{"id":266,"date":"2009-12-01T09:33:09","date_gmt":"2009-12-01T13:33:09","guid":{"rendered":"http:\/\/www.hnetalk.com\/Provider\/?p=266"},"modified":"2009-12-01T09:33:09","modified_gmt":"2009-12-01T13:33:09","slug":"2010-formularies-now-available-please-see-below","status":"publish","type":"post","link":"https:\/\/hnetalk.com\/provider\/2010-formularies-now-available-please-see-below\/","title":{"rendered":"2010 Formularies now available.  Please see below:"},"content":{"rendered":"<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">Dear Provider,<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 4pt;\"><span style=\"font-family: Times New Roman;\">\u00a0<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">The 2010 Health New England (HNE) formularies are is now available on line at <span style=\"text-decoration: underline;\">hne.com<\/span>. Formularies available include:<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">\u00a0<\/span><\/span><\/p>\n<ul style=\"margin-top: 0in;\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"margin: 0in 0in 0pt; mso-list: l1 level1 lfo2;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">The HNE Formulary for our three-tiered pharmacy benefit package lists our Tier I (Generic) and Tier II (Preferred Brand) drugs. Medications not listed on the formulary default to Tier III (Non-Preferred Brand).<\/span><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0in 0in 0pt; mso-list: l1 level1 lfo2;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">The HNE Performance Formulary is our innovative, 2-Tier pharmacy benefit. Tier 1 includes all generic drugs. Tier 2 includes specific brand name drugs carefully selected based on clinical efficacy and cost efficiency. This HNE Performance Formulary rider is sold only with a limited number of plans.<\/span><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0in 0in 0pt; mso-list: l1 level1 lfo2;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">The HNE Medicare Advantage Formulary \u2013 exclusively for members enrolled in our Medicare Advantage plans with pharmacy coverage<\/span><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0in 0in 0pt; mso-list: l1 level1 lfo2;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">The HNE Be Healthy Formulary \u2013 exclusively for members enrolled in our MassHealth plans.<\/span><\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">\u00a0<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">The formulary also lists of medications with <\/span><\/span><\/p>\n<ul style=\"margin-top: 0in;\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"margin: 0in 0in 0pt; mso-list: l0 level1 lfo1;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">Quantity limitations<\/span><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0in 0in 0pt; mso-list: l0 level1 lfo1;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">Step therapy requirements (i.e., a trial of a generic drug in that class), <\/span><\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0in 0in 0pt; mso-list: l0 level1 lfo1;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">Prior-authorization requirements. <\/span><\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">\u00a0<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">We have forms available for your use when prescribing these medications. Completing the form can avoid delays in our review process by ensuring that we have all the information we need to make a decision. You can obtain forms on the HNE website, <span style=\"text-decoration: underline;\">hne.com,<\/span> or by contacting HNE Member Services at 1-800-310-2835. You also may request prior authorization by calling our designated Prior Authorization line at 1-866-209-1057.<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">\u00a0<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">The HNE online formulary is updated throughout the year as changes are made to the formulary.<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">\u00a0<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">Please consider the cost differential between each tier when prescribing. For example, under the HNE Formulary, copayments vary by plan; however, in general, the copayment differential between Tier II and Tier III is at least $15.00\/month, The difference between Tier I and III is at least $35.00\/month.<span style=\"mso-spacerun: yes;\">\u00a0 <\/span>By using generic drugs or prescribing therapeutic equivalents at a lower tier level, you can significantly reduce costs to your patients. Lower costs often translate to enhanced medication compliance. HNE covers at least one therapeutic agent for each disease state at the Tier I and Tier II levels.<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">\u00a0<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">We appreciate your continued partnership in providing access to high-quality, affordable care to our community here in Western Massachusetts. If you have any questions, please call your Provider Relations representative at 413-787-4000.<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">\u00a0<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">Sincerely,<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">Donna L. O\u2019Shea, M.D.<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0in 0in 0pt;\"><span style=\"font-size: 11pt;\"><span style=\"font-family: Times New Roman;\">Associate Medical Director<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dear Provider, \u00a0 The 2010 Health New England (HNE) formularies are is now available on line at hne.com. Formularies available include: \u00a0 The HNE Formulary for our three-tiered pharmacy benefit package lists our Tier I (Generic) and Tier II (Preferred Brand) drugs. Medications not listed on the formulary default to Tier III (Non-Preferred Brand). The [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[8],"tags":[],"class_list":["post-266","post","type-post","status-publish","format-standard","hentry","category-updates"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-4i","_links":{"self":[{"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/266","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=266"}],"version-history":[{"count":0,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/266\/revisions"}],"wp:attachment":[{"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=266"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=266"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=266"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}