Tennessee Pharmacists Association

December 19, 2019

On January 1, 2020, at 12:00 AM Eastern, the Pharmacy Benefits Manager (PBM) for the TennCare Pharmacy Program and the CoverRx Program is changing from Magellan to OptumRx. OptumRx has provided information and links to help pharmacies prepare for the transition, including the following:

  • TennCare Pharmacy benefits are not changing.
  • It is not necessary for pharmacy providers to register with OptumRx.
  • Magellan I.D. Cards are good until December 31, 2019.
  • New OptumRx I.D. Cards are expected to be mailed to active TennCare members prior to January 1, 2020.
  • Existing Prior Authorizations obtained during calendar year 2019 with an expiration date after January 1, 2020, will be transferred to OptumRx and will not require any action.
  • Reversals straddling the transition will be accepted.
  • All TennCare phone and fax numbers remain the same and will be transferred to OptumRx at 12:00 AM Eastern on January 1, 2020.

For much more information, check out the Frequently Asked Questions for TennCare providers and members, available now. The OptumRx TennCare website and OptumRx CoverRx website will both be live by January 1, 2020.  You may also contact your OptumRx Provider Educator below:

East Tennessee
Heather Cline
heather.cline@optum.com
952-324-4308Middle Tennessee
Ginger Stoves
ginger.stoves@optum.com
956-662-6361West Tennessee
Jud Jones
robert.j.jones@optum.com
952-324-4045
TPA will stay in communication with TennCare and OptumRx during this transition period. In addition to contacting the Provider Educators listed above, all TPA members are encouraged to contact our office about any implementation issues or operational inconsistencies, so we can work together to ensure a smooth transition.