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December 2014

 

Speaking of seamless transfer...
Sean Tvelia

 

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The FA is working hard to resolve member concerns regarding the transition to WellDyne. (photo by Sean Tvelia)

This semester, as the FA representative to the Employee Medical Health Plan (EMHP), I’ve been pretty busy fielding calls and emails about the transition to WellDyne as our pharmaceutical prescription provider. It hasn’t been seamless.

Interestingly, although the faculty who contact me are incredibly frustrated with WellDyne, I’ve received just as many compliments as complaints and it seems that a majority of our members are happy with WellDyne.

Some of the more serious issues leading to member frustration involve step therapy and WellDyne’s requirement that members with prescriptions identified in our step therapy program try less expensive generics first. Step therapy is a design of EMHP’s plan and has been consistent between both ESI and WellDyne. During this transition members on step therapy medications were often forced to try other medications if those medications were not part of the previous step therapy under ESI. Although I understand how frustrating this may be, having been caught up in this myself, these issues would have occurred regardless of what pharmaceutical company was chosen as a result of the RFP process.

Some faculty who have experienced difficulty as a result of this process have suggested we change providers. When EMHP does an RFP process, one of our primary considerations is anticipated degree of disruption to our members’ service. No matter what company we work with, let’s face it: some disruption is inevitable. Moving away from WellDyne now would introduce even more disruption.

With that said, if you have already tried the generic medications in WellDyne’s step therapy program, your doctor needs to contact WellDyne, show that they’ve done this and provide a rationale for moving to the brand.

If you are having problems with receiving a prescription and/or have questions regarding step therapy or the process don’t hesitate to call EMHP (631.853.4866) and ask.

Most importantly, contact me if you’re having trouble. Although I may not be able to do exactly what you want, I can at least assist you through the process and stitch up some of those seams. Please don’t let your frustration build up. I’m happy to help: 451-4151 or sean@fascc.org.