Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid www.mass.gov/masshealth MassHealth Transmittal Letter NF-57 July 2011 TO: Nursing Facility Providers Participating in MassHealth FROM: Terence G. Dougherty, Medicaid Director RE: Nursing Facility Manual (Revised Appendix F) MassHealth is updating Appendix F of the Nursing Facility Manual. Appendix F lists those drugs that are subject to the unit-dose-dispensing and return requirement for nursing facilities and pharmacies. (See 130 CMR 456. 621 for applicable requirements.) The revised Appendix F is effective August 1, 2011. MassHealth Web Site This transmittal letter and attached pages are available on the MassHealth Web site at www.mass.gov/masshealth. Questions If you have any questions about the information in this transmittal letter, please contact MassHealth Customer Service at 1-800-841-2900, e-mail your inquiry to providersupport@mahealth.net, or fax your inquiry to 617-988-8974. NEW MATERIAL (The pages listed here contain new or revised language.) Nursing Facility Manual Pages F-1 and F-2 OBSOLETE MATERIAL (The pages listed here are no longer in effect.) Nursing Facility Manual Pages F-1 and F-2 — transmitted by Transmittal Letter NF-48 Commonwealth of Massachusetts MassHealth Provider Manual Series Nursing Facility Manual Subchapter Number and Title Appendix F. Unit-Dose Drugs Transmittal Letter NF-57 Page F-1 Date 08/01/11 Unit-Dose Drugs This appendix lists the unit-dose-packaged drugs that a nursing facility must return to the dispensing pharmacy in accordance with 130 CMR 456.621 when the use of the drug for the member is discontinued. The minimum quantity of unused doses applicable to each drug on this list that is acceptable for return is one. Abilify Advair Aricept Arixtra Atripla Avonex Copaxone Epzicom Flovent Fragmin Geodon Humalog Invega Invega Sustenna Isentress Lantus Levaquin Lovenox Novolog Pegasys ProAir HFA Pulmicort Rebif Reyataz Spiriva Truvada Vancocin Zyprexa Commonwealth of Massachusetts MassHealth Provider Manual Series Nursing Facility Manual Subchapter Number and Title Appendix F. Unit-Dose Drugs Transmittal Letter NF-57 Page F-2 Date 08/01/11 This page is reserved.