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>Any Willing Pharmacy

 

Maine's Any Willing Pharmacy Requirements

Pursuant to Maine’s “any-willing-pharmacy” law, 24-A M.R.S.A. § 4317, insurance carriers offering health plans subject to the Maine Health Plan Improvement Act that provide prescription drug benefits through a network of participating pharmacies may not refuse to contract with a pharmacy that is willing to meet the terms and conditions for participation in the health plan’s pharmacy network.  If the network is a tiered network, Maine pharmacies must be offered the opportunity to participate in each tier.  A pharmacy benefits manager may not require a pharmacist or pharmacy to participate in one network in order to participate in another network.  The pharmacy benefits manager may not exclude an otherwise qualified pharmacist or pharmacy from participation in one network solely because the pharmacist or pharmacy declined to participate in another network managed by the pharmacy benefits manager.

The insurance carrier is responsible for assuring that the pharmacy network it uses for its fully insured health plans** complies with Maine’s “any-willing-pharmacy” requirements, whether the carrier manages the network itself or contracts with a network administrator.  Preferred provider arrangements (PPAs) are also required to comply with Maine’s “any-willing-pharmacy” law pursuant to 24-A M.R.S.A. § 2673-A(3).
In order to comply with Maine’s “any-willing-pharmacy” law, carriers are required to make specimen pharmacy contracts readily available to Maine pharmacies upon request for each network subject to the requirement.  A network administrator may provide this information on the carrier’s behalf.

** Maine’s “any-willing-pharmacy” requirement does not apply to self-funded employer health plans administered by insurance carriers.

The information below has been collected for Maine Insurance carriers pursuant to Bulletin 377 in order to provide Maine pharmacies with contact information to obtain the terms and conditions of pharmacy networks they may wish to join. 

Click on a link in the list directly below and you will be brought to that company’s information.

 

Aetna Health Inc

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Cheryl Johnson
Title: Pharmacy Business Compliance Officer
Mailing Address: 601 Union Street Suite 810
                              Seattle, WA 98101
Direct Telephone: (425)-558-9420
Fax: (425)-558-9420 - Please email Cheryl Johnson prior to faxing
E-Mail: JohnsonC2@aetna.com

Mail Order Pharmacies that Participate in the Network:

  • Aetna Pharmacy Home Delivery

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

  • Aetna Health Management is a licensed PBM in Maine; however, CVS Caremark is our primary PBM for network contracting responsibilities.

 

Aetna Health Management LLC

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Cheryl Johnson
Title: Pharmacy Business Compliance Officer
Mailing Address: 601 Union Street Suite 810
                              Seattle, WA 98101
Direct Telephone: (425)-558-9420
Fax: (425)-558-9420 - Please email Cheryl Johnson prior to faxing
E-Mail: JohnsonC2@aetna.com

Mail Order Pharmacies that Participate in the Network:

  • Aetna Pharmacy Home Delivery

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

  • Aetna Health Management is a licensed PBM in Maine; however, CVS Caremark is our primary PBM for network contracting responsibilities.

 

Aetna Life Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Cheryl Johnson
Title: Pharmacy Business Compliance Officer
Mailing Address: 1601 Union Street Suite 810
                              Seattle, WA 98101
Direct Telephone: (425)-558-9420
Fax: (425)-558-9420 - Please email Cheryl Johnson prior to faxing
E-Mail: JohnsonC2@aetna.com

Mail Order Pharmacies that Participate in the Network:

  • Aetna Pharmacy Home Delivery

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

  • Aetna Health Management is a licensed PBM in Maine; however, CVS Caremark is our primary PBM for network contracting responsibilities.

