Incorrect Copays Charged for Lipitor
UnitedHealthcare, the Empire Plan’s Prescription Drug claims administrator, informed the Department of Civil Service about a processing error related to the Empire Plan’s Lipitor Brand for Generic strategy. For settled/ratified employee groups (including PEF), effective with the November 30 launch of the Lipitor generic version (atorvastatin), the brand drug was changed to a Level 1 copay while the generic version was placed on Level 3. The pharmacy messaging should prompt the pharmacist to dispense the lower cost brand version at the Level 1 copay instead of the Level 3 generic version. Due to a system error, pharmacies failed to receive the point of service messaging starting on December 1st, 2011. The error was to be fixed on December 8, 2011. As a result, members were incorrectly dispensed the generic version and assessed the higher Level 3 copayment. UnitedHealthcare will AUTOMATICALLY issue refunds to affected members for the overpaid copayments (difference between the Level 1 and Level 3 copays. UnitedHealthcare anticipates the refund will be issued in 6-8 weeks.
If you expect a refund and haven’t received it by February 10, 2012, call 877-7-NYSHIP or 877-769-7447 and press "4" for the Empire Plan Prescription Drug Program.