Dear @UofCalifornia @ucdavis— Jonathan Eisen (@phylogenomics) March 7, 2022
This is NOT OK.
I just got a notice by letter in mail that my insurance will no longer cover the insulin I have been getting "as of January 1, 2022". Letter was dated in February and was received after March 1, 2022.
This is NOT OK.
Well, the saga continues -- just got this from Navitus. They say I "may be eligible" for an extension of 1 bonus month with my prior prescription. Pretty useless to be honest. pic.twitter.com/ASUHvYuUwn— Jonathan Eisen (@phylogenomics) March 14, 2022
Below is the email from UC. More about this in a bit but I wanted to share the full text for people to see here.
An important message from UC about your pharmacy benefitsDear Jonathan,We are writing to acknowledge — and apologize for — the problems many members of the UC community are experiencing with Navitus Health, a new administrator of pharmacy benefits for UC employee and Medicare PPO plans, and to let you know what we are doing to fix the problems.Last year, University of California Health (UCH) and UC Systemwide Human Resources selected Navitus Health to administer pharmacy benefits, starting Jan. 1, 2022. This decision was made following an extensive formal bid process, conducted by a committee with representatives from UCH, Systemwide HR, UC faculty with pharmacy expertise and UC’s retiree association.Navitus was selected as the partner that could provide UC with the best overall flexibility, service, and affordability. However, since UC’s transition to Navitus Health, we have heard from too many members who have been negatively impacted by this change.Some members have had to change prescription drugs, been required to complete time-consuming authorization processes and experienced denials by Navitus, causing unnecessary anxiety and frustration. Navitus failed to meet the scheduled target date for mailing a clinical transition letter, causing hardship and worry for faculty, staff, retirees and their family members.Additionally, like many employers Navitus has faced customer service staffing challenges, leading to wait times that far exceed Navitus’ standards and UC performance guarantees. Among other things, this has put undue pressure on benefits professionals at UC locations and in the UC Retirement Service Center and the UCPath Center, as they have worked to provide support that should be handled by Navitus.We take these problems — and our responsibility to ensure that members of UC health plans have access to the prescriptions they need — very seriously. UCH and UC Systemwide Human Resources have been in constant communication with Navitus, and we want to let you know what we are doing to fix these problems.Support with member transitions
- Due to the delay in mailing clinical transition letters, Navitus has provided an extended transition period to the end of April for drugs that are not covered. Extension letters and an email campaign were recently initiated.
- Navitus will call members who need to transition to new medications directly and offer help with authorizations, denials, and appeals. Those who have experienced a denial for a Not Covered/Non-Formulary medication will also receive a phone call offering help.
- UCH, Alliant (a UC consultant) and Navitus will audit and review the protocols Navitus uses for denials to ensure they are in alignment with Navitus internal guidelines, industry standards and Medicare guidelines – and to identify and correct any gaps.Customer service improvements
- Navitus has committed to adding an additional 35 customer service representatives (an increase from 125 to 160) by the end of April, and hopes to add another 15 staff after that, along with additional support for UC benefits professionals.
- Navitus has also added two more personnel with pharmacy clinical expertise to help UC benefit professionals support members.
- In addition, Navitus is exploring a concierge-type customer service model to ensure UC members receive the dedicated assistance they need.Again, we sincerely apologize for any difficulties you or your family members have experienced during this transition. We are committed to you receiving the critical health care you deserve, without unnecessary inconvenience or frustration.Sincerely,Cheryl Lloyd Dr. Carrie ByingtonVice President Executive Vice PresidentSystemwide Human Resources University of California HealthPlease do not reply to this message. Replies to this message are routed to an unmonitored mailbox.
So some updates. I posted about the letter here and to Twitter.
And here is the whole thread on Threadreader.
Well, in case you missed it. Two weeks ago I posted about the disastrous and dangerous and incompetent new University of California pharmacy benefits "system" which warned me, two months after the fact, that they were cutting off coverage of my insulin 1/n https://t.co/QuTBaQBsaQ— Jonathan Eisen (@phylogenomics) March 22, 2022
One key point - the saga was covered by Caleb Hampton in the Davis Enterprise.
And then I posted that I had received a communication from UCOP that they would tell Navitus to cover my insulin.
Alas, I then got a call and letter from Navitus saying that they were denying my request for an exemption for one of my insulins and approving a request for another.