SPBM: October 26, 2022 Update

 

Do you have issues with the implementation of the Single PBM? Please utilize the OPA SPBM Help Line.

Update on Supplemental Dispensing Fees:
As a reminder, there are four supplemental dispensing fee payments that will be issued in this State Fiscal Year. 

• Payment 5 – Between November 1 – 15, 2022 (July – Sept 2022 claims)
• Payment 6 – Between February 1 – 15, 2023 (Oct – Dec 2022 claims)
• Payment 7 – Between May 1 – 15, 2023 (Jan – March 2023 claims)
• Payment 8 – No later than August 15, 2023 (April – June 2023 claims)

Note that the November payment will be issued by the Medicaid Managed Care Organizations and then the remainder of the payments will be issued by Gainwell.  Gainwell will issue the final three payments separately from your weekly payments and they will be marked as your supplemental dispensing fee.  Also, the tiers will be increased to $0.70 to $1.25. The FAQ document includes more details on the fee schedule: