Renewals are Coming…and They will Keep Coming!

Virginia resumed conducting Medicaid/FAMIS eligibility renewals in March 2023. This kicked off a yearlong process during which all 2.2 million members will have their eligibility redetermined. More than 679,927 Virginians have already had their eligibility reviewed, and the rest will have theirs reviewed on a staggered basis from now until April 2024.

The Summer edition of the SignUpNow (SUN) newsletter features answers to 10 FAQs that will help you help your patients or clients with Medicaid navigate this process and maintain coverage if they are eligible. Don’t forget TPC provides the ability to track new & renewal Medicaid applications and their status for reporting purposes!

Need to brush up on Medicaid eligibility? Check out VHCF’s Fall Medicaid/FAMIS Eligibility at VHCF's SignUpNow Workshops!

SignUpNow – Medicaid/FAMIS workshops cover the “ins and outs” of the eligibility requirements, application procedures, and post-enrollment information for Virginia’s Medicaid/FAMIS programs for children and families.
SignUpNow – ABD workshops cover eligibility requirements, application procedures, and post-enrollment information for Virginia’s Aged, Blind, or Disabled (ABD) Medicaid covered groups.

Click here to register!

NEW Brandname MEDICATIONS Now Available in TPC

As new medications are approved by the FDA and become available on PAP(s), they are added to TPC. We continue to make updates regularly and there are over 3,600 medications available from more than 350 PAPs in TPC. Check out some of the most recent additions and more to come! Don’t forget to share these newly available products with your providers so they are aware of new medication options when considering what to prescribe for patients.

Abilify Asimtufii (Psychiatric)

Cosela (Hematology/Oncology)

Hulio (Dermatologic/Gastrointestinal/Rheumatologic)

Rhopressa (Ophthalmic)

Rocklatan (Ophthalmic)

Uzedy (Psychiatric)

Vaxneuvance (Immunization)

Zavzpret (Neurologic)

Highlights of Important PAP Updates for Patients & Providers

For Patients with ASTHMA/COPD

Effective August 1, 2023, AZ&Me’s PAP made changes to the availability of Symbicort through its PAP and it is no longer available to NEW patients. Existing patients can still get refills through 12/31/2023, but effective 1/1/2024, Symbicort will be fully removed from AZ&Me’s PAP.

Medications with Changes in Availability

Looking for recent updates? Be sure to log in to TPC and click on “Program Changes” in TPC under the research menu. All updates are posted there. Recent changes include:

Get Your Final Refills and Check TPC for Alternative Brand Options

Flovent Diskus, Flovent HFA, Imitrex Nasal Spray renewals must be submitted soon:
10/1/2023: No longer available to new patients
11/1/2023: Last day to submit a renewal application for existing patients
11/15/2023: Last day to submit a renewed Rx for existing patients
12/1/2023: Last day request a refill for existing patients
12/31/2023: Meds removed from PAP.

Teva Cares will provide refills for ProAir HFA for existing patients refills until 10/31/2023. The eligibility period for ProAir Respiclick was also extended to existing patients through 12/31/2023. New patients are not being enrolled.

Albuterol is the generic option available in TPC through Rx Outreach at $35 per inhaler, through AMP for clinic members, & NC MedAssist for NC state residents at no cost. Good Rx may offer coupon savings at around $25 per inhaler but may vary depending on the area your patient lives

AZ&Me will provide refills for Byetta, Daliresp, Faslodex, Iressa, Kombiglyze, Onglyza, Pulmicort Flexhaler & Qtern for existing patients through 12/31/2023. Effective 1/1/2024 these medications will be fully removed as most of these products have low usage.

Reminders: Programs Closed to New Patients

Lilly Cares products with limited availability to eligible enrolled patients include: Baqsimi, Straterra, Symbyax, Zyprexa & Zyprexa Zydis.

New patient applications for Trulicity are NOT being accepted due to high global demand but existing patients can continue to receive refills.

Medications Removed from PAP: Check for Substitutes in TPC

AbbVie has removed the following products from its PAP: Acuvail, Androgel, Bystolic, Carafate, Combigan, Estrace, Infed, Lexapro, Liletta, Lo Loestrin fe, Lumigan, Namenda (Namenda XR remains available), Pred Forte, Pylera & Rapaflo.

GSK has removed Advair Diskus, Advair HFA, & Beconase AQ for all patients.

Alternative brand-name medications from different PAPs will be added to the Substitutes section of TPC. Check the Research menu for more info on recent program changes in TPC.

Viatris has launched a new medication, Breyna™ (budesonide and formoterol fumarate dihydrate) Inhalation Aerosol, the first generic version of Symbicort. The medication details are not yet available to include in TPC, but can be requested from the Viatris PAP as it is available on the Group 1 application in TPC.

Read more about the launch and stay tuned for the availability of this new product in TPC coming soon!

Elevate Your Skills with TPC Training & Networking

Whether you're new to TPC or a seasoned pro, our training sessions and networking opportunities will take your proficiency to the next level. TPC is more than a software; it’s a community. Don’t miss these opportunities to level up your skills and connect with your peers.