 

American National Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Joseph Songy
Title: Senior Claim Compliance Analyst
Mailing Address:
 
Direct Telephone: (281)-538-4878
Fax: (281)-535-4669
E-Mail: Joseph.Songy@ANICO.com or HealthClaims.Compliance@ANICO.com

Mail Order Pharmacies that Participate in the Network:

  •  

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

 

American Republic Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Meg Brown
Title: Vice-President and Chief Administrative Officer
Mailing Address:   601 6th Ave
                                Des Moines, Iowa 50309
Direct Telephone: (515)-245-4253
Fax: (515)-247-2491
E-Mail: meg.brown@americanenterprise.com

Mail Order Pharmacies that Participate in the Network:

  • Express Scripts
  • CuraScripts

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

 

Anthem Health Plans of Maine, Inc

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Alana Faith Rothman
Title: Staff V.P.Compliance and Audit
Mailing Address:   Wellpoint, Inc.
                                 4241 Irwin Simpson Rd
                                 Mason, OH  45040
Direct Telephone: 513-336-3352
Fax: 513-336-3682
E-Mail: Alana.Rothman@anthem.com

Mail Order Pharmacies that Participate in the Network:

  • ESI Mail Pharmacy Service, Inc.
    dba Express Scripts
    4600 North Hanley Road
    St. Louis, MO 63134
  • ESI Mail Pharmacy Service, Inc.
    dba Express Scripts
    7909 South Hardy, Suite 106
    Tempe, AZ 85284
  • Express Scripts
    One Millennium Drive
    Willingboro, NJ 08046
  • Express Scripts (formerly Medco of Ohio)
    255 Phillipi Road
    Columbus, OH 43228
  • Express Scripts of Indiana
    4750 E 450 South
    Whitestown, IN 46075-8404
  • Express Scripts (formerly Medco of Nevada, Inc.)
    6225 Annie Oakley Drive
    Las Vegas, NV 89120


Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:
Express Scripts serves as the pharmacy benefit management company for Anthem Health Plans of Maine, Inc., doing business as Anthem Blue Cross Blue Shield, and offers a pharmacy preferred provider arrangement in the state of Maine.  Pharmacies interested in becoming a preferred provider should call the Express Scripts Network Contracting and Management Department at 1-866-296-9943, or send a written request to Express Scripts, Network Contracting and Management Department, One Express Way, St. Louis, MO  63121.

 

Anthem Health Plans of Maine, Inc (DeCare Dental Networks)

Compliance Officer with Responsibility for Network Pharmacy Operations in Maine:
Name: Ken Kramer
Title: Manager Network Development and Management - NE
Mailing Address: 3560 Delta Dental Dr.
                              Eagan, MN 55121
Direct Telephone: 651-994-5470
Fax:
E-Mail: kkramer@decare.com

 

Caremark LLC and CaremarkPCS Health LLC

Compliance Officer with Responsibility for Network Pharmacy Operations in Maine:
Name: Danny Pagnillo
Title: Director of Network Operations
Mailing Address:   9501 E. Shea Blvd., MC080
                                Scottsdale, AZ 85260
Direct Telephone: (480)-661-2008
Fax: (480)-314-6964
E-Mail: danny.pagnillo@caremark.com

Mail Order Pharmacies that Participate in the Network:

  • CVS Caremark Advanced Technology Pharmacy, L.L.C. d/b/a/ CVS Caremark
  • Caremark Texas Mail Pharmacy L.L.C. d/b/a CVS Caremark
  • CaremarkPCS Pennsylvania Mail Pharmacy L.L.C. d/b/a CVS Caremark

Insurance Carriers and Health Plans that Use the Caremark Pharmacy Network:

 

CIGNA Health and Life Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Deborah Nelson
Title: Compliance Manager
Mailing Address:   Cigna Pharmacy Management
                                900 Cottage Grove Road
                                Hartford, Connecticut 06152
Direct Telephone: (860)-226-7742
Fax: (860)-226-3535
E-Mail: Deborah.Nelson2@Cigna.com

Mail Order Pharmacies that Participate in the Network:

  • CIGNA Home Delivery Pharmacy

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

 

 

