TRICARE Pharmacy Network Issue

Overview

Early fall of 2022, NHIA member pharmacies began reporting that TRICARE patients had received letters from Express Scripts stating the local home infusion pharmacy they currently use will not be in network as of October 24, 2022. The letters instructed patients that to avoid out of network expense premiums they should change their pharmacy to Accredo Pharmacy, a mail order pharmacy owned by Express Scripts.

NHIA also received reports from home infusion providers that sufficient notice was not provided regarding specialty network changes and opportunities for participation. Many providers stated they did not receive any notice, while others reported that they received notice for some commonly owned home infusion sites, but not others. Some reported signing and returning the notice within the short timeframe, but the patients they service are still receiving notices that they are no longer in network.

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