Dear Michigan Pharmacy Owner,
We are proud to announce that Sav-Mor Pharmacy Services & Michigan Independent Pharmacy Association (MIPA) have worked diligently with Blue Cross Complete (PerformRx) to remove transaction/transmission fees for approved pharmacy claims for ALL Michigan Pharmacies! Additionally, Blue Cross Complete has agreed to refund any transaction/transmission fee pharmacies may have occurred in the first quarter of 2024 (this is expected to happen in the coming weeks).
MI House Bill 4348, which was made effective 1/1/2024, prohibited pharmacies from being charged a transaction fee or a fee to transmit a prescription claim electronically. Sav-Mor was able to successfully negotiate these transmission fees out of our contract with PerformRx in 2021. However, through our reconciliation program we were able notice these transmission fees to other Michigan pharmacies who happen to belong to various other PSAOs, even after the House Bill 4348 effective date of 1/1/2024. Because Sav-Mor is constantly monitoring claims for our members and working with state and federal legislators, Blue Cross Complete (PerformRx) will make these adjustments across all Michigan Pharmacies regardless of PSAO/Contracting entity!
We are proud to highlight this small victory and continue to work with other payors & the Department of Insurance and Financial Services (DIFS) to regulate the payors/PBM’s according to the guidelines of HB4348. Sav-Mor and MIPA will continue to work alongside the Michigan Pharmacists Association to further introduce key legislation that provides protection for pharmacies across Michigan. We already have complaints and communication out to other payors to try to resolve the transmission fee issue.
What should I do now? How can I review these transactions/transmission fee’s?
The average transmission/transaction fee was $0.18 cents per approved claim. If you would like to see the financial impact for your pharmacy in 2024, ask your pharmacy reconciliation system to identify transaction adjustment fees for PerformRx (BIN#019595). If they cannot supply this information or you do not currently work with a company for your claims reconciliation, Sav-Mor would love to show you how we provide pharmacy reconciliation for over 150+ pharmacies. To learn more, reach out to [email protected].