CIGNA Pharmacy Management Services

Compliance Officer with Responsibility for Network Pharmacy Operations in Maine:
Name: Deborah Nelson
Title: Compliance Manager
Mailing Address:   Cigna Pharmacy Management
                                900 Cottage Grove Road
                                Hartford, Connecticut 06152
Direct Telephone: (860)-226-7742
Fax: (860)-226-3535
E-Mail: Deborah.Nelson2@Cigna.com

Insurance Carriers and Health Plans that Use the CIGNA Pharmacy Management Pharmacy Network:

 

Connecticut General Life Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Justin Kaiser
Title: VP, Provider Relations
Mailing Address:   1600 McConnor Parkway
                                Schaumburg, IL 60173
                                
Direct Telephone: (224)-231-1823
Fax:
E-Mail: Justin.Kaiser@catamaranrx.com

Mail Order Pharmacies that Participate in the Network:

  • Catamaran Home Delivery of Florida, Inc., Miramar, FL
  • Catamaran Home Delivery of Ohio, Inc., Avon Lake, OH
  • Catamaran Home Delivery of Texas, Inc., San Antonio, TX
  • Express Scripts, St. Louis, MO
  • Walgreens, Tempe, AZ
  • Walgreens, Orlando, FL

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

 

 

Continental General Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Meg Brown
Title: Vice President and Chief Administrative Officer
Mailing Address:   601 6th Ave
                                Des Moines, Iowa 50309
Direct Telephone: (515)-245-4253
Fax: (515)-247-2491
E-Mail: meg.brown@americanenterprise.com

Mail Order Pharmacies that Participate in the Network:

  • Express Scripts
  • CuraScripts

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

 

Express Scripts Administrators LLC

Compliance Officer with Responsibility for Network Pharmacy Operations in Maine:
Name: Christopher McGinnis
Title: Assistant Secretary
Mailing Address:   One Express Way
                                St. Louis, MO 63121
Direct Telephone: (314)-684-6306
Fax: (800)-417-8163
E-Mail: CAMcGinnis@express-scripts.com

Mail Order Pharmacies that Participate in the Network:

  • ESI Mail Order Processing, Inc. d/b/a Express Scripts
  • ESI Mail Pharmacy Service, Inc. d/b/a Express Scripts
  • Express Scripts Pharmacy, Inc. d/b/a/ Express Scripts

Insurance Carriers and Health Plans that Use the Medco Health LLC Pharmacy Network:

 

 

Golden Rule Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Gail Kahl
Title: Director
Mailing Address:   UnitedHealthcare Legal and Regulatory NE Region
                                48 Monroe Turnpike
                                Trumbull, CT 06611
Direct Telephone: 1-888-889-7658 or (203)-459-6378
Fax:
E-Mail: gail_a_kahl@uhc.com

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

  • Medco Pharmacy Services Department
    MS B3-1
    100 Parsons Pond Drive
    Franklin Lakes, NJ 07417
    Direct Telephone: 1-800-922-1557

 

Harvard Pilgrim Health Care Inc

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: John J. Burke
Title: Vice President of Corporate Compliance
Mailing Address:   Harvard Pilgrim Health Care Inc
                                93 Worcester Street
                                Wellesley, MA 02481
Direct Telephone: (617)-509-6063
Fax: (617)-509-7531
E-Mail: jack_burke@hphc.org

Mail Order Pharmacies that Participate in the Network:
Walgreens
Regulatory Law Department
104 Wilmot Road
Deerfield, IL 60015

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:
Name: Roderick M. Wade
Title: Vice President, Contract Management
Mailing Address:   Medimpact Healthcare Systems, Inc.
                                10680 Treena Street, Stop 5
                                San Diego, CA 92131-2446
Direct Telephone: (858)-790-6561
Fax: (858)-621-5147
E-Mail: Rod.Wade@MedImpact.com

 

HPHC Insurance Company Inc

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: John J. Burke
Title: Vice President of Corporate Compliance
Mailing Address:   Harvard Pilgrim Health Care Inc
                                93 Worcester Street
                                Wellesley, MA 02481
Direct Telephone: (617)-509-6063
Fax: (617)-509-7531
E-Mail: jack_burke@hphc.org

