eForms updated with gender, step therapy exception information
April 12, 2024
This article is for prescribers caring for our members
Please share with staff or other clinicians who request medication authorizationsWe have updated the following eForms used to request authorization for medications you prescribe. All health insurers in Massachusetts were required1 to revise these forms to comply with new step therapy protocol requirements. Please start using these eForms for your medication authorization requests. Once you’ve completed the eForm and click Submit, you’ll get a confirmation that your request has been submitted to us for review.
- Massachusetts Standard Forms for Medication Prior Authorization Requests
- Massachusetts Standard Form for Hepatitis C Medication Prior Authorization Requests
What’s new?
The eForms now include:
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Expanded gender inclusivity |
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An “Exceptions to Step Therapy” section used to request coverage for a higher step medication when the lower step alternative is not clinically appropriate. |
Resources
- September 29, 2023 news article describing how we have complied with the new step therapy law and the protocols on coverage exceptions.
- Medical policies and pharmacy medical policies: bluecrossma.com/medical-policies.
- Mass Collaborative website (prior authorizations): masscollaborative.org. Click Prior Authorizations under the Solutions tab.
Questions?
Contact Pharmacy Operations at 1-800-366-7778.
1. MGL Chapter 176O, Section 12A.
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