MedImpact Healthcare Systems Inc

I had a phone interview with Katrina M. for the Arizona facility. During that interview I was informed how important it is to be at work, prompt regarding your schedule yet when asked for an in person interview I arrived 15 minutes early. The Security Guard called Katrina and emailed he with no response. I waited 10 minutes past the scheduled interview time and Katrina still couldn’t be reached. So I left and informed the Security Guard that if Medimpact wants to reschedule the interview have Katrina call me. If management can’t be on time and keep their word why would anyone want to do business with them. This privately held company has a strange way of showing how important customers are (internal and external) to them. I don’t recommend anyone use their service or work there either. Katrina you have a lot to learn on what it means to be a manager and how important keeping your word is!

On April 6, 2018 one of my treatment physicians sent a Prior Authorization request to Med Impact. It was denied. After sending several documents to support the request, I was informed yesterday that I had exhausted my appeals and that the dispute was being sent to and outside party for external review. Tonight I received notification from that company stating they agreed with Med Impact and the request was denied. The dispute was related to two of the medications I was taking and possible adverse side-affects if taken together. Med Impact has been paying for both medications for over a year without notifying me of possible complications related to the drugs. It was not until the April 6, 2018 request that I was notified of the problem. I reached out to Med Impact to explain to me why these medications were being paid for for over a year without my being notified of the problem. I even asked if they could iform me of any safe alternatives. When I learned of the problem, I immediately made an appointment with my primary care physician where I explained the situation. I haven't taken the drug in over a month and have a letter my physician explaining that I am no longer taking the medication in question. Still I was denied on appeal. I trust my doctors to prescribe medications that fit within the parameters set forth by Med Impact. As I stated, Med Impact has known about both of these medications and said nothing. I have been on this medication for a number of years. It is expensive. I truly believe this decision was made simply because Med Impact saw an opportunity to discontinue having to pay for it. Otherwise I would have been notified of the problem earlier and given an opportunity to resolve it to meet the criteria they have established. I am no longer on the medication in question and have not been for over a month and still Med Impact refuses to act in good faith.

My complaint against Med Impact is straight forward. Med Impact has paid for two of my medications for over a year. When I submitted a Prior Authorization for one of these medications, it was denied due to fact that there were possible adverse effects while taking the two together! A year and now you make me aware by denying my PA? Disgusted with the underhanded move to discontinue paying for the prescription! I even had my Primary Care Physician change medications to adhere to their objection!

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the consumer.

Dear Revdex.com Representative,Per Revdex.com representative direction via telephone today, MedImpact Healthcare Systems, Inc. hereby submits its response and resolution that we have contacted the consumer directly with a satisfactory outcome.  Please let me know if additional information is...

needed.Sincerely,[redacted]Director, Regulatory ComplianceMedImpact Healthcare Systems, Inc.

Revdex.com:
I have...

reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

MedImpact Healthcare Systems,
Inc. (MedImpact) received and researched this complaint.  Research yielded that standard process was
appropriately administered.  In this
instance, MedImpact is contracted with the consumer’s health plan to perform
pharmacy benefit management...

services.  The
health plan provides custom Prior Authorization Guidelines to MedImpact to
utilize for prior authorization of drugs. 
In each instance that the consumer requested the drug [redacted], it was
denied based on the fact that the requests did not meet the criteria as
outlined by the health plan.  The
consumer has the option for a second level appeal before exhausting MedImpact’s
internal process.  This option would provide
the consumer another opportunity to request the drug.  MedImpact appreciates the opportunity to
address Revdex.com consumer complaints.  If
additional information is required, you can contact me directly at [redacted]
or [redacted]. 
Thank you,
[redacted]
Regulatory Compliance
Administrator II
MedImpact Healthcare Systems,
Inc.

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the member.