Mail Order Pharmacies that Participate in the Network:
Walgreens
Regulatory Law Department
104 Wilmot Road
Deerfield, IL 60015

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:
Name: Roderick M. Wade
Title: Vice President, Contract Management
Mailing Address:   Medimpact Healthcare Systems, Inc.
                                10680 Treena Street, Stop 5
                                San Diego, CA 92131-2446
Direct Telephone: (858)-790-6561
Fax: (858)-621-5147
E-Mail: Rod.Wade@MedImpact.com

 

MedImpact Healthcare Systems, Inc.

Compliance Officer with Responsibility for Network Pharmacy Operations in Maine:
Name: Lisa Byerley
Title: Corporate Compliance Officer/VP, Corporate Compliance
Mailing Address:   10181 Scripps Gateway Court
                                San Diego, CA 92131
Direct Telephone: (858)-790-6370
Fax: (858)-621-5147
E-Mail: lisa.byerley@medimpact.com

Mail Order Pharmacies that Participate in the Network:

  • Walgreens

Insurance Carriers and Health Plans that Use the Medimpact Pharmacy Network:

  • Harvard Pilgrim Health Care Inc
  • HPHC Insurance Company Inc

 

MEGA Life and Health Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Susan Dew, Sr. Vice-President
Title: SVP, Chief Ethics & Compliance Officer and Legal Officer for Regulatory matters
Mailing Address:   9151 Boulevard 26
                                North Richland Hills, TX 76180
Direct Telephone: (817)-255-5516
Fax: (817)-255-8125
E-Mail: susan.dew@healthmarkets.com

Mail Order Pharmacies that Participate in the Network:

  • Mail Order prescriptions are available through our PBM, CVS Caremark.

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

  • CVS Caremark is our PBM that contracts with providers and administers pharmacy benefits.

The MEGA Life and Health Insurance Company does not contract directly with pharmacies.

 

Pharmaceutical Technologies, Inc.

Compliance Officer with Responsibility for Network Pharmacy Operations in Maine:
Name:
Jake Curtiss
Title: Compliance Officer
Mailing Address:   Pharmaceutical Technologies, Inc.
                                PO Box 407
                                
Boys Town NE 68010
Direct Telephone:
(402) 965-8800 ext 1047
Fax:
E-Mail:
jcurtissr@pti-nps.com

Mail Order Pharmacies that Participate in the Network:

  • Integrated HMO Pharmacy
    Walgreens

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:
Mailing
                 
Pharmaceutical Technologies, Inc.
                  PO Box 407
                 
Boys Town NE 68010

 

PBM Plus, Inc.

Compliance Officer with Responsibility for Network Pharmacy Operations in Maine:
Name: Jennifer Krusa
Title: Division Compliance Officer
Mailing Address:   40 Twosome Dr, Unit 1
                                Moorestown, NJ 08057
Direct Telephone: 856-482-5791
Fax: 856-780-4029
E-Mail: Jennifer.krusa@omnicare.com

Mail Order Pharmacies that Participate in the Network:

  • PBM Plus Mail Service Pharmacy LLC

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:
Mailing Address:  PBM Plus, Inc.
                               40 Twosome Dr, Unit 1
                               Moorestown, NJ 08057

 

Standard Security Life Insurance Company of New York

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Thomas A. Gibbons
Title: Chief Compliance Officer
Mailing Address:   485 Madison Ave
                                New York, NY 10022

Direct Telephone: (602)-906-2654
Fax: (602)-906-2654
E-Mail: tgibbons@sslicny.com

Mail Order Pharmacies that Participate in the Network:

  • CIGNA Home Delivery Pharmacy
    P.O. Box 1019
    Horsham, PA 19044-9805

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

  • The Bureau has been advised that CIGNA Pharmacy Management is the PBM.

