United Health Care Making Changes to Benefit Plan as it Relates to Compounding and Bulk Chemicals

Additional Compounding Drug Changes Set for July 1

April 9, 2014

                  

To continue ensuring appropriate use of compounds, a couple of additional updates will be made to the bulk chemical/compounds strategy on July 1.  
Effective July 1 there will be additional updates to the bulk chemical/compound program:

• Compounds will now be subject to pharmacy benefit programs (supply limit, notification, etc): Members receiving a compound prescription with an ingredient in one of our pharmacy benefit programs will now need to follow the program guidelines. For example, today if a pharmacy submits a claim for a compound with tretinoin (active ingredient in Retin-A), it will bypass our notification review (in most cases).  Effective July 1, this type of claim would be stopped and the review process would be required to determine coverage.
• An additional 8 bulk chemicals will be excluded. 

Member letters will be mailed out June 1 (May 1for fully insured states that require early notice) notifying them of the additional bulk chemicals exclusion and will also reference that their compound medication may be subject to various clinical programs that their benefit plan may participate in.
For more information, please contact your UnitedHealthcare representative.
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