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and has confirmed with the consumer's health plan that they will be directly resolving the complaint with the consumer.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be...

satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

Terrible pharmacy provider. I'd avoid this company at all cost. Go with ExpressScripts as a better provider

I have been having problems with gout for the past couple years. My doctor put me on Allpurinol, and that was supposed to help repress the outbreaks. Once I started taking the medicine, I felt horrible and got bad headaches. I went back to the doctor and he reduced my dosage. Again, I had the same side effects. So my dosage was again reduced to a 1/4 of what I was originally taking. Well, the gout returned with a vengance. I have had over 6 outbreaks in the past 5 months, with each one being painful. This last visit to the Dr, they prescribed me Uloric and gave me a sample bottle of it along with a 90-day prescription and a savings card that basically took away my co-pay at the pharmacy. I took the sample pills and had no side affects, when I went to get my 90 day supply, they said it needed a prior authorization form completed.
I called Medimpact Healthcare and they said I needed to be on Allpurinol first. I said, I HAVE been and I had horrible side affects from it and had to stop taking it. You should have a record of the medicine I have been prescribed already in your database. Whats wrong with you people!
The way you control the medicines the doctors prescribe is horrendous. Making them fill out extra paperwork just to pay for something that WE have insurance for. Now just do your dang job and pay for it. Now I have run out of my sample and I still don't have my Uloric.
I hope for your sake that I don't get another outbreak while I am waiting or I will be tempted to hire a dang lawyer and sue your company. This is totally ridiculous.
I demand that you respond to this review acknowledge that you read my complaint.

In NY, coordination of benefits for pharmacy charges must be done manually. MedImpact was the company contracted by BC/BS to perform this service. The contract ended in 2016, but MedImpact was responsible for claims through the end of 2016. I submitted multiple claims for my spouse's prescription co-pays, to be applied to my health insurance deductible so that I could obtain reimbursement for those charges from my HRA. When I contacted MedImpact to first ascertain whether or not they received my faxed claim forms, customer service indicated that I was unknown to them, that they were no longer contracted by BC/BS and my file had been purged, and then informed that they could no longer speak with me. I worked with BC/BS to attempt to resolve the issue, and their customer service representatives reached out to MedImpact. I then received an accounting from MedImpact , which showed that none of the prescription co-pays were applied to my deductible as they were duplicate claims (this was the first submission of all of these claims.) This prevents me from obtaining reimbursement from my HRA. I spoke with BC/BS this morning, and they are going to reach out to MedImpact again to try and figure out why these claims are flagged as duplicates, but it isn't likely that this will be resolved in time for me to submit the corrected paperwork to the HRA for reimbursement. I have never worked with such a terrible company; they are blatantly disinterested in providing any form of customer service, and save themselves a lot of work by just denying that you have any business contacting them, regardless of the circumstance. I am fortunate enough to work in a job that has afforded me some knowledge of the healthcare system, and if I am this frustrated dealing with MedImpact, I can only imagine what others with less knowledge are experiencing at the hands of this company.

Review: This is a complaint against the companies in subject. Ever since they took over the drug prescription insurance and dispense for the state of Michigan from Medco, my premium (copay) for brand name medications has gone from $20-40 to $80 and more.This complaint is about a particular prescription, back in March 2013, of Ritalin LA for my son who has ADHD. Novixus, the online pharmacy that now has the exclusive monopoly to provide 90-day prescriptions to state of Michigans employees, decided to switch the prescription to a generic brand (Methylphenidate ER) without consulting us or his doctor. A week later, my sons condition had worsened. Need to mention here that before settling on Ritalin LA, his doctor had tried other medications, which we obtained from our local pharmacy. Only Ritalin LA finally worked. So, I talked to my sons doctor about the generic not working. He wrote a new prescription with a dispense as written note, and that is when the problems started with Novixus and Medimpact. I was told that I would pay a premium of $170, unless my sons doctor could provide proof that the brand name was necessary. I called Medimpact about this and was told that there was nothing else to do but to pay $170.Realizing that my discussions with both Novixus and Medimpact were going nowhere, I picked up the phone and called [redacted] of Michigan. A very kind lady offered to help. She put me on hold and called Novixus and then Medimpact. She came back and explained that my sons doctor just need to send in the paperwork needed to prove that my son needed the brand name, which was the only medication that worked in his case. She also explained that the copay would just be $80. Still high but obviously better than $170. I said no problem. She sent the paperwork to the doctors office, which was filled. Novixus is now withholding a new prescription and is using my son's health as a hostage to force me to pay the $170.Desired Settlement: I clearly indicated that I was ready to pay $80 copay, even though that is still too high so that my son can get the needed medication.

Business

Response:

MedImpact Healthcare Systems, Inc.

("MedImpact") received and researched the consumer's complaint (received by MedIpmact on 10/10/13) and resolved the complaint directly with the consumer. MedImpact is contracted with the consumer’s health plan to

perform pharmacy benefit management services.

