31, 2017.

Meridian Medical Technologies and Mylan voluntarily recalled EpiPen and EpiPen Jr (0.3 mg and 0.15 mg strengths) Auto-Injectors currently on the market. This recall was initiated due to reports of possible device malfunctions that could result in the devices failing to activate or requiring increased force to activate in an emergency or life-threatening situation.

The recall includes the NDC and lot numbers in the table below.

Drug recall notice for Ventolin HFA (albuterol) inhalers

We want to alert you to a recall of Ventolin HFA (albuterol) inhalers, effective April 5, 2017.

GlaxoSmithKline (GSK) voluntarily recalled more than 593,000 Ventolin HFA (albuterol) inhalers currently on the market. This recall was initiated due to a defect in certain lots of the inhaler that causes the product to deliver fewer doses than indicated. The defect does not pose a danger to patients; so, they are not being asked to return inhalers they have purchased.

The recall includes the NDC and lot numbers in the table below.

NDC Product Lot Expiration Configuration/Count

0173-0682-20

Ventolin HFA 200D

6ZP9848, 6ZP0003, 6ZP9944 March 2018 through April 2018 Dosage delivery

If patients are concerned their inhalers are not working properly, they should contact their dispensing pharmacy for guidance. No guidance was provided from the manufacturer at time of publication.

Changes made to Humana’s preferred diabetic supplies and short-acting insulin

Humana made changes that took effect Jan. 1, 2017.

Morphine equivalent dose (MED) safety edits implemented

Effective Jan. 1, 2017, Humana Pharmacy Solutions implemented additional utilization management tools in its opioid utilization program that will result in point-of-sale edits. The edits will be based on opioid thresholds.

Certain compound drugs require an exception for Medicare members

Effective Jan. 1, 2017, compounded medications utilizing an oral formulation of certain ingredients will be considered nonformulary and require an exception before Medicare members can fill under their Part D benefits.

Avoid Argus transaction rejections

Effective Oct. 11, 2016, Argus will reject transactions submitted with a decimal in the diagnosis code field (434-DO), as well as those submitted with lowercase letters in an alphanumeric field.

Pharmacies may be eligible for a claims refund

In accordance with Louisiana House Bill 436, pharmacies may be eligible for refund of 10 cents per claim where a fee was previously applied.

Humana pharmacy claims affected by Health Care Financing Administration (HCFA) term date regulations

Effective Sept. 1, 2016, certain Humana Medicaid pharmacy claims will be returned with NCPDP reject code 77: Discontinued Product/Service ID Number.

Humana offers reimbursement for flu and pneumonia vaccines

Humana will reimburse network pharmacies for providing influenza and pneumococcal vaccinations to Humana Medicare Advantage (MA), Medicare Advantage-Prescription Drug (MAPD) and Humana commercial members.

Get information about 2017 Medicare formulary changes

Effective Jan. 1, 2017, certain drugs in the Humana Medicare formularies will have new limitations or will require utilization management for the 2017 plan year.

Humana reminds pharmacies about Schedule II drug prescribing requirements

Humana would like to remind pharmacies to monitor pharmacy claims for accuracy and comply with federal and state laws, rules and regulations when filling prescriptions and submitting claims for refills and partial fills of Schedule II drugs.

How to find information regarding the Hernandez settlement agreement

Pharmacies serving Humana Medical Plan (Medicaid) members must meet all requirements set forth in the Hernandez settlement agreement.

Cost-share-protected members are exempt from balance billing for Medicare-covered services

The Centers for Medicare & Medicaid Services’ (CMS) guidelines and state Medicaid guidelines prohibit Medicare-contracted providers from collecting cost-share for Medicare-covered services, including Part B prescription services provided at point-of-sale from members who are protected by the state from cost-sharing.