Reunited and Together Again!

For the first time since the start of the pandemic, The Pharmacy Connection (TPC) hosted in-person Roundtables in Suffolk, Richmond, Abingdon and Roanoke. An online option was also made available for those not able to attend in-person and for out-of-state users. We had over 100 individuals attend from 100 different organizations. Thank you to everyone who was able to join us! Attendees networked, shared and discussed key resources for successful Medication Assistance Programs (MAPs), explored ways to identify alternative medications available in TPC and how to prepare for the return of Medicaid renewals.


Don’t Miss Out: We look forward to networking on the next monthly support call scheduled for June 21. Pre-register here to receive login details.


If you missed one of these sessions, please be on the lookout for follow-up materials in your email and the next in-person and online Roundtable sessions will be scheduled for the Fall!

Medicaid Renewals Are Coming and Have Already Resumed

for More than 200,000 Virginians

The special federal pandemic rule that kept nearly all Medicaid enrollees covered from March 2020 until April 2023, has now ended. Virginia is taking a staggered approach to renew enrollees over the next 12 months. Some enrollees may have already received their renewal packet, while others may receive one over the next year. All need to be sure to respond by the specified due date.


Renewal outcomes for enrollees may include: a successful renewal, loss of coverage due to no longer being eligible, or loss of coverage for administrative reasons. What can you do to help?

 

Ways to Help Eligible Virginians Keep their Medicaid Coverage


1)   Update their contact information with Virginia Medicaid.

  • Through their Medicaid/FAMIS MCO;
  • Online at commonhelp.virginia.gov;
  • By calling the local Department of Social Services; or
  • By calling Virginia’s One Benefits line at 1-833-5CALLVA.


2)   Watch for a renewal notice via mail from the local Department of Social Services.


3)   Open the renewal notice and respond by the due date or sooner.


Want to become more familiar with the eligibility ins and outs? Check out our SignUpNow Workshops. Also, don’t forget that TPC provides the ability to track new & renewal Medicaid applications and their status for reporting purposes! 

NEW Brandname MEDICATIONS Now Available in TPC

As new medications are approved by the FDA and become available on PAP(s), they are added to TPC. We continue to make updates regularly. Check out some of the most recent additions. Don’t forget to share these newly available products with your providers so they are aware of new medication options when considering what to prescribe for patients.


Skyclarys (Neurologic)

Tezspire (Asthma/Pulmonary)

Xermelo (Gastrointestinal)

Veozah (Obstetrics/Gynecology)

Generic Medications Available through Rx Outreach for FREE

For a limited time, eligible individuals can obtain up to 90-day supplies of these generic medications on a first-come, first-served basis at no cost from Rx Outreach (enter $0 in the search bar to see complete list and available strengths) that are available in TPC

NO COST HEARING AIDS: Helping Others Hear via Neighbors in Need  

Hearing Aids can typically cost thousands of dollars. Starkey Cares provides hearing aids at no cost to eligible patients through a program called Neighbors in Need. Individuals with an annual household income at or below $27,180 or $36,620 for 2 in the household may be eligible. Click here for the full list of income eligibility.


To get started, visit starkey.com/starkeycares or call 855-686-2202 with your zip code to locate a Starkey Cares partner office near you to schedule a free hearing test. If the Starkey Cares partner thinks you may qualify to participate in the program, the provider will assist with the online application that will need to be completed. If approved, the applicant pays a $300 application fee that helps covers Starkey staff time for managing the process. The Starkey Cares partner will assist in completing the order and fit the individual for the proper hearing aids.

Highlights of Important PAP Updates for Patients & Providers

TPC sends out regular communication via email with important changes to PAPs. We also use the time during the monthly technical support calls to discuss challenges, solutions, new ideas and more when it comes to assisting patients in need. Below are key updates for this Spring. Manage your TPC email subscription options here.


NEW!

