Observation Stays No Longer Subject to Concurrent Review

FirstCare Transitioning to New PBM in 2016—Navitus Health Solutions

Wednesday, October 28, 2015

We are pleased to inform our provider community of an exciting change in our prescription drug program. Effective January 1, 2016, Navitus Health Solutions will be the exclusive pharmacy benefits manager for all FirstCare members. This move simplifies and consolidates our pharmacy processes, improving our services to our members and providers. FirstCare and Navitus are committed to lowering drug costs, improving health, and providing superior customer service.
Our mail-order and specialty pharmacy vendors are also aligning under Navitus as these services will be offered through Navitus’ partners NoviXus (mail-order) and Lumicera (specialty pharmacy).
This week, we have distributed an informational letter to our contracted providers, outlining the changes that accompany this transition to Navitus, including details regarding:

  • New prescription drug formulary for 2016;
  • Updated Specialty Pharmacy information, and;
  • Revised Prior Authorization (PA) processes. 
For further details on these and other items covered in the letter, watch your mailbox and/or click here to see a sample of the letter.
If you have questions, please email our Provider Relations Team at provider_relations@firstcare.com.

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