• Editor: Vic Vangel • Contributors: Chris Burke, Gary Gilmore, Paul Jeffrey, James Monahan, Chuck Young, Nancy Schiff • 

Copayment Changes 

Effective February 1, 2009, the pharmacy copayments 
will be as follows. 

• $1 for each prescription and refill for each generic drug 
and over-the-counter drug covered by MassHealth in the 
following drug classes: antihyperglycemics, 
antihypertensives, and antihyperlipidemics; 


• $2 for each prescription and refill for other generic drugs 
and over-the-counter drugs covered by MassHealth; 


• $3 for each prescription and refill for brand-name drugs 
covered by MassHealth. 




All other copayment rules remain unchanged. Please see 
130 CMR 450.130 for regulations about copayments. 

MHDL Updates 

1. Additions 




The following newly marketed drugs have been added to 
the MassHealth Drug List. 

Akten (lidocaine ophthalmic gel) 

Alvesco (ciclesonide) 

Durezol (difluprednate) – PA 

Enterg H (alvimopan) 

Fusilev (levoleucovorin) – PA 

Keppra XR (levetiracetam extended-release) – PA 

Nplate (romiplostim) – PA 

Nucort (hydrocortisone/aloe vera) – PA 

NutreStore (L-glutamine) – PA 

Sancuso (granisetron transdermal system) – PA 

venlafaxine extended-release tablet 

Veripred (prednisolone) – PA 

 H This drug is available only in an inpatient hospital setting. 
MassHealth does not pay for this drug to be dispensed through 
the retail pharmacy or physician’s office. 

2. Change in Prior-Authorization (PA) Status 




a. The following prior-authorization requirement is 
effective February 16, 2009. 

 Doryx (doxycycline) – PA 

b. The following drug will no longer require prior 
authorization. 

 gabapentin 

3. Deletions 




The following drugs have been deleted from the 
MassHealth Drug List. 

MassHealth does not pay for drug products (including 
identical, similar, or related drug products) that the U.S. 
Food and Drug Administration has proposed, in a Notice 
of Opportunity for Hearing (NOOH), to withdraw from the 
market because they lack substantial evidence of 
effectiveness for all labeled indications. 

Accuzyme (papain/urea) 

Auralgan (antipyrine/benzocaine) 

Ethezyme (papain/urea) 

Granul-derm (castor oil/peru balsam/trypsin) 

Granulex (castor oil/peru balsam/trypsin) 

Kovia (papain/urea) 

Panafil (papain/urea/chlorophyllin/copper complex) 

TBC (trypsin/balsam peru/castor oil) 

Ziox (papain/urea/chlorophyllin) 

4. Corrections 




The following drugs have been added to the MassHealth 
Drug List. They were omitted in error. These additions do 
not reflect any change in MassHealth policy. 

Coraz (hydrocortisone/salicylic acid/sulfur) – PA 

Halotin (haloprogin) – PA 

salicylic acid ° 

Xyntha (antihemophilic factor, recombinant) 

° PA status depends on the drug’s formulation. 

Important Updates about NewMMIS 

Steps you need to take now include: 

• Coordinate with software vendors for 835 viewing. 


• Prepare your operations for the provider registration 
process. 


• Designate staff in your organization who will require 
access to the Provider Online Service Center. 


• Identify the functions designated staff will perform 
within the Provider Online Service Center. 


• Revisit any e-Learning courses to increase 
proficiency on difficult or often-used tasks. 




Provider PIN Registration Letters for NewMMIS 

MassHealth will mail the provider PIN (personal 
identification number) registration letters soon. Once you 
receive your PIN registration letter, you should prepare 
your operations as directed in the letter. Both the job aid 
and e-Learning courses can be accessed at: 
www.mass.gov/masshealth/newmmis. 



Please direct any questions or comments (or to be taken off of this fax distribution) to 
Victor Moquin of ACS at 617-423-9830. 

www.mass.gov/masshealth/pharmacy 

Number 48 

January 28, 2009