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September 12, 2014 – SOUTHFIELD, Michigan – Hydrocodone Combination Products (HCPs) (Vicodin®, Lorcet®, Norco®, etc.)

The Drug Enforcement Administration (DEA) has officially ruled that all hydrocodone combination products be rescheduled as Schedule 2 controlled substances. This rule is effective October 6, 2014 and aims to minimize the misuse of these drugs.

Drugs are classified into five distinct categories or schedules depending upon the drug’s acceptable medical use and the drug’s abuse or dependency potential. As the drug schedule changes -- Schedule 2, Schedule 3, etc., so does the abuse potential -- Schedule 5 drugs represent the least potential for abuse.

HCPs will be reclassified from Schedule 3 to a more-restrictive Schedule 2 category. Thus, traditional HCP prescriptions cannot be faxed, phoned in, or refilled at any retail or mail order pharmacy.

This rule was passed as a federal law and therefore affects everyone regardless of diagnosis, provider, or current prescription for a hydrocodone combination product.

Hydrocodone Combination Products*

  • HYDROCOD/APAP 10/325MG TABLETS
  • HYDROCOD/APAP 7.5-325 TABLETS
  • HYDROCOD/APAP 7.5-325MG SOLUTION
  • HYDROCOD/APAP 7.5/325MG TABLETS
  • HYDROCOD/HOMATROP 5/1.5MG TABLETS
  • HYDROCOD/IBUPROFEN 5-200MG TABLETS
  • HYDROCOD/IBUPROFEN 7.5/200MG TABLETS
  • HYDROMET (HYDROCODONE/HOMATROPINE)5/1.5MG SYRUP
  • LORTAB 10-300MG/15ML ORAL ELIXIR
  • LORTAB 10-325MG TABLETS
  • NORCO 10-325MG TABLETS
  • NORCO 5/325MG TABLETS
  • NORCO 7.5/325 TABLETS
  • REPREXAIN 10-200MG TABLETS
  • VICODIN 5-300MG TABLETS
  • VICODIN ES 7.5-300MG TABLETS
  • VICODIN HP 10-300MG TABLETS
  • VICOPROFEN 7.5MG/200MG TABLETS
  • XODOL 10-300MG TABLETS

*This list is intended as a general reference and is not a comprehensive listing of all HCPs

We are strongly encouraging members who are currently being prescribed a hydrocodone combination product to notify their physician to discuss any changes that may affect them.

If you have any questions regarding this update, please feel free to contact the EHIM Pharmacy Call Center at 800-311-3446

April 14, 2014 – SOUTHFIELD, Michigan – In 2013, thousands of people across the United States disposed of 324 tons of expired and unwanted medications at more than 5,000 Drug Enforcement Agency (DEA)-sponsored National Prescription Drug Take-Back Day sites. Officials hope even more people participate in this year’s event, scheduled for April 26, 2014.

At EHIM, we are committed to educating our employer groups, members, and the general public about the risks of expired or unwanted prescription medication and encourage everyone to participate, said Kevin H. Fantich, an EHIM pharmacist.

“Many homes end up with unwanted or expired prescription and over-the-counter medications,” he said. “Old prescriptions left in medicine cabinets or elsewhere in the home can often be an easy source for those who would like to abuse prescription medications.”

Dr. Fantich also warned that large quantities of expired or unwanted medication may lead to confusion among people already taking a large number of medications. Disposing expired medication can also help prevent accidental ingestion by children and pets, he said.

For more information, visit the DEA National Take-Back Initiative website, or search for the nearest collection site where unused or expired medications can be properly disposed of on April 26.

About EHIM Inc.

EHIM is an innovative solution to containing costs in healthcare. Operating as a third party administrator, pharmacy benefit manager and consultant, EHIM is true to what the name stands for: custom-designed programs tailored to the education and overall Employee Health Insurance Management. Founded in 1987, EHIM is a certified WBENC woman-owned business servicing members throughout the country. For more information, visit www.ehimrx.com or call 248.948.9900.

October 30, 2013 – SOUTHFIELD, Michigan – For more than two decades, EHIM has remained committed to offering innovative healthcare solutions to organizations and businesses across the United States. Despite the speculation of what 2015 will bring, EHIM will continue to offer customized pharmacy programs that provide hands on clinical management which result in significant cost savings to our clients. Our EHIM Cares program has saved our clients over $3M alone since its inception in 2011.

In spite of the confusion and what is being communicated by many insurance carriers on their stance of carve-out programs, EHIM’s self funded pharmacy program continues to be a viable healthcare option for employer groups.

We encourage all clients to take advantage of the transitional rules that apply in 2014 with respect to carve out. In addition to the financial savings that can be achieved with a self funded pharmacy benefit, there are other benefits to a client and their members with pharmacy carve out:

  • In 2014, as EHIM understands under the Affordable Care Act (ACA) clarification FAQs that were issued in February 2013, plan sponsors are not required to implement a maximum out of pocket accumulator for the pharmacy program, if the pharmacy benefits are administered by a separate vendor than your medical benefits and the group does not currently have a maximum out of pocket in place.
  • With a self funded prescription benefit program, groups are generally not obligated to meet the “metal” plans nor are they mandated to include all “essential” health benefits.
  • The new “insurance tax” under the ACA is NOT assessed on self funded benefits. This “insurance tax” will only be assessed to fully insured plans and is estimated to be between 2% - 4% of the premium.
  • With a prescription carve out, it provides the client two independent sets of data to analyze their overall health care package and compare and contrast the utilization trends and patterns reported by each for verification and validation of one another.

