Provider Resources

Provider Education


US Inflation Reduction Act (IRA): 2023 Medicare Prescription Drug Changes

Drug Cost Inflation Increase Limits

Beneficiaries pay less for some drugs covered under Medicare Part B and nearly all Part D covered drugs, if the drug cost increases faster than the US inflation rate (Part B 20% coinsurance is based on the lower-adjusted price)

Insulin Products

Beneficiaries may not pay more than $35 for a 30-day supply of Part D insulin products even if they have not met their deductible(s) or have entered the Part D Coverage Gap. Effective July 1, 2023, insulin covered by Part B (applicable when administered using an insulin pump) also may not cost more than $35 for a 30-day supply

  • ATRIO Health Plan members pay $0 copay for covered Part D insulin until the coverage gap, during which they will pay $35 for a 30-day supply (see "Formulary Insulins” table)
  • ATRIO Health Plan members pay 20% coinsurance for Part B insulin up to $35 for a 30-day supply

NOTE : Between January 1st and January 18th, 2023, ATRIO members may have been charged more than $35 for Part D insulin if they were in the Coverage Gap or if they received a non-formulary insulin product (e.g., Lantus) during a transition fill(s)

  • What should members do?
    • Members can call ATRIO Customer Service at 1-877-672-8620 (TTY: 711) and request reimbursement
  • What can prescribers do?
    • Switch your ATRIO members to a formulary insulin, if clinically appropriate

Beneficiaries must not have cost-sharing for all vaccines recommended for adults by the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP), such as the shingles vaccine; this change brings Part D vaccine coverage more in line with Part B for other approved vaccines (including the flu and COVID-19)

NOTE : Following the end of the US Public Health Emergency (PHE) on May 11, 2023, cost-sharing may begin to apply for approved Part B COVID treatments

Claims Submission Address

ATRIO Health Plans

338 Jericho Turnpike #135

Syosset, NY 11791

Please continue to send REFUND CHECKS to:

ATRIO Health Plans

2965 Ryan Drive SE

Salem, OR 97301

Tools and Resources

Medicare Star Rating Resources

View ATRIO’s Star Ratings Program page for measure descriptions and resource materials.

For questions on the Star Ratings Program, please click here to contact ATRIO Quality Improvement.

Opioid Information for Prescribers

Opioid drugs (“opioids”) have serious risks such as addiction, overdose, and death. CMS is very concerned about the opioid epidemic and its effect on our communities, and is committed to a complete strategy to combat this public health emergency. Several drug management programs are in place to prevent and combat opioid overuse.

Click here to see the formulary-level opioid safety edits at the point of sale, as recommended by CMS.

Payer IDs

VSP Information:

VSP Provider Customer Service Line:

1.800.615.1883 Monday – Saturday: 6:00 a.m. – 5:00 p.m. PST

Sunday: Closed

Additional helpful provider information can be found at the following link:

To learn more about becoming an in network VSP provider please see link below:

Extra Benefits:

To see extra benefits ATRIO offers, please select the link below:

Last updated Oct 20, 2023