The consumer’s health plan is responsible for the plan benefit designs

and formularies, including copay and DAW protocols, and MedImpact is

responsible for implementing the health plan’s designated prescription benefit

plan. The resolution was made to the consumer's satisfaction.

Review: I am registering this complaint against MedImpact. My problem with them is strictly business. I regularly get a prescription, and for medical reasons, need the name brand, and have received a prior authorization from my doctor for this name brand. When MedImpact took over my pharmacy benefits at the beginning of this year, they did not recognize the prior authorization. When I called to complain about this, they informed me that I needed to get a new prior authorization from my doctor. I obtained this information, received a voicemail message from them (which I still have) that my prior authorization was accepted, and the prescription was initially authorized. However, I recently received a letter from MedImpact stating that my prior authorization would not be accepted because I had not first tried and failed two generics. My complaints against them are as follows: First, they did not recognize my existing prior authorization- an example of poor client management. Second, they reversed their own policy regarding prior authorizations. Third, the standard that they require- failure of two generic drugs, is immoral, unethical, and dangerous. They are asking me to undergo a medical experiment that I do not consent to, and the only level of proof they will accept is harm.Desired Settlement: I want MedImpact to acknowledge my prior authorizations for my prescription at the name brand.

Business

Response:

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the consumer.

Review: Medimpact has prolonged a Prior Authorization of my prescription. I was sent a notice dated 1-14-16 (received the mail on Tuesday 1-19-16) stating that I would need a prior authorization on a prescription that I have been taking since 2008. After several years of trial and error with "alternate medications," this non-generic drug was the only medication that did not alter my mood or cause any adverse side-effects. The other medications caused mood swings, anxiety, suicidal thoughts, severe muscle cramps, nausea, headaches, etc.

I went to my doctor's office on 1/27/16 to drop off the PA request and pick up my RX which could not be filled until 2/2. Upon dropping off my prescription on 2/2/16, the pharmacy notified me that I needed a PA. I immediately contacted my doctor who faxed the form. After my doctor faxed the Medical Request Form (MRF) on two separate occasions (Medimpact denies receipt of one fax made), Medimpact then asked for Chart Notes on 2/5/16. The chart notes were faxed on 2/8/16 and again on 2/10. I called Medimpact on 2-11-16 to check my PA status and they said it was denied because they did not receive the chart notes, which were sent and documented by my doctor's office on2/8/16 and 2/10/16. My doctor's office called Medimpact and refiled the MRF with the chart notes, AGAIN.

At this point, I have called Medimpact on 3 separate occasions wasting approximately 90 minutes of my time trying to rectify the situation. Medimpact places the blame on my insurance company or my doctor's office and has not cleared this situation.

I have been without Medication since February 1st. My work performance and overall mood have been greatly affected. Not having proper medication and abruptly stopping a medication that I've been taking for 8 years is unethical. Medimpact prolongs or denies approval to directly benefit at the patient's expense. I will have to jump hoops and remain unmedicated until this is cleared. Meanwhile, Medimpact saves $ on an unfilled RX.Desired Settlement: Medimpact 1) Will provide adequate time for a patient to complete the PA process (30 days minimum) 2) Patients should not have to go without medicine. Due to the tight timeline on controlled substances and the inconvenience patients have to incur to simply pick up a prescription, Medimpact should provide a grace period for these prescriptions 3) Medimpact should not be able to benefit at the patient's expense. They save money while patients are forced to wait, or change to potentially dangerous/less effective drugs. No company should be able to benefit by prolonging approval or denying approval of prescriptions that have been beneficial and effective for patients.

Business

Response:

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the consumer.

Review: I have chronic Hepatitis C and have been denied the life saving medicine [redacted]. Hep C is basically a death sentence and a very painful one. I have worked 10 years for Eufaula City Schools and this is the first time l have had any problems with my insurance which can cost mey life.Desired Settlement: I want prior authorization from MedImpact and approval of the prescription [redacted].

Business

Response:

MedImpact Healthcare Systems,

Inc. (MedImpact) received and researched this complaint. Research yielded that standard process was

appropriately administered. In this

instance, MedImpact is contracted with the consumer’s health plan to perform

pharmacy benefit management services. The

health plan provides custom Prior Authorization Guidelines to MedImpact to

utilize for prior authorization of drugs.