The client can consolidate and offer one prescription benefit to all employees, regardless of the medical program. With a carve out, the medical benefit does not have to dictate the prescription coverage that is provided.

As always, EHIM encourages all clients to consult with their benefit advisors on how various aspects of the Affordable Care Act (ACA) may impact healthcare offerings. EHIM is here to support and work with the agents and their clients regarding the different healthcare changes and mandates taking effect over the course of the next couple of years. We are dedicated to providing and designing new long-term healthcare solutions for our clients that will increase cost savings as well as the overall health and wellbeing of our members.

Company Promotes Self-Funded as Viable Healthcare Option for Employer Groups

BREAKING NEWS:

U.S. Treasury officials announced late yesterday that employers will not be required to provide health insurance to their full-time employees working an average of 30 or more hours a week until 2015. Employers who do not provide coverage before the extended deadline will not be subject to penalties under the employer shared responsibility provisions.

Requirements that employers and insurance carriers notify the IRS regarding who is covered under their plans are similarly delayed.

Treasury officials announced that guidance explaining the delayed effective date will be issued within the coming week. The individual mandate and other key provisions of the Act are not impacted by this delay and are expected to roll out in accordance with existing time schedules.

EHIM will continue to keep clients informed of new developments and the ramifications of these changes.

FDA concerns about therapeutic equivalence with two generic versions of Concerta® tablets (methylphenidate hydrochloride extended-release)

Based on a recent analysis of data, the Food and Drug Administration (FDA) has voiced concerns about whether or not two approved generic versions of Concerta® tablets (methylphenidate hydrochloride extended-release tablets) are therapeutically equivalent to the brand-name drug, Concerta®.

Concerta® is used to treat attention-deficit hyperactivity disorder in adults and children. The FDA has not identified any serious safety concerns with these two generic products.

This change may result in a change in copay for some EHIM members if they choose to continue to receive a product that is not therapeutically equivalent. Products that are not therapeutically equivalent to their brand counterparts are recognized as a branded medication according to the FDA.

It is important to note that the FDA has not identified any serious safety concerns with these products. Patients should not make changes to their treatment except in consultation with their health care professional.

The FDA has changed the therapeutic equivalence rating for the Mallinckrodt and Kudco products ONLY. The Actavis version has been deemed therapeutically equivalent to its brand counterpart, Concerta®. This means the Mallinckrodt and Kudco products are still approved and can be prescribed, but are no longer recommended as automatically substitutable at the pharmacy (or by a pharmacist) for Concerta®.

If you have any questions regarding this update, please feel free to contact the EHIM Pharmacy Call Center at 800-311-3446.

Concerta® tablets (methylphenidate hydrochloride extended-release) [based on therapeutic equivalence]

  • Currently APPROVED Generic Manufacturer:
  • Actavis
  • Currently UNAPPROVED Generic Manufacturers:
  • Mallinckrodt
  • Kudco

Announcing EHIM’s 2015 Maximum Out-Of-Pocket Partners!

December 4, 2014 – Southfield, Michigan -- EHIM is pleased to announce we continue to increase the number of health benefits administrators we are working with to successfully integrate all components of the Accountable Care Act provisions which will affect most employer health plans in 2015.

As of January 1, 2015, EHIM will have integrated EDI feeds, including maximum out of pocket benefit limits to comply with the Affordable Care Act, established with many providers such as:

  • Activa
  • Ameraplan
  • ASR
  • Auxient
  • Blue Care Network (2nd quarter 2015)
  • Blue Cross Blue Shield of Florida
  • Blue Cross Blue Shield of Michigan (BCBSM)
  • Blue Cross Blue Shield of Tennessee
  • CBG
  • Consumers Mutual
  • Health Alliance Plan (HAP)
  • Health First
  • Health Plus
  • Health Scope
  • HealthSmart
  • IMS
  • KBA
  • Meritain
  • NGS
  • Priority Health

This list of providers will increase with additional requests for integrations continuing throughout 2015. If your current medical carrier or TPA is not listed above, and you are seeking confirmation that they are set up to support an EDI out of pocket maximum integration with EHIM, please contact us.

“We are very happy that EHIM has the opportunity to work with so many different Trading Partners. Establishing successful integrations with a multiple carriers is both crucial in dealing with the many complexities of healthcare reform, and also reinforces our ability and commitment to providing cutting-edge and cost-effective solutions for employer healthcare needs,” said Mindi Fynke, EHIM President and CEO.

As companies continue to struggle with the rising cost of employee healthcare benefits and the multiple challenges of healthcare reform, partnering with EHIM is critical for controlling expenses and profitability. EHIM has created several unique strategies clients can adopt to further manage Essential Health Benefits mandated by the Affordable Care Act, and related Maximum out of Pocket (MOOP) which impact how employees health benefits are administered.

For more information, please call EHIM at 248-948-9900. We can assist you.

PBM Carve-Out Options Remain Available For 2015!

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Healthcare Reform Changes

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SIIA National Conference and Expo

October 5-7, 2014
Phoenix, AZ
Booth #800