Here is the latest edition of Model Consulting's Week in Review Newsletter. We
hope you find the Newsletter informative and helpful.
Model Consulting Labor Day Holiday Schedule
Please be advised that
Model Consulting will be closed on Friday September 4th and Monday September 7th
in observance of the Labor Day Holiday. We will re-open on Tuesday September
8th at our normal business hours.
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Aetna: 2010 Summary of
Formulary Updates and New Safety Edits
Each
year, Aetna Pharmacy Management (APM) updates its Preferred Drug List. This
list shows many of the drugs covered by Aetna
pharmacy plans. It's updated regularly based on the latest medical findings,
information from the Food and Drug Administration (FDA), drug makers and cost
arrangements, which include manufacturer rebates. Since these updates can
greatly affect members and their prescriptions, APM is sending summary of
change notices to all members in commercial pharmacy benefits plans. Also in
the notices is information about applicable Precertification and Step-Therapy
List updates as well as precertification safety edits, kit and Rx/OTC
exclusions. All updates take effect January 1, 2010.
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Aetna: Buying Power Through Unique Discount and Savings Program
HARTFORD,
Conn., May 20, 2009 - As part of its commitment to find new and innovative ways
to help customers during times of uncertainty, Aetna (NYSE: AET)
today announced that it will enhance customer access to discounts and savings
through its Aetna Resource Connection program. The program, available to
brokers and those employers with 1-300 employees, leverages Aetna's
buying power to provide discounts and savings to customers to help them save
time and money on their monthly business expenses. Customers can learn more
about the program by visiting www.AetnaResourceConnection.com.
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HealthAmerica: Electronic Directories Offer Several Advantages
Our goal is to provide high quality, affordable
health care coverage. Because of this, we will no longer be printing paper
provider directories. Going green with paperless provider directories
helps the environment and helps to save money. It also encourages members
to use the most up-to-date information.
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Highmark: August Updates Newsletter
This month's newsletter (attached)
includes articles regarding:
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Wellness Tip of the Month
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Legislative Updates/News
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Pennsylvania Cancer Education Network
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Pharmacy Updates
Please contact your Model Consulting
representative if you have any questions about this information.
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Horizon BCBSNJ:
Radiology Groups Remain in Horizon Networks
Horizon
Blue Cross Blue Shield of New Jersey is pleased to announce that we have been
successful in our negotiations with the southern and central New Jersey radiology groups. All of the
radiology groups will remain in our networks. The groups are as follows:
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UnitedHealthcare: BRCA Genetic Testing Notification
Beginning August 16, 2009, UnitedHealthcare and
certain affiliates will require prior notification for all BRCA (Breast Cancer
Genetic Testing) tests, ordered by all physicians without exception (HCPCS codes
S3818 - S3823).
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UnitedHealthcare: Covering H1N1 Flu Vaccine for its Members
As you may have read, all regions of
the U.S.
have now reported positive cases of the H1N1 flu. The latest comments from the
Centers for Disease Control and Prevention (CDC) suggest the situation remains
fluid.
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