In each instance that the consumer requested the drug [redacted], it was

denied based on the fact that the requests did not meet the criteria as

outlined by the health plan. The

consumer has the option for a second level appeal before exhausting MedImpact’s

internal process. This option would provide

the consumer another opportunity to request the drug. MedImpact appreciates the opportunity to

address Revdex.com consumer complaints. If

additional information is required, you can contact me directly at [redacted]

or [redacted].

Review: URGENT: My child has been without his medication since Wednesday (09.03.13). He was diagnosed with ADD in 2004. He must have this medication to focus. The lack of it is affecting his schoolwork AND GRADES!! He is unable to focus and concentrate. To much time has been wasted on the part of Medimpact at my son's expense. I am holding Medimpact directly responsible for any negative results from withholding my child’s medication. Medimpact is putting my child in danger by forcing him to suddenly stop taking [redacted]. Recommendation is to gradually reduce the dose before stopping it completely. Bottom line - COST!! Please also see timeline I have provided.

I have been gathering other research on Medimpact to be included. It will come a little later because of the URGENCY of my child NOT having his medication!!

I have also included MOODY RATINGS because as I suspected, it indicates Medimpact’s ambition to achieve TOP CREDIT WORTHINESS RATINGS, in my opinion, at the cost of their plan member’s health. From JAN 2011 (STABLE) = “POOR STANDING“, “VERY HIGH CREDIT RISK” thru JULY 2014 when their “RATING OUTLOOK“ was changed to POSITIVE.

I have also included member comments as REPORTED TO THE Revdex.com. While there are only 9 complaints submitted from December 2011 - July 2014 (Revdex.com reporting period), I assume the lack of member awareness as to their rights has a lot to do with this. If there were more member awareness, I have no doubt there would me many more complaints in the 3 year reporting period.

Our doctor, NOT Medimpact will decide which meds my child needs. As with any medication, it is very important to take EVERYDAY at the same time on a consistent basis to promote better functioning.

Medimpact requested a PA form from our doctor Wednesday (09.03.14). He completed it explaining exactly why my son needs the med, and returned it the same day. Please read comments below:

Reason for med: "Patient metabolizes medicine quickly (high metabolizer) and effect wears off in middle of school day - he requires bid dosing to get through school and homework."

Other med tried: “Lower doses of Vyvanse (Concerta, Adderall XR, Focalin XR, Kapvay, Welbutrin, Daytrana by preview M.O.) all were less effective and did not cover whole day.”

Other pertinent: “Vyvanse has worked best of all these @bid”

history

You can plainly see that our doctor has done his part.

I spoke to a Medimpact rep Friday (09.05.13) at about 3:30 pm to inquire about the status, I was told that an appeals form HAD in fact, been faxed out at 5:00 pm the day before (Thursday) to the doctor. rec 102 Of course I verified with the doctor's office Monday (09.08.14), they did not receive anything on Friday. I also spoke with Latoya at Medimpact on Monday at 2:00 p.m., I specifically asked if I needed to do anything with the appeals form and she said "no, the doctor fills out all of the appeals form(s)." rec102 Yet, when I spoke to the doctor's office again on Tuesday 09.09.14, I was told that the forms were confusing. They thought I had to fill in info.

I have been communicating with [redacted] (OGB) via email about this.

*Please note in an email to [redacted], I indicated this started on the 5th, but that was incorrect, it began on the 3rd.

I first initiated contact with [redacted] Tuesday (09.09.14). I began calling the office for [redacted] at about 10:30 am on (09.09.14). I finally spoke to him that afternoon between 3:30 and 4:00. He requested I email him as he would only be in the office “another 20 minutes“, so I did.

Meanwhile, Tuesday (09.10.14), our doctor has to take time to complete an appeals form requested by Medimpact, really stating the same information. He does not have the time to do double the work for Medimpact. Please read the following comments:

“As already detailed to you (see copy sent 9.3.14) Vyvanse works better than numerous other medications, and longer, but still only last 6 -7 hours in this patient, so that half his day is not covered, with negative effect on school, homework and behavior. It is not unusual for many people to require bid dosing since there is a wide variation of metabolic degradation. It is unfair to limit treatment of individuals just because of genetic drug metabolism. The FDA approves of Physicians writing multiple doses”.

Well there ya go, the doctor is the professional here, he knows exactly what he is talking about. I have yet to see Medimpact’s medical lisence. I really do NOT appreciate them withholding my child’s medication. I hope they (MI) do realize that with this type of medication, it is not safe to just stop taking it.

The following day [redacted] emailed me the following comments:

On Wednesday (09.10.14)

[redacted]: "Below is what I've discovered so far. More to come as I updated."

