These benefit changes will reduce member cost share for Mental Health, Behavioral Health and Substance Use Disorder (MH/SUD) and emergency medical transportation benefits. Previously filed claims will be retroactively adjusted back to dates of service on or after January 1, 2016. Members who paid the incorrect cost sharing amount will receive a separate letter and refund, as appropriate.
Blue Shield has entered into an agreement with CVS Health to support manufacturer rebate and pharmacy network contracting for its outpatient pharmacy benefit and has received approval from the Department of Managed Health Care.
A new resource, created in pamphlet form, helps consumers and their providers understand protections related to their mental health and substance use disorder (MH and SUD) benefits and take action if their benefits are denied.