Affected Fox enrollees must receive their drugs through LI-NET through March 31, although they can remain in LI-NET, which has an open formulary
, through April 30.
In BlueCross BlueShield of South Carolina's open formulary
benefit design, "once a drug is FDA approved, we will cover it.
Dual eligibles have gotten used to the open formulary
under Medicaid, but some of Medicare's formularies might be closed, "and we don't know what those will be.
"Also, while formularies (restricted lists of drugs that Medicare drug plans will cover) are allowed by the law, we do know so far that at least one Medicare drug plan--the AARP-sponsored United plan, which is member- and consumer-run and has for years served AARP members well, has 59,000 participating drug stores, a mail-order service and a good price discount record--will offer an open formulary
and will cover all FDA-approved drugs.
An open formulary
is one in which prescribed products are reimbursable regardless of whether or not they are on the formulary.
The original consent order, the groups point out, required that PCS maintain an open formulary
to ensure that other pharmaceutical manufacturers be given access to the PCS-administered patient base.
He says the company's open formulary
satisfies concerns over the confidentiality of manufacturer pricing.
Customers may elect an 'open formulary
' under which all drug products may be reimbursed regardless of formulary status."