I assume the next message is from Medimpact:

"This plan member's drug has a quantity limit of 1 per day. The physician requested a prior authorization for a quantity of 60 per 30DS but it was not approved for that quantity so I'm trying to find out why. At this time, if the plan member wants to fill this medication without any issues, he can fill it at 1 per day. I did not call the pharmacy since I was not sure if the plan member wanted to fill a quantity of 1 per day for now."

MEDIMPACT ACTUALLY REQUESTED THE PA, NOT OUR DOCTOR

To which I replied on (09.10.14):

Who put a quantity limit of 1/day on any drug for me or my child? I Guess there was no response to my comments about the 2 times I called Medimpact or the confusing forms. They obviously have no concern that my child has been, and, still is, without his medication. Filling it now would defeat the whole purpose. He would run out of it before we could get another prescription because of the type of drug it is. That makes no sense. They have about 1 more day before I file a complaint with the Insurance Commissioner. This is ludicrous!

To which [redacted] replied (09.10.14):

“The manufacturer of the drug put the one per day limit.” (BLAME GAME) While they’re playing games, my child suffers.

I asked [redacted] to send me a contact number, reference number etc... so I could contact “the manufacturer“. He told me he did not have access to that info. (very convenient)

I spoke to my Pharmacist. I told [redacted] the manufacturer is not the hold up, I imagine the $517/month has a lot to do with it. That's what I pay my premiums for. My child is still waiting because of $$. This is completely absurd and my child needs his medication NOW.

To make matters worse, I was told by Neshia at Medimpact Friday (09.12.14) at 4:52 p.m. that starting Thursday (09.11.14) the process will take up to 15 days. rec110

I was never consulted about any choice of a phamracy benefits management, so I never agreed to these terms. I pay my premiums, I should not be treated this way. Their souloutions are not working for me, as their website claims. If I had a choice, it would NOT be Medimpact.

I have included comments of 8 individual members as reported to the Revdex.com. These are copy/paste, you will find these exact comments on the Revdex.com website. Please note the consistency in, price fluctuation, medimpact recommendation to “TRY” other meds before getting the one that their doctor has recommended, PA issues, timeliness issues, poor business practice, total disregard for life, unnecessary prolonging denial of medication, in one complaint, only partial reimbursement for medications. While these may be resolved, THE POINT IS, THESE MEMBERS SHOULD HAVE NEVER HAD TO GO THIS FAR FOR WHAT IS RIGHTLY THEIRS.

PLEASE NOTICE THE DISAPPOINTMENT AND DISCOURAGEMENT BY MEMBERS AFTER MEDIMPACT HAS BEEN CONTRACTED AS PHARMACY BENEFITS MANAGEMENT.

5/1/2014 (I’m curious to know how many times the scamming members issue has happened) (at least 2 member complaints contain comments as to “I hate to bad mouth” or, 06.27.12 - “I always try to handle myself w/dignity and grace and not cause a scene“)

“I hate to bad mouth the employees at Med Impact”, “scam attempting to obtain my credit card number“. Seriously, the first time I called I "won a trip to the Bahamas", the second time I "won a $100 voucher to fine retail location". “No explanation other than I needed to try 3 different medications before they could approve my Generic birth control. Well my doctor filled out a form requesting that the medication be approved for me and once again I was denied.” ". All I needed to do was give my credit card number to pay the "$1.99 activation fee".

3/10/2014 “I regularly get a prescription, and for medical reasons, need the name brand, and have received a prior authorization from my doctor for this name brand.” “I obtained this information, received a voicemail message from them (which I still have) that my prior authorization was accepted, and the prescription was initially authorized. However, I recently received a letter from MedImpact stating that my prior authorization would not be accepted because I had not first tried and failed two generics.”

11/6/2013 “Ever since they took over the drug prescription insurance and dispense for the state of Michigan from Medco, my premium (copay) for brand name medications has gone from $20-40 to $80 and more. He wrote a new prescription with a dispense as written note, and that is when the problems started. I was told that I would pay a premium of $170, unless my sons doctor could provide proof that the brand name was necessary. I called Medimpact about this and was told that there was nothing else to do but to pay $170.”

