Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111
www.mass.gov/dma	
	MassHealth
	All Provider Bulletin 120
	March 2003

	TO:	All Providers Participating in MassHealth

	FROM:	Douglas S. Brown, Acting Commissioner

	RE:	Important Information about the MassHealth Pharmacy Program

Introduction	This bulletin provides important information about several issues related to the MassHealth Pharmacy Program.  

MassHealth Drug	More Frequent Updates	
List	Beginning April 1, 2003, the Division may sometimes update the MassHealth Drug List (“the List”) twice a month.  Updates to the List may occur on the first business day of the month or 14 calendar days later, or both.  The Web site will indicate the effective dates of the updates, some of which may be effective immediately upon publication.  

	This bulletin supersedes the information about the frequency of updates to the List that was issued in All Provider Bulletin 115, dated July 2002.  Pharmacies and prescribers should check the List on the Division’s Web site for changes according to this new schedule.  

	Summary Page and E-mail Alerts
	Although the Division does not send a bulletin to providers each time there are 
	changes to the List, the Division does provide a summary page on the Web site when the List is updated, and sends e-mail alerts to those who sign up for them.  The e-mail alert notifies all subscribers that the Division has posted a revised List to its Web site.  Signing up for e-mail alerts is easy and free, and will ensure that you receive prompt notification when the List has been updated.

	Web Site
	To view, print, or download the most up-to-date version of the List, go to www.mass.gov/dma.  Click on “Providers,” then “Pharmacy Information.”  The List also contains instructions for subscribing to e-mail alerts.  

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MassHealth Drug	Paper Copies
List	Providers who do not have access to the Internet may obtain a paper copy of
(cont.)	the latest update of the List by sending a written request to:

MassHealth Publications
P.O. Box 9101
Somerville, MA  02145
Fax:  617-576-4487
	
Include your MassHealth provider number, address, and a contact name with your request.  MassHealth Publications will send you the latest version of the List.  You will need to submit another written request each time you want a paper copy. 

Review of	The Division will accelerate the implementation of its pharmacy policy decisions
Psychiatric Drugs	based on its review of drugs by therapeutic class.  The Division plans to
for the List	complete its initial review of several therapeutic classes of psychiatric drugs, as well as other therapeutic classes, by April 1, 2003.  The Division will update the List to reflect new prior-authorization requirements and other requirements accordingly.

	As the Division formulates its policies about psychiatric drugs, careful
	consideration is given to the fact that psychiatric disorders are complex.  The 
	clinical response to psychotropic drugs varies among patients; and stabilizing 
	certain patients with complex psychiatric disorders is difficult.  
	 
The Division’s goal in this difficult financial environment is to work collaboratively with providers to maintain clinically appropriate care for MassHealth members in a financially responsible manner.

Antidepressants
On April 1, 2003, the Division plans to post updates to the List on the Division’s Web site based on its review of antidepressants and other therapeutic classes.  Any new requirements for antidepressants will be effective for prescriptions written on or after May 1, 2003.  

Antipsychotic and anticonvulsant drugs
On May 1, 2003, the Division will post updates to the List on the Division’s Web site based on its review of antipsychotic and anticonvulsant drugs.   Any new requirements for these drugs will be effective for prescriptions written on or after June 2, 2003.

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Pharmacy	The Massachusetts legislature created a pharmacy assessment in the FY 2003 
Assessment	State Budget (Section 101 of Chapter 184 of the Acts of 2002).  Pharmacies are required to pay an assessment on all non-Medicaid, non-Medicare prescriptions.  Please be advised that, in accordance with 130 CMR 450.203, MassHealth members cannot be charged the assessment, even if MassHealth is not the primary payer of the prescription. 

Requirement to	In accordance with 130 CMR 450.130(E), providers may not refuse services to 
Provide Services	any member who states that he or she is not financially able to pay the 
When Members 	copayment at the time the service is provided.  In addition,
Cannot Pay the	130 CMR 406.411(D)(1) specifies that providers may not split prescriptions by 
Copayment 	filling them for a period or quantity less than that specified by the prescriber.  Therefore, unless the pharmacy has insufficient stock, failure to fill the prescription for the duration the prescriber has specified, due to the member's inability to pay the copayment, constitutes an improper refusal of service.

Questions	If you have any questions about the information in this bulletin, please call the Drug Utilization Review Program at 1-800-745-7318.