TPA staff received numerous calls, emails, and communications from its members this afternoon regarding a significant drop in TennCare reimbursement which reportedly occurred today for its preferred Abbott glucose test strip products. TPA immediately alerted TennCare pharmacy leadership about this urgent issue, and after investigating, TennCare pharmacy leadership immediately investigated and advised TPA that Magellan incorrectly applied a maximum allowable cost (MAC) price to all Abbott glucose test strip products in error. Magellan is in the process of removing the MAC rate for the Abbott glucose test strip products to prevent any further reimbursement issues. As soon as this process is completed, Magellan will identify all claims which were processed with the affected NDC numbers and contact each pharmacy directly. When contacted, pharmacies will need to reverse and re-bill any affected claims in order to get properly reimbursed for the affected Abbott glucose test strip products.
TPA appreciates the communication and prompt response by TennCare and its pharmacy leadership to this urgent issue. TPA staff will continue to work with TennCare and will provide additional updates to our members if new information is made available.