 

State Farm Mutual Automobile Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Leathea Speer
Title: Healthcare Analyst
Mailing Address:   State Farm
                                One State Farm Plaza
                                Total Rewards – Benefits, C-1
                                 Bloomington, IL 61710
Direct Telephone: (309)-766-7507
Fax: (309)-766-2480
E-Mail: Leathea.speer.bhly@statefarm.com

Mail Order Pharmacies that Participate in the Network:

  • CVS Caremark Mail Order Pharmacy
  • CVS Caremark Specialty Pharmacy
  • Prime Therapeutics Mail Order Pharmacy
  • Prime Therapeutics Specialty Pharmacy

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

 

Trustmark Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Dawn Dyer
Title: Regulatory Reporting Analyst
Mailing Address:   400 Field Drive
                                Lake Forest, IL 60045
Direct Telephone: (847)-283-2291
Fax: (847)-615-3872
E-Mail: dawn.dyer@trustmarkins.com

Mail Order Pharmacies that Participate in the Network:

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

  • CVS CareMark
    Mailing Address: 2211 Sanders Road, 10th Floor, Northbrook, Illinois 60062, Attn: Vice President, Legal Services and Managing Counsel
    Direct Telephone
    : (800)-746-7287
    Fax: (847)-559-4879
    E-Mail
    : www.cvscaremark.com

 

Unicare Life and Health Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Alana Faith Rothman
Title: Staff V.P. Compliance and Audit
Mailing Address:   Wellpoint, Inc.
                                4241 Irwin Simpson Rd
                                Mason, OH 45040
Direct Telephone: 513-336-3352
Fax: 513-336-3682
E-Mail: alana.rothman@anthem.com

Mail Order Pharmacies that Participate in the Network

  • ESI Mail Pharmacy Service, Inc., dba Express Scripts, 4600 North Hanley Road, St. Louis, MO 63134
  • ESI Mail Pharmacy Service, Inc., dba Express Scripts, 7909 South Hardy, Suite 106, Tempe, AZ 85284
  • Express Scripts, One Millennium Drive,Willingboro, NJ 08046
  • Express Scripts (formerly Medco of Ohio), 255 Phillipi Road, Columbus, OH 43228
  • Express Scripts of Indiana, 4750 E 450 South, Whitestown, IN 46075-8404
  • Express Scripts (formerly Medco of Nevada, Inc.), 6225 Annie Oakley Drive, Las Vegas, NV 89120

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

  • Express Scripts serves as the pharmacy benefit management company for Anthem Health Plans of Maine, Inc., doing business as Anthem Blue Cross Blue Shield, and offers a pharmacy preferred provider arrangement in the state of Maine.  Pharmacies interested in becoming a preferred provider should call the Express Scripts Network Contracting and Management Department at 1-866-296-9943, or send a written request to Express Scripts, Network Contracting and Management Department, One Express Way, St. Louis, MO  63121..

 

UnitedHealthcare Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Gail Kahl
Title: Director
Mailing Address:   UnitedHealthcare Legal and Regulatory NE Region
                                48 Monroe Turnpike
                                Trumbull, CT 06611
Direct Telephone: 1-888-889-7658 or (203)-459-6378
Fax:
E-Mail: gail_a_kahl@uhc.com

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

  • OptumRx
    Attn: Pharmacy Network Contracting
    17900 Von Karman Ave
    M/S CA 016-0202
    Irvine, CA  92614
    Phone:  800-613-3591 Option 7

 

Washington National Insurance Company

Compliance Officer with Responsibility for Maine Pharmacy Operations:
Name: Nancy Sweet
Title: Vice President and Chief Compliance Officer
Mailing Address:   11825 North Pennsylvania Street
                                Carmel, IN 46032
Direct Telephone: (317)-817-4784
Fax: (317)-817-2826
E-Mail: nancy.sweet@cnoinc.com

Mail Order Pharmacies that Participate in the Network:

  • Express Scripts Mail Order

 

Pharmacy Network Administrator or PBM Responsible for Pharmacy Contracting:

 

Last Updated: June 3, 2014