Originally published on Mar 16, 2017.
In correspondence with Five Rivers RX, OptumRX stated that they will not allow any further extensions to both companies seeking an extension for the first time and companies looking for re-extension.
Their full communication sent 8:29AM EST on 3/16/17 read as follows:
At this time Optum Rx is not allowing any further extensions.
Optum, Provider Credentialing
Fax: (866) 835-4148
This email was signed by “RS,” a different member of the team than “LK” (Lauren Koruba), who managed the awarding of extensions through late February.
Importantly, Optum has not stated whether or not they will be abandoning their VAWD requirement. However, with hundreds of companies still having their VAWD application processed (including full-line distributors, international manufacturers and others), it remains doubtful that they would begin to deny reimbursements to pharmacies that purchase from those sources.
Implemented on October 1, 2016, their VAWD requirement was extremely controversial, causing uproar from their downstream partners and even triggering a lawsuit. There are several reasons why OptumRX might abandon their VAWD requirement, only six months after implementation:
- NABP’s inability to process VAWD applications in a timely manner, sometimes taking upwards of 36 months to process an application
- OptumRX underestimated the number of applicants and industry players requiring an extension
- Association of Independent Pharmaceutical Wholesalers’ (AIPW) lawsuit against OptumRX, HHS and CMS
- A company’s ability to shut down and reopen under a new name, effectively giving them up to a 12 month extension without any real scrutiny of business practices
We will provide more information as it breaks.
About Five Rivers RX
Five Rivers RX is a leading pharmaceutical compliance services firm that uses experience, relationships and knowledge to develop custom solutions for their clients. The company provides numerous services including VAWD Accreditation, state Board licensing and federal registration. Five Rivers helps third-party logistic firms, distributors and manufacturers in the pharmaceutical industry focus on their supply chain while reducing costs, enhancing efficiency and improving quality. Five Rivers is committed to helping their clients thrive and to providing peace of mind.