Panel reviews and approves ratification and amendment to Navitus contract after billing mismatch

The JBC-Employee Benefits Division Oversight Subcommittee voted Thursday to review the ratification and to approve an amendment increasing authorized spending on the Navitus Health Solutions pharmacy contract by $22,000,000, after staff described a billing mismatch related to a manufacturer coupon program.

Grant Wallace, Director of the Employee Benefits Division, told the committee the amendment is intended to align the contract spending authorization with how Navitus bills two separate invoices: a per-member, per-month administrative invoice and a separate claims invoice for filled prescriptions. Wallace said fees for administering a manufacturer coupon program — calculated as 20% of the coupon amount — were being posted to the administrative invoice rather than netted against claims as division staff had expected. "We are not asking for any new or additional funding," Wallace said. "We have the funding available to cover this, and I'd be glad to answer…