People insured through Horizon NJ Health will no longer be able to get their prescriptions at CVS Pharmacy locations, unless they are willing to pay full price.
Effective April 30, CVS will be considered an out-of-network pharmacy for Horizon NJ Health, a subsidiary of Horizon Blue Cross Blue Shield of New Jersey. The company serves more than 800,000 publicly insured children and adults in the Medicaid and NJ FamilyCare programs.
The change is a result of disagreements over pricing. Horizon claims CVS was demanding a substantial increase in the cost of prescription drugs, but the drugstore disputes that.
“CVS Pharmacy submitted a proposal that was equitable and competitive with other New Jersey Medicaid plans, but Horizon rejected it and demanded rates that are unsustainable for our pharmacy business,” according to a CVS statement.
A Horizon spokesman said Friday that “CVS refused to negotiate a fair price and chose instead to leave our Medicaid pharmacy network.”
The move does not affect Horizon Blue Cross Blue Shield of New Jersey’s commercial medical plans.
CVS remains in-network with the state’s other managed care health plans. These are: Aetna Better Health of New Jersey, Fidelis Care, UnitedHealthcare Community Plan, and Wellpoint.