EUTF update: pharmacy benefit management
January 11, 2012
On January 10, 2012, HGEA was informed of the following related to the pharmacy benefit management (PBM):
- Actives and non-Medicare retirees (bargaining unit employees and retirees under 65): The EUTF confirmed the effective date that CVS will take over as May 1, 2012. There have been questions from members as to why CVS couldn’t just take over on January 1, 2012 shortly after the award since they should have been planning for the transition in the interim. The two main reasons for this not happening are 1) transitions from one PBM to another for similar plans normally take three to four months due to the complexity of the plan and the significant number of participants and 2) once informedRx filed the protest, in accordance with the state procurement code, all discussions and contact between CVS and EUTF had to cease until the hearings officer’s decision.
- Medicare retirees (65 and older): In accordance with the hearings officer's decision, the EUTF evaluation committee met to rescore the proposals based on certain items raised in informedRx’s protest. The trustees approved the evaluation committee’s recommendation and awarded the PBM contract for Medicare retirees to CVS. The planned effective date is June 1, 2012, as normally Medicare retiree programs take longer than actives because the plan must also work with the Centers for Medicare & Medicaid Services (CMS). However, informedRx can again protest the awards and put a stay on the transition.
We will continue to provide regular updates to members via eBulletin and our HGEA website.