Corcoran et al v. CVS Health Corporation

Northern District of California, cand-4:2015-cv-03504

Exhibit 16

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Exhibit 16 From: Sent: To: Charles Sandler <Sandlerc@dhmh.state.md.us> Monday, November 30, 2009 4:39 PM Kevin.Gorospe@dhcs.ca.gov; SOJOURCY@dhec.sc.gov; lisa.weeks@dhhs.nc.gov; LFarrand@dhhs.state.nh.us; PAvarista@dhs.ri.gov; sparker2@dhs.state.ia.us; eidet@dhw.idaho.gov; donna.proffitt@dmas.virginia.gov; childsa@dshs.wa.gov; George.L.Oestreich@dss.mo.gov; Marc.Shirley@fssa.in.gov; mrb01@health.state.ny.us; Antoinette Brown; barbara.dean@hhsc.state.tx.us; Lisa. Voils@illinois.gov; Margaret.Scott@jfs.ohio.gov; LeAnn.Bell@khpa.ks.gov; mj.terrebonne@la.gov; Jennifer.Palow@maine.gov; Kelli.Littlejohn@medicaid.alabama.gov; LDonovan@medicaid.dhs.state.hi.us; judith.clark@medicaid.ms.gov; okeefet@michigan.gov; rcitron@mt.gov; bjoyce@nd.gov; Barbara' 'Mart; nancy.nesser@okhca.org; Asseyj@scdhhs.gov; kimberly.eggert@state.co.us; paul.jeffrey@state.ma.us; sara.j.drake@state.mn.us; Julie.McKeay@state.nm.us; ralph.m.magrish@state.or.us; c-tcathers@state.pa.us; mike.jockheck@state.sd.us; 'Nicole Woods'; tmorley@utah.gov; carrie.gray@wisconsin.gov; Peggy.A.King@wv.gov RE: $4 generics Subject: We look at those pharmacies and chains that advertise the $4.00 per month and/or $9.99 to 11.99 for a 90 day supply to bill us at their U/C. We also watch the pharmacies and chains that offer free antibiotics to not bill us at all. We have a problem with the chains that have a "CLUB" or some other group one must pay a fee to belong to get the special prices. That makes their special prices exempt from a U/C because that price is not available to the general public. Chuck Charles A. Sandler, PD Chief, Pharmacy Services Division Maryland Medicaid Pharmacy Program 201 W. Preston Street Room 409 Baltimore, MD 21201 410-767-1460 sandlerc@dhmh.state.md.us >>> Antoinette Brown <antoinette.brown@health.Wyo.qov> 11/30/2009 4:26 PM >>> Same for WY. Antoinette Brown, R.Ph. Pharmacy Program Manager 6101 Yellowstone Road, Suite 259 B Cheyenne, WY 82002 Phone: 307-777-6016 Toll Free: 800-438-5785 Fax: 307-777-8623 This e-mail transmission and any attachments to it contain information from the Wyoming Department of Health. The contents are confidential and/or privileged. The information is intended to be solely for the use of the individual or entity named above. If you are not the intended recipient, any disclosure, copying, distribution or use is prohibited. If you have received this e-mail in error, please immediately notify me by telephone or return e-mail so that I can arrange for the deletion of the information and destruction of any copies that have been made at no cost to you. CONFIDENTIAL TX-STATE-WINK-00132358 CVSSM-0025668 CVSC-0405882 -----Original Message----- From: Mart, Barbara [mailto:Barbara. Mart@nebraska.gov] Sent: Wednesday, November 25, 2009 10:39 AM To: 'Nicole Woods'; Kevin, Gorospe@dhcs.ca.gov; SOJOURCY@dhec.sc.gov; lisa.weeks@dhhs.nc.gov; LFarrand@dhhs.state.nh.us; Sandlerc@dhmh.state. md.us; PAvarista@dhs.ri.gov; sparker2@dhs.state.ja.us; eidet@dhw.idaho.gov; donna.proffitt@dmas, virginia.qov; childsa@dshs.wa.gov; George. L.Oestreich@dss.mo.gov; Marc.Shirley@fssa.in.gov; mrb01@health.state.ny.us; Antoinette