Inland Empire Health Plan (IEHP) Passes CMS Formulary Review

RANCHO CUCAMONGA, Calif: Inland Empire Health Plan (IEHP) participated in the 2019 Centers for Medicare and Medicaid Services (CMS) Formulary Review, where no discrepancies were found between IEHP's approved CMS Formulary and the Formulary published to the plan's website.

The Formulary lists Part D prescription drugs covered by IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan). IEHP DualChoice is the largest not-for-profit Medicare-Medicaid plan in the nation with almost 29,000 members.

The Formulary is a critical component to the care that our providers and pharmacies use to treat our members. The IEHP Pharmacy and Therapeutic Subcommittee utilizes healthcare industry clinical guidelines and CMS guidelines to develop, update and administer the Formulary for CMS's approval, said IEHP Pharmacy Senior Director Dr. Edward Jai.

CMS monitors the posting and accuracy of these Formulary documents by extracting comprehensive Formulary and utilization management documents from plan websites and comparing these to the CMS-approved Formulary effective January 1, 2020. When discrepancies are identified by CMS, the plan will be asked to work aggressively to correct any confirmed errors and may be subject to formal compliance action.

It all comes down to ensuring our members receive correct and effective care. Publishing a Formulary on our website that mirrors the CMS-approved Formulary is critical because it allows us to communicate and coordinate the appropriate care for our members, said IEHP Chief Marketing Officer Susan Arcidiacono.

To learn more about the IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) Formulary, visit iehp.org.
(PRN | 5 months ago)

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Inland Empire Health Plan (IEHP) Passes CMS Formulary Review