MassHealth posted a bulletin that MassHealth will not pay for certain high-cost drugs if purchased through the 340B Drug Pricing Program. This change applies to claims for MassHealth members in Fee-for Service, the Primary Care Clinician (PCC) Plan and Primary Care Accountable Care Organizations. Providers serving MassHealth members enrolled in Accountable Care Partnership Plans (ACPPs), Managed Care Organizations (MCOs), One Care plans, Senior Care Organizations or the MassHealth behavioral health vendor should refer to Managed Care Entity Bulletin 7 for additional information regarding payment policies applicable to those plans.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.