Brown; barbara.dean@hhsc.state.tx.us; Lisa. Voils@illinois.gov; Margaret.Scott@jfs.ohio.gov; LeAnn.Bell@khpa.ks.gov; mj.terrebonne@la.gov; Jennifer Palow@maine.gov; Kelli.Littlejohn@medicaid.alabama.gov; LDonovan@medicaid.dhs.state.hi.us; judith.clark@medicaid.ms.gov; okeefet@michigan.gov; rcitron @mt.gov; bjoyce@nd.gov; nancy.nesser@okhca.org; Assevi@scdhhs.gov; kimberly.eggert@state.co.us; paul.jeffrey@state.ma.us; sara.j.drake@state.mn.us; Julie. McKeay@state.nm.us, ralph.m.magrish@state.or.us; C-tcathers@state.pa.us; mike.jockheck@state.sd.us; tmorlev@utah.gov; carrie.gray@wisconsin.qov; Peggy.A.King@wv.gov Subject: RE: $4 generics When this all started we did a provider bulletin clarifying that those prices are considered the pharmacy's Usual & Customary & must be sent as such on the claims. Our pricing logic then picks this up as the allowable for that claim. We do monitoring on the back end & Program Integrity follows up if pharmacies are not sending an accurate U&C. And we add anything on a $4 list to our SMAC list. Barbara Mart, R.P. Pharmacy Consultant Nebraska Dept of Health and Human Services Division of Medicaid and LTC Phone-402*471-9301 Fax-402*742-2348 barbara.mart@nebraska.gov -----Original Message----- From: Nicole Woods [mailto:Nicole.Woods@tn.gov] Sent: Tuesday, November 24, 2009 8:38 PM To: Kevin. Gorospe@dhcs.ca.gov; SOJOURCY@dhec.sc.gov; lisa.weeks@dhhs.nc.gov; LFarrand@dhhs.state.nh.us; Sandlerc@dhmh.state.md.us; PAvarista@dhs.ri.qov; sparker2@dhs.state.ia.us, eidet@dhw.idaho.gov; donna.proffitt@dmas,virginia.gov; childsa@dshs.wa.gov; George.L.Oestreich@dss.mo.qov; Marc.Shirley@fssa.in.gov; mrb01@health.state.ny.us; antoinette.brown@health, wyo.gov; barbara,dean@hhsc.state.tx.us; Lisa. Voils@illinois.gov; Margaret.Scott@jfs.ohio.gov; LeAnn.Bell@khpa.ks.gov, mj.terrebonne@la.gov; Jennifer Palow@maine.gov; Kelli-Littlejohn@medicaid.alabama.gov; LDonovan@medicaid.dhs.state.hi.us; judith,clark@medicaid.ms.gov; okeefet@michigan.qov; rcitron@mt.gov; bjoyce@nd.gov; Mart, Barbara; nancy.nesser@okhca.org; Asseyi@scdhhs.gov; kimberly,eggert@state.co.us; paul.jeffrey@state.ma.us; sara.j.drake@state.mn,us; Julie. McKeay@state.nm.us; ralph.m.magrish@state.or.us; c-tcathers@state.pa.us; mike jockheck@state sd.us; tmorley@utah.gov; carrie.gray@wisconsin.gov; Peggy A.King@wv.gov Subject: $4 generics Hi all, I was wondering if any of the States had any special pricing in place surrounding the generics that are commonly found on retail stores' $4 generic lists. Historically, we have simply audited the pharmacies that have the $4 lists to ensure they are submitting the claims with a $4 usual and customary charge. But we are now looking into setting a cap of sorts on these generics to limit payment to all pharmacies to $4. I was wondering if any other states were doing anything similar at this time. Thanks, and Happy Thanksgiving. - Nicole CONFIDENTIAL TX-STATE-WINK-00132359 CVSSM-0025669 CVSC-0405883