8/13/2013 “Review: MedImpact is a pharmacy benefit manager who makes money be making it difficult or impossible for patients to obtain medications prescribed by their docot or immunizations. The company has refused to pay for a Hepatitis immunization despite it being a contractual benefit paid at 100 percent without deductions of copays. My pharmacist, Doctor and myself have been unable to get MedImpact to follow their own formulary, medicare regulations, and contractual obligations.”

No business response

“SEEM TO PRACTICE DISCOURAGING UTILIZATION AS A MEANS TO SAVE MO9NEY.”

6/27/2012 “Apparently Medimpact has determined that my daughter's life means nothing. My daughter has seizures. Her medication could be the difference between life and death for her.” “The pharmacy is forced to call each month for approval to fill her prescription and this month the approval was declined. So, what happens to my daughter now that they have chosen to treat her like a number? She is obviously nothing to them but she is everything to me. I always try to handle myself w/dignity and grace and not cause a scene but this is ridiculous and unacceptable.”

5/16/2012 “very first time since diagnosed with diabetes my blood sugar is now controlled with this medicine. Sent my prescription and it was denied by medimpact. My physician has faxed medical necessity and have no received reply for over 3 weeks. I pay for my insurance and expect the services. Why not allow me to have a medication prescribed by my physician that will over the long run keep me healthier longer and diminish the number of medications needed to control my diabetes. I am apalled at this company that has taken over our prescription plan it is all about the money and the patient is only a number to them.”

2/9/2012 “I submitted a prescription for a pain medication on Tuesday, January 24 at 2 pm. I was told my insurance had to ok it. I called but they were already closed by the time I got the message. I called Wednesday AM and was told it takes 24-48 hours so I waited. I called today, Friday, and was told it was being reviewed. I received a call at 6:10 that it was denied. My issue is not the denial but the timeliness of their process. By 6:10 my doctor has left for the weekend so I have no recourse for alternative medication now until Monday. That's almost a week since I dropped off my initial prescription. That time line is ridiculous. Each time I called, I asked to speak to a supervisor and was told they don't have them. Eventually on Friday night one called me. I later called and asked for the corporation's name and address. I was told they don't have an address. Of course they do, it's in San Diego. They were unhelpful and obstructive at every turn.”

12.12.11 “completed MedImpact Prescription Claim Form was mailed to MedImpact at 10680 Treena Street 5th Floor, San Diego, CA 92131, accompanied by all of the appropriate receipts and documentation. In the interim, I was in contact with __ from MedImpact at __ via email to track the progress of my claim. After many weeks, MedImpact mailed me a check in the amount of $28.45 rather than the full reimbursement of $143.97. I contacted Ms. __ and requested the remaining funds paid for the prescriptions, and was told that MedImpact would not reimburse me further!!!! I do not believe that MedImpact or __is allowed to deduct anything from a full reimbursement because a member is out of town. I am on General Assistance -- this seems fraudulent and illegal. Can you please help and advise? I can forward copies of all documentation including these emails from __.Thank you very much for your help.”

Oct 2011 https://www.[redacted].com/research/[redacted]-downgrades-MedImpacts-CFR-to-Caa2...⇄ />
RATINGS RATIONALE

The downgrades to a Caa2 CFR and Caa1 PDR are based on concerns that MedImpact will not meet Moody's expectations for profitability or cash flow generation over the next 12 to 18 months. The Caa2 CFR reflects a higher likelihood, in our view, that MedImpact's capital structure is unsustainable and the company could face potential liquidity challenges. The Caa2 also reflects MedImpact's high leverage, small revenue base, and historical lack of financial controls stemming from a highly concentrated ownership structure. Moody's understands that delays in client implementations and higher than expected working capital needs have contributed to negative cash flow from operations and significantly lower cash balances during 2011.

"MedImpact's EBITDA and cash flow are expected to track well below our expectations, even as sales from new clients begin to flow through," said [redacted], a Senior Credit Officer at Moody's. "Moody's believes that MedImpact's ability to adjust to any potential changes in vendor payment terms will be even more limited with reduced profitability, cash flow and cash balances," continued [redacted]. Going forward, we believe the company will continue to face challenges in improving profitability due to its higher interest expense.

The ratings also reflect MedImpact's position as a niche pharmacy benefit manager (PBM) that serves mid-sized customers, including hospital systems, regional managed care organizations and state Medicaid health plans. Because MedImpact acts solely as an agent and does not purchase drugs or own mail order fulfillment or specialty services, its revenue base is very small compared to the three rated, full-service PBMs: CVS/Caremark (Baa2), Express Scripts (Baa3) and Medco (Baa3).

