MassHealth has issued a new draft of the Pharmacy Manual at 130 CMR 406. The new regulations make the following changes:
- Adds compounded drugs, and medically necessary cosmetic drugs for the treatment of alopecia or gender identity that are listed on the MassHealth Drug list, to the list of Covered Drugs and Medical Supplies at 406.412.
- Deletes the language in the current regulations at 406.413 that prohibits MassHealth from paying for any drug used for the treatment of obesity. The prohibition has been eliminated and MassHealth will now pay for drugs to treat obesity that are included on the MassHealth Drug List.
- Adds the new section 406.446 relative to Pharmacy Drug Review and Counseling that requires pharmacies that are servicing MassHealth patients to offer prospective drug review and counseling that are consistent with the current MA law that requires pharmacists to make an offer to counsel. Only a patient’s refusal of counseling must be documented.
These changes will become effective on January 1, 2024.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.