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MassHealth Pharmacy Initiatives and Clinical Information


Concomitant Opioid Benzodiazepine Initiative       See Table 69

Please see the links below for a description of the Concomitant Opioid Benzodiazepine Initiative (COBI), including a medication list and frequently asked questions. The link to Table 69 above can be used for more information on PA requirements and evaluation criteria.

Concomitant Opioid Benzodiazepine Initiative  | 

   

Chimeric Antigen Receptor (CAR)-T Immunotherapies Monitoring Program       See Table 75

Please see the links below for a description of the Chimeric Antigen Receptor (CAR)-T Monitoring Program, including medications and requirements for reporting member outcomes. The link to Table 75 above can be used for more information on PA requirements and evaluation criteria.

Chimeric Antigen Receptor (CAR)-T Immunotherapies Monitoring Program  | 

   

Hospital Outpatient Prior Authorization Initiative

Please see the following links to find out more information about Provider Transmittal Letters and Subchapter 6.

https://www.mass.gov/lists/all-provider-transmittal-letters

https://www.mass.gov/doc/physician-phy-subchapter-6/download

 

 

Pediatric Behavioral Health Medication Initiative       See Table 71

Please see the links below for a description of the Pediatric Behavioral Health Medication Initiative (PBHMI), including a medication list and situations that require prior authorization (PA) for members < 18 years of age. The link to Table 71 above can be used for more information on PA requirements and evaluation criteria.

Pediatric Behavioral Health Medication Initiative  | 

Please see the following link to find out more information about the Pediatric Behavioral Health Medication Initiative (e.g., Letter to Prescribers).

https://www.mass.gov/info-details/pediatric-behavioral-health-medication-initiative-pbhmi-information

 

Opioid and Pain Initiative       See Table 8

Please see the following link to find more Opioids and Controlled Substances Information (e.g., Letter to Prescribers).

https://www.mass.gov/lists/opioids-and-controlled-substances-information

Opioid and Pain Initiative  | 

  

Second-Generation (Atypical) Antipsychotic Initiative   See Table 24

Please see the following link to find out more information about second-generation (atypical) antipsychotics (e.g., Letter to Prescribers).

https://www.mass.gov/lists/second-generation-antipsychotics-also-known-as-atypical-antipsychotics

  

Zolgensma Monitoring Program       See Table 76

Please see the links below for a description of the Zolgensma Monitoring Program, including requirements for reporting member outcomes. The link to Table 76 above can be used for more information on PA requirements and evaluation criteria.

 

Zolgensma Monitoring Program  | 

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