The stable outlook reflects our expectation that the company will not see further deterioration in cash flow or liquidity, which would require a draw down on its external credit facility. If there is further deterioration in operating results (associated with delays in client implementation, contract renewals or loss of members) the ratings could be downgraded. A need to borrow to address payable needs and weakened liquidity could also result in a rating downgrade.

Jan 2011 - July 2014

https://www.[redacted].com/credit-ratings/MedImpact-Holdings-Inc-credit-rating-[...⇄ July 2014 went from stable to positiveDesired Settlement: Immediate approval to fill RX!!!!

Business

Response:

Good Morning,

Attached please find MedImpact's letter response to this complaint. Please contact me at any time with any questions.

Sincerely,

[redacted]@medimpact.com

October 3, 2014

RE: Revdex.com Review: ID [redacted]

Dear Ms. [redacted]:

Medlmpact Healthcare Systems, Inc. takes Revdex.com inquiries and resulting resolution seriously. Please contact your health plan and

physician to discuss the specifics regarding your son's medication. Medlmpact does not determine health plan benefits, but rather is

contracted with your health plan to perform pharmacy benefit management services. Your health plan, not Medlmpact, is solely

responsible for determining the health plan's prescription benefit designs and formularies offered to its members. Medlmpact is

responsible only for the administration of a health plan's designated prescription benefit plan.

We have researched this inquiry and have found that all processes were appropriately followed by Medlmpact, in coordination with

your health plan. Specifically, Medlmpact followed the process outlined in its contract with the State of Louisiana Office of Group

Benefits. In this instance, the decision related to the medication was upheld by a third party Independent Review Organization (IRO).

We again suggest that you contact your health plan directly to resolve any questions or concerns.

Medlmpact is dedicated to providing unsurpassed quality customer service and at no time in its 25-year history has it placed profits

over patient safety. We strive for a customer-centric approach when delivering service excellence. Medlmpact is committed to

ethical business conduct and full compliance with all state and federal laws. We believe what the company stands for is just as

important as the services it has to offer. To support this commitment and belief, Medlmpact has established a Code of Ethics and

Business Conduct which sets forth the expectations regarding the legal and ethical standards that employees and agents of

Medlmpact are expected to uphold while acting on Medlmpact's behalf.

As to the other comments contained in your letter, I can personally assure you that Medlmpact has never engaged in the conduct

you describe. As pharmacy benefit manager, Medlmpact would not, and does not solicit personal information including credit card

information. Nor would Medlmpact promise cash or trips to a member of a client health plan. Your health plan determines benefit

coverage including co-payments.

Please contact your health plan directly with any questions, and do not hesitate to contact me with any questions on this response

at ###-###-#### & [redacted]@medimpact.com.

Sincerely,

Director, Regulatory Compliance & Privacy Officer

Medlmpact Healthcare Systems, Inc.

Medimpact has caused so many problems for me since the company I work for has been using them for prescriptions. They will decide that they are going to require prior authorizations on my prescription whenever they want. They say that the prior authorizations are good for 6 months which is simply not true. I’ve had to pay out of pocket so many times because medimpact will decide that they are going to require me to get another prior authorization, even though I got one the month prior. This month (end of Dec) I was told after going to pick my prescription up that they are requiring another one, so I did everything that they have asked of me and my doctor has done everything that they have asked and the pharmacy has done everything that they have asked, but now they’re dragging their feet intentionally just so they don’t have to pay for medications that they should. Now that they managed to take just long enough to the point where everything is starting over tonight since it's now new years eve, and the prior authorization still hasn't gone through, I will now have to pay $850 out of pocket. I wish I could put into words what they have put me through, not only financially but mentally. This is a constant stress that I always have to deal with because I know how they are and the kind of stuff they pull. I would never recommend this company to anybody and if your work uses them then I would recommend going another direction or put in a request that they get a new prescription company. This company has also made it clear that it doesn't matter what my doctor says or does, they are the ones that decide if my medication should be covered or not. They tried to tell me and my doctor that I would need to see a therapist in order for them to cover the cost of my medication even when my doctor has told them that I don't need to see a therapist. This company is willing to do what ever they can to not pay for what they should. They want to be able to say that they cover these things, but if you read between the lines, you will see that there are all sorts of rules that they don't tell you about. Sorry for the long complaint but if I can help at least one person not have to go through what I've gone through with this company then it's worth it.