  • Boehringer Ingelheim Cares Patient Assistance Program now offers a new online refill option available here for existing patients in addition to phone refills. The program recommends completing the online enrollment 10 business days prior to the next refill date to allow for processing and shipment. To request a refill online, you will need the prescription number, patient DOB, and shipping zip code.


  • Sanofi Patient Connection has an updated reorder process! After 5/31/2023, a reorder form no longer needs to be submitted for each 90-day supply if there are no dosage or insurance changes. Refills will be sent automatically to the address listed on the original application. Reorder forms should be submitted for patients who have stopped therapy, had a dosage change or an insurance update.

 

Changes in Availability

  • Ozempic 0.25mg/0.5mg (2mg/1.5ml) from Novo Nordisk remains in short supply but patients enrolled in the PAP have started to see shipments resume for other dosage options. Ozempic 0.25mg/0.5mg (2mg/1.5ml) will be transitioning to 0.25mg/0.5mg (2mg/3ml).


  • The last day to submit renewal applications and prescriptions for existing patients on Advair Diskus, Advair HFA and Beconase AQ to GSK PAP was 5/1/2023. These products will be fully removed from the GSK PAP June 1, 2023. Additional temporary assistance may be obtainable for Medicare Part D patients. Please contact the GSK PAP if you need check eligibility for your specific patients. Discuss this change with your providers to identify the most suitable alternative brandname option for your patients based on their condition. Several alternatives that are available on PAPs in TPC include: Breo Ellipta, Dulera, Symbicort and Wixela Inhub. In TPC, check Research-Medications or the TPC mobile app for other options.


  • Viatris has extended eligibility for currently enrolled patients approved for Lyrica, Lyrica CR and Dilantin. Individuals currently enrolled with commercial insurance will no longer be eligible for assistance after June 30, 2023. Enrollment will continue until the patient’s enrollment date ends or June 30, 2023, whichever comes first. Those with prescription coverage through a government program will no longer be eligible for assistance after December 31, 2023. No new patients are being accepted into the PAP for these products. Questions regarding your enrolled patients can be directed to Viatris at 1-888-417-5782.

Training & Networking Opportunities

Sign up for an online TPC training session if you are new to your organization and need to learn the basics. If you currently use TPC and are looking to refresh your skills or want to learn about additional features, sign up for Advanced Training.


We also host monthly calls where we provide updates and give users the opportunity for a Q & A session. It’s also a great opportunity to brainstorm and learn from other TPC users. All sessions are Eastern Standard Time. For more information or to register for one of these sessions and view additional dates, click here. 

SignUpNow Offers Live Interactive Workshops


Do you work with clients who are 65+ years old, enrolled in or eligible for Medicare and/or need assistance with renewal of their Medicaid eligibility? SignUpNow now offers 2 training workshops on how to help these individuals apply for and renew their eligibility for Medicaid! 


Workshop dates and registration is available at vhcf.org/workshops.

SignUpNow – Medicaid/FAMIS workshops cover the “ins and outs” of the eligibility requirements, application procedures, and post-enrollment information for Virginia’s Medicaid/FAMIS programs for children and families, including:


  • New Adult Coverage (“Medicaid Expansion”)
  • Programs for children and pregnant women (FAMIS, FAMIS Plus, FAMIS Prenatal, FAMIS MOMS, and Medicaid for Pregnant Women)
  • Low Income Families with Children (LIFC)
  • Medicaid for Former Foster Care Youth
  • Plan First (family planning)

SignUpNow – ABD workshops cover eligibility requirements, application procedures, and post-enrollment information for Virginia’s Aged, Blind, or Disabled (ABD) Medicaid covered groups, including:


  • ABD with Income ≤80% FPL
  • Virginians who receive Supplemental Security Income (SSI) or an Auxiliary Grant
  • Medicare Savings Programs (Qualified Medicare Beneficiary, Special Low-Income Medicare Beneficiary, etc.)
  • Virginians needing Long-Term Services and Supports (LTSS), including those who are Institutionalized, in Hospice, or receiving Community Based Care.