Poly-Pharmacy Member Case Management Services
In this program, a Medicaid Managed Care Organization (MCO) identifies its high-risk “poly-pharmacy” members and delegates the case management of them to a Covered Entity. The Covered Entity, which has an existing 340B contracted pharmacy relationship with CCN, sub-delegates part of its case management responsibilities for these members to CCN (under a separate contract). Using mail, telephone, and outreach techniques, CCN case managers (on behalf of the Covered Entity) provide ongoing case management services to all identified members, on a voluntary basis. Through this process, all members receiving case management services become patients of the Covered Entity and are eligible for 340B discounted medications. These members are offered the opportunity to utilize the Covered Entity’s 340B specialty pharmacy program, operated by CCN. Members electing to use this program receive specialty pharmacy services as a complement to their ongoing case management services, the Covered Entity is reimbursed for its clinical services, and the Medicaid MCO receives a discount on medications dispensed through the program.
For more information on CCN’s 340B Poly-Pharmacy Member Case Management Services, please contact CCN’s Business Development department, toll-free 877.301.2526.