Aetna Better Health to Return to Pre-October Reimbursement Rates

The Pennsylvania Department of Human Services informed PPA yesterday that CVS/Caremark intends to return its MAC pricing for Aetna Better Health MCO back to the levels that were in place prior to the atrocious cuts implemented in October 2017. You should now be seeing this change for the two MCOs using CVS/Caremark as their PBM – Aetna Better Health and Gateway Health. If for any reason you are not seeing reimbursement rates return to the levels they were at prior to the October 2017 cuts, please file MAC appeals with CVS/Caremark and, most importantly, contact us so that we can keep the state Medicaid office informed. You can contact Jeff Stuby, PPA’s Government Relations Manager at 717-234-6151, ext 6, or Pat Epple, PPA’s CEO at 717-234-6151, ext 3.
A big shout out to our own Mel Brodsky who also worked tirelessly to get the MAC pricing back to what they were prior to October. Give him a call at 215-464-9890 if you run into any issues with your reimbursement rates.