MassHealth issued the following two updates on March 26:
- Transmittal Letter ALL-246 – This letter transmits updates to 130 CMR 450.000: Administrative and Billing Regulations. Subsection 130 CMR 450.130 has been amended to reflect that MassHealth members will no longer be required to make copayments. Copayments have been temporarily eliminated since May 1, 2023; this update extends this policy indefinitely. These regulations are effective April 1, 2024.
- Managed Care Entity Bulletin 112 – This bulletin relates to certain drugs that may be used for the treatment of obesity that a provider purchased through the 340B Drug Pricing Program (340B stock). The bulletin applies to Accountable Care Partnership Plans (ACPPs), Managed Care Organizations (MCOs), One Care Plans and Senior Care Organizations (SCOs) (collectively referred to as “Managed Care Entities”). In MCE Bulletin 109, the Executive Office of Health and Human Services (EOHHS) directed Managed Care Entities not to pay for specified GLP-1 agonist drugs if those drugs were purchased through the 340B Drug Pricing Program, effective April 1, 2024. Through this Bulletin, EOHHS is delaying the effective date of this policy until July 1, 2024.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.