Providers

BCN: November 2023 Pharmacogenomics Mailing and Invites You to Sign Up for Regular PGx Reports

November 29, 2023

Blue Care Network mailed additional letters in November 2023, to primary care physicians and prescribers with BCN patients who are being offered the opportunity to receive a pharmacogenomics, or PGx, test as part of BCN’s new Blue Cross Personalized MedicineSM program.

One or more of your physicians is included in this additional mailing. Attached is a generic copy of the letter mailed. In addition, each physician received a list of his or her patients being offered the test, a Quick Start Guide and a copy of the member communication (also attached).

BCN - Follow-up from 2024 BCN/BCNA/MAPPO Gain Share Contracting Meeting

November 14, 2023

Thank you to those of you who could join us on the evening of October 25 for the BCN/BCNA/MAPPO Gain Share Contract and Program updates for 2024.  We know some of you had conflicts and were not able to attend, so we recorded the meeting.  Due to the size of the file, we are pushing the recording of that meeting through your EDIFECS accounts tomorrow.  It sometimes takes several hours for those to go through, so I’d give it until Wednesday to retrieve it. 

BCN - October 2023 Pharmacogenomics Mailing and Invites You to Sign up for PGx Reports

October 31, 2023

Dear BCN-Affiliated Medical Care Group Business Administrator:

Blue Care Network mailed additional letters in October 2023, to primary care physicians and prescribers with BCN patients who are being offered the opportunity to receive a pharmacogenomics, or PGx, test as part of BCN’s new Blue Cross Personalized MedicineSM program.

Lakeland Care Annual Payor Conference- Documents

October 27, 2023

Thank you all who joined us at the Hilton Garden Inn for our annual payor conference.  It was so much fun to get together again and see our friends in person! We hope you found our conference helpful and, as promised, below are the presentations by our payor partners:

Priority Health - Meijer Specialty Pharmacy No Longer a Participating Network Specialty Pharmacy effective January 1, 2024

October 24, 2023

Beginning Jan. 1, 2024, Meijer Specialty Pharmacy has chosen to no longer participate in our specialty pharmacy network for commercial and individual members. This change only impacts drugs covered under the pharmacy benefit. Drugs covered under the medical benefit aren’t affected.

Medicare and Medicaid members can continue to use Meijer Specialty and retail pharmacies for all their prescriptions. All members may continue to use Meijer’s retail pharmacies for their prescriptions that don’t require a fill at a network specialty pharmacy.

 

Priority Health - PriorityActions Emails Begin on October 19, 2023

October 17, 2023

Beginning Oct. 19, you’ll receive biweekly PriorityActions emails that will include important and actionable information to help you work with us and care for our members, your patients.

 

Why is this change happening?

As we continue improving our communications to help us work together, we’re excited to launch a biweekly email that delivers important content to you on a consistent basis, reduces your inbox clutter and allows you to easily reference important content in one place.

 

Priority Health: Humira Coverage Ending -- Replaced with Biosimilars for Commercial Members effective Dec. 31, 2023

October 9, 2023

To maintain our commitment to providing our members with the most effective therapies at the lowest possible cost, Humira coverage will end for our commercial group and individual members on Dec. 31, 2023. This includes both new-start and existing prescriptions.

Humira will remain on the Medicare formulary, with prior authorization requirements, through 2024.

Effective Oct. 1, 2023, coverage for the Humira biosimilars, Hadlima and Adalimumab-adaz (manufactured by Sandoz) was added to our Medicare, commercial and individual member formularies.