State & FederalMedicaidDecember 31, 2021

Botox update for Empire BlueCross BlueShield HealthPlus members

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Effective January 1, 2022, CVS Specialty Pharmacy* and IngenioRx Specialty Pharmacy* will no longer distribute the brand name drug Botox,® but it will still be available to Empire BlueCross BlueShield HealthPlus (Empire) members either through buy and bill or through an available retail pharmacy.

 

Please note:

  • This is not a change in member benefits. This is a change in the Botox vendor only.
  • If the member is not using CVS Specialty Pharmacy or IngenioRx Specialty Pharmacy to obtain Botox, no action is needed.

 

For Botox managed under a member’s medical benefit

Effective January 1, 2022, you will need to buy this drug and bill Empire.

 

If you have questions regarding a member’s medical specialty pharmacy benefits, call Provider Services at 1-800-450-8753.

 

For Botox managed under a member’s pharmacy benefit

Effective January 1, 2022, members who currently obtain Botox through IngenioRx Specialty Pharmacy using their pharmacy benefit must change to another in-network pharmacy that distributes Botox.

 

If you have questions regarding a member’s pharmacy benefit, call Pharmacy Member Services at
1-833-207-3117.

 

* CVS is an independent company providing pharmacy services on behalf of Empire BlueCross BlueShield HealthPlus. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Empire BlueCross BlueShield HealthPlus.

 

NYE-NU-0381-21 November 2021

PUBLICATIONS: January 2022 Newsletter