CVS Announces Split From Walmart

Active and pre-retiree members should take note that CVS Health has announced that as of April 30, 2019, Walmart will no longer be a part of the CVS Caremark Pharmacy Networks. (This change does not affect our Medicare members). Our records indicate that 76 SWSCHP active/pre-retiree members are users of the network through Walmart. These members will have to secure prescription medications through other pharmacies.

You can read the CVS press release on this matter:

CVS Health Announces Walmart Decision to Leave CVS Caremark Commercial and Managed Medicaid Retail Pharmacy Networks

I am writing to inform you that, despite our good-faith efforts and diligent negotiations, Walmart has opted to leave the CVS Caremark pharmacy benefit management commercial and managed Medicaid retail pharmacy networks. Any network change must place patient care as the highest priority and, as such, CVS Caremark has requested that Walmart continue to fill prescriptions as an in-network participating pharmacy through April 30, 2019. This transition does not affect Walmart’s participation in the CVS Caremark Medicare Part D pharmacy network. In addition, Walmart’s Sam’s Club division remains in the CVS Caremark pharmacy networks.

At a time when everyone is working hard to find ways to reduce health care costs, Walmart requested rates that would ultimately result in higher costs for our clients and members. While we have enjoyed a long relationship with Walmart as a low-cost provider in our broad national networks, based on our commitment to helping our clients and consumers manage rising pharmacy costs, we simply could not agree to their recent demands for an increase in reimbursement.

Our focus now is an orderly transition for any affected plan members and ensuring we place patient care as our highest priority. With continuity-of-care in mind, we have requested that Walmart continue to fill prescriptions as an in-network participating pharmacy through April 30, 2019, and are awaiting a response on the transition period.

CVS Caremark’s priority will be to ensure members do not have a disruption in therapy and that their transition to a new pharmacy is simple and as convenient as possible. Members affected by this network change will be notified and will have access to information to help them identify nearby in-network pharmacies where they can fill their prescriptions, including independently owned, community-based pharmacies, other local pharmacies in grocery stores and mass merchants, as well as regional and national chains.

We expect minimal member disruption because, with more than 63,000 other pharmacies that will remain in our national network, we continue to exceed industry benchmarks with regards to network pharmacy access by a significant margin. In fact, the average distance that a member would need to travel to reach an in-network pharmacy remains virtually unchanged.

Widely adhered to Tricare access standards specify:

  • 90 percent of urban members must have an in-network pharmacy within 2 miles

  • 90 percent of suburban members must have an in-network pharmacy within 5 miles

  • 70 percent of rural members must have an in-network pharmacy within 15 miles

With Walmart participating in our retail pharmacy networks, we meet these access standards:

  • 99.15 percent of urban plan members can access an in-network pharmacy within 0.9 miles

  • 99.66 percent of suburban plan members can access an in-network pharmacy within 1.2 miles

  • 98.46 percent of rural plan members can access an in-network pharmacy within 5.9 miles

With Walmart no longer participating in our retail pharmacy networks, the average distance a member must travel to an in-network pharmacy is virtually unchanged. Fewer than one-tenth of 1 percent of members would experience any access change:

  • 99.08 percent of urban plan members can access an in-network pharmacy within 0.9 miles

  • 99.60 percent of suburban plan members can access an in-network pharmacy within 1.2 miles

  • 98.43 percent of rural plan members can access an in-network pharmacy within 5.9 miles

As we begin to prepare members for a transition, we are hopeful that Walmart will agree to work amicably with us in the best interest of patients. Our priority is to ensure that patients continue to have access to their medications during this transition period. We also remain open to continuing timely, good-faith negotiations with Walmart in the hopes of reaching an agreement to provide quality pharmacy care at a reasonable cost.