Impacted: Health plan market clients

Standard actions regarding major weather events  
Recent wildfires in California and winter storms affecting the southeastern United States have resulted in states of emergency being declared for various impacted areas. Prime Therapeutics (Prime) is actively monitoring the situation and will implement appropriate measures, and provide updates as needed. 

What we’ll do to support clients and members 
Provided are standard actions we’ll take to ensure a consistent service delivery. 

Ensuring access  
Prime will support clients and members who are impacted during potential adverse events by:  

• Assessing impact using zip code data to determine the affected service area(s). Note: During active weather events, the Healthcare Ready: RxOpen site may be activated by the National Council for Prescription Drug Programs (NCPDP) to identify pharmacy chains and local pharmacies that are closed due to adverse events. 
• Executing a Dynamic Prior Authorization (DPA) early-refill override for members residing in states where the governor has declared a state of emergency, using a standard two-week default period for the DPA. This includes notifying pharmacies within the impacted service area of the DPA put into place.   
• Notifying clients of DPA activity and providing reporting. Clients can shorten or extend the DPA period by communicating with their Prime account representative.   
• Actively monitoring impacted employees to maintain service levels for clients and members.  

Meeting home delivery and specialty pharmacy needs 
Regardless of which home delivery and specialty providers your plan works with, Prime and our vendors will: 

• Monitor shipments and proactively manage packages where deliveries are expected to be impacted by the event. 
• Execute contingency plans to provide 24/7 coverage for urgent member needs, including pharmacist consultations, shipments to alternate locations and retail fills when and where possible.   

Questions? 
Reach out to your account team representative if you have questions about Prime’s adverse event preparedness and unexpected pharmacy closures.