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).
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
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
Luxturna Monitoring Program See Table 72
Please see the links below for a description of the Luxturna Monitoring Program, including requirements for reporting member outcomes. The link to Table 72 above can be used for more information on PA requirements and evaluation criteria.