Important update on Botox® for Empire members
Effective January 1, 2022, CVS Specialty Pharmacy and IngenioRx Specialty Pharmacy will no longer dispense the brand name drug Botox®. However, Botox will still be available to Empire BlueCross BlueShield (“Empire”) members through other vendors.
- This is not a change in member benefits. This is a change in the Botox vendor only.
- If the member is not using IngenioRx Specialty Pharmacy or CVS Specialty Pharmacy to obtain Botox, no action is needed.
- This change will not affect any other specialty pharmacy coverage.
Medical specialty pharmacy benefits
Our members who currently obtain Botox through CVS Specialty Pharmacy using their medical specialty pharmacy benefits must move this prescription by January 1, 2022. Here are the options:
- Providers can purchase Botox for their patients, then supply it Empire members. Providers would then bill Empire for the drug and administration of the drug. This will require a new prior authorization to notify Empire of this change.
- If the Empire member’s pharmacy benefit manager is IngenioRx, providers can transition the Botox prescription to receive the drug using their pharmacy benefits. Transferring the coverage will require a new prescription and new prior authorization for IngenioRx.
For questions regarding a member’s medical specialty pharmacy benefits, call Provider Services using the information on the back of the member’s ID card.
Pharmacy benefits manager benefits
Effective January 1, 2022, members who currently obtain Botox through IngenioRx Specialty Pharmacy using their pharmacy benefits must move this prescription from IngenioRx Specialty Pharmacy to another in-network specialty pharmacy that distributes Botox. If there are refills still available on the current prescription, members can transfer it to the new pharmacy. If not, members will need a new prescription.
For questions regarding a member’s pharmacy benefits, call Pharmacy Member Services using the information on the back of the member’s ID card.
November 2021 Newsletter