Partnership in Care – MetroPlusHealth HIV Special Needs Plan (SNP) Overview for Providers
IMPACTED LOBs: Medicare and MAP
TO: Long Term Care Facilities/SNFs
10/01/2026
Dear MetroPlusHealth Provider,
Thank you for your continued partnership with MetroPlusHealth and your commitment to delivering high-quality care to our members. We are writing to inform you that several Long-Term Care (LTC) pharmacies will no longer participate in our pharmacy network for the 2027 plan year. We want to ensure that MetroPlusHealth members residing in your facility continue to have uninterrupted access to their medications through an in-network pharmacy provider.
Specifically, SPS Health and Remedi, a division of Clarest Health, have terminated their participation agreements with CVS Caremark effective January 1, 2027. As a result, pharmacies affiliated with these organizations will be considered out of network beginning on that date. A list of affected pharmacies is included in the attached document.
As a reminder, MetroPlusHealth participating provider agreements and plan policies generally require providers to refer members only to in-network providers, except where otherwise permitted under MetroPlusHealth policies or applicable plan terms. This requirement applies to all provider types, including pharmacies.
If your facility currently utilizes any of the pharmacies listed in the attached document, we strongly encourage you to begin planning now to transition to an in-network pharmacy provider for the 2027 plan year. visit, https://metroplus.org/search-providers-metroplushealth/home. If you have any questions or would like to discuss this matter further, please contact [email protected].
Thank you for your prompt attention to this important matter and for your continued partnership in serving MetroPlusHealth members.
Sincerely,
MetroPlusHealth
