On March 21, the Department of Insurance hosted its second of three public hearings on PBM regulations. This hearing focused on the licensing process and standards. NACDS submitted testimony and participated in the hearing. The final hearing is scheduled for April 4.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

In April 2025, MassHealth will migrate its Medicaid Management Information System (MMIS) base application and Provider Online Service Center (POSC) to an Amazon Web Services (AWS) data center. MassHealth has published All Provider Bulletin 401- MMIS POSC Migration to Amazon Web Services, which outlines key cutover information. All published bulletins can be found on Mass.gov   

The MassHealth Business Support Service (BSS) Provider Relations team will be hosting an information session on March 10 at 10:00 am. Please register online. The following information will be addressed:  

• Reasons for Migration: Understanding the benefits of transitioning to AWS. 

• Timeline of Activities: Key steps along with dates and times you need to be aware of. 

• Provider Impact: How this change may affect your workflow which might include technical impact of the changes, adjusted claims processing timelines, checking member eligibility; along with steps you can take to minimize any disruptions. 

If you have questions, please contact MassHealth at (800) 841-2900 or provider@masshealthquestions.com. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

The MassHealth Pharmacy Program updated pharmacists on standing orders for dispensing over-the-counter prenatal vitamins and over-the-counter oral hormonal birth control. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

NACDS and the Massachusetts Chain Pharmacy Council have begun engaging the governor’s office and legislative leaders on the budget proposal that includes a $2/prescription assessment to help pay for MassHealth pharmacy benefit program.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On January 22, Gov. Maura Healey (D) announced her Fiscal Year 2026 budget proposal. The proposal includes two relevant sections for pharmacies:  

1. The Commonwealth may impose a fee on each prescription dispensed in the state by pharmacies which will include retail, hospital, compounding, specialty and 340B pharmacies. The amount each pharmacy shall pay shall not exceed the lesser of the $2.00 per prescription dispensed by the pharmacy, or an amount equal to 6% of the revenues received by the pharmacy. The Executive Office of Human Services (EOHS) is also given the power to enforce this provision through license suspensions, fines and liens. MassHealth has indicated that these new funds will be used to increase the dispensing fees for all pharmacies that dispense prescriptions in the Fee-for-Service Program and to mandate dispensing fee floors for all pharmacies that participate in the MassHealth MCO pharmacy contracts.  
2. EOHS will seek to create a Universal Adult Vaccine Program. This proposal would expand the current Childhood Vaccination Purchase Trust Fund and require pharmacies to participate in the new program for providing state-sponsored adult vaccines.  

NACDS will continue to work with the Massachusetts Chain Pharmacy Council to engage the administration and legislature. A collective meeting had been scheduled for the end of the month with MassHealth and Mercer on the ongoing cost of dispensing study issues. This meeting and others will be moved up sooner.  

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On December 6, the Board of Pharmacy published new regulations relative to pharmacy licensing and the Continuous Quality Improvement Program.

Amendments to 247 CMR 6.00

Created six new license categories for certain types of pharmacy practice:

1. sterile compounding,
2. complex sterile compounding,
3. institutional sterile compounding,
4. non-resident drug stores,
5. non-resident sterile compounding,
6. non-resident complex non-sterile compounding.

The proposed changes explain which license types are needed for which activities, set forth the eligibility requirements and procedures for obtaining each type of license, and set forth grounds for denial of licensure due to lack of suitability. The proposed changes update requirements related to the change of a pharmacy’s manager of record, location or ownership, pharmacy renovations and the closure of a pharmacy. The proposed changes remove practice standards from this section in order that all such practice standards may be aggregated at 247 CMR 9.00.

Amendments to 247 CMR15.00

Requires pharmacies to establish and implement a “Continuous Quality Improvement Program,” meaning a system for identifying and documenting prescription dispensing errors; notifying affected patients, and health care providers as necessary; analyzing the error to identify causes and contributing factors; and using the information to improve pharmacy systems and workflow.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

The Board of Pharmacy issued the following two updates:

• Policy 2024-02: Implantable Infusion Pumps – Outlines requirements for extended infusion times of compounded sterile preparations via implanted pumps.
• 247 CMR 13.00: Nuclear Pharmacy Licensure Requirements and Professional Practice Standards – The most significant change was to remove the requirement for the separate nuclear pharmacist license and defer nuclear pharmacist qualifications to the nuclear regulations at 105 CMR 120.526: Training for an Authorized Nuclear Pharmacist.

Also in Massachusetts, MassHealth released the latest Pharmacy Facts that includes a COVID-19 Vaccination Reimbursement Update.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On October 4, MassHealth released the results of its cost of dispensing study. It was announced that the proposed updated dispensing fee for chain pharmacies will be reduced by $1.51 per prescription from $10.02 to $8.51. This proposed change is scheduled to take effect on July 1, 2025. The dispensing fee for independent pharmacies will be increased by 19 cents to $10.21.  The division also announced a policy change that will require managed care organizations (MCOs) to pay the MassHealth fee-for-service rate to independent pharmacies instead of the current managed care contract rate.  MCOs will continue to pay chain pharmacies the negotiated contract rate. The raw data from the cost of dispensing survey is expected to be made available within the next two weeks. The proposed amendments will be submitted to CMS for its approval.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.