New Pharmacy Benefits Manager
Effective October 1, 2024, Maryland Physicians Care (MPC) will change to a new retail pharmacy benefit manager (PBM), CVS Caremark. When MPC transitions to CVS Caremark on October 1, 2024, the MPC Pharmacy team will perform the Prior Authorization (PA) process for retail pharmacy benefit medications and prescriber peer-to-peer reviews. CVS Caremark will not perform these functions for MPC.
The MPC Pharmacy team will review all PA reviews for pharmacy benefit medications (ePA/fax/telephonic). Requests can be submitted to MPC by:
Fax: 833-896-0656
Phone: 888-258-8250
Existing electronic prior authorization processes will remain the same.
There will be no immediate impact on the formulary as MPC will continue to utilize the current preferred drug list during the transition to CVS Caremark. No changes to medications processed under the PBM or medical benefit will occur during the transition. All MPC members will receive a new ID card reflecting the new PBM and processing information for CVS Caremark. There should be minimal disruption to the pharmacy network access with the new PBM transition. Any member impacted by pharmacy distribution will receive notice before the transition offering assistance to change their pharmacy.
If you have any questions, call MPC Customer Service at 800-953-8854. To update your email address and fax number, email MPC at ProviderDataManagement@mpcMedicaid.com.
