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Clinical & Pharmacy

In the “Current” tab, you’ll find news published during the past year. Use the “Archive” tab to view news going back an additional two years.

12/6/22 Schedule wellness visits with your Medicare Advantage patients
12/1/22 March 2023 Medical and Pharmacy Policy updates now available
11/29/22 Introducing the Inpatient Only list
11/17/22 Encourage your patients to take flu shot, COVID-19 booster
11/1/22 February 2023 Medical and Pharmacy Policy updates now available
10/14/22 Synagis benefits and coverage for 2022-2023 season
10/1/22 January 2023 Medical and Pharmacy Policy updates now available
9/9/22 Help your patients control their blood pressure
9/1/22 December 2022 Medical and Pharmacy Policy updates now available
8/29/22 Steps we’re taking to help our members with diabetes
8/22/22 How do you recommend? Boost your HPV vaccination rates
8/22/22 How do you recommend? Encouraging patients to stay current on vaccines
8/16/22 New fertility pharmacy joined our network
8/16/22 Are your patients past due for preventive care?
8/8/22 Novavax approved as fourth COVID-19 vaccine
8/1/22 November 2022 Medical and Pharmacy Policy updates now available
7/1/22 October 2022 Medical and Pharmacy Policy updates now available
6/30/22 Reduce COPD care disparity: Check Rx after discharge
6/28/22 Are you collaborating with mental health providers?
6/24/22 Reproductive health travel benefit
6/7/22 Prior authorization for Rx infant formula suspended until Aug 18
6/1/22 September 2022 Medical and Pharmacy Policy updates now available
5/19/22 Transplant approvals to extend for two years
5/17/22 Help your patients with asthma breathe easier
5/16/22 2022 information about our clinical programs
5/6/22 Authorization requirements previously relaxed to resume May 17
5/6/22 Remdesivir approved as treatment for kids under 12
5/5/22 New partnerships expand options for mental health care
5/2/22 Reminder: Total joint replacement level of care review
5/1/22 August 2022 Medical and Pharmacy Policy updates now available
4/28/22 Removing authorization requirements for hysterectomies
4/18/22 Bebtelovimab fights COVID subvariant now dominant in Massachusetts
4/15/22 Authorization will be required for commercial EPO, PPO members
4/7/22 Submit psychiatric specialing service requests with authorization
4/1/22 July 2022 Medical and Pharmacy Policy updates now available
3/28/22 Metro Drugs to leave fertility specialty pharmacy network May 1
3/16/22 COVID-19 treatments available across Massachusetts
3/2/22 Auth requirements and credentialing procedures continue to be relaxed
3/1/22 June 2022 Medical and Pharmacy Policy updates now available
2/28/22 New ABA medical policy to replace InterQual criteria
2/25/22 Include cancer diagnosis on oncology claims
2/24/22 Kidney disease support program for commercial members through Cricket Health
2/10/22 New resources for at-home COVID-19 testing
2/1/22 May 2022 Medical and Pharmacy Policy updates now available
1/27/22 FDA Changes: Some Monoclonal Antibody Treatments No Longer Covered
1/18/22 At-home COVID test coverage for members began Jan 15
1/1/22 April 2022 Medical and Pharmacy Policy updates now available
12/27/21 Schedule wellness visits with your Medicare Advantage patients
12/10/21 New chronic kidney disease program for Medicare Advantage members