Commonwealth of Massachusetts 
Executive Office of Health and Human Services 
Division of Medical Assistance 

600 Washington Street 
Boston, MA 02111


 MassHealth 
Pharmacy Bulletin 66 
December 2000

 TO: 
Pharmacies Participating in MassHealth 

FROM: Wendy E. Warring, Commissioner 

RE: 
Suspension of Pharmacy Bulletin 64—PA for Sedative-Hypnotic Sleep 
Medications 

Prior Authorization The Division of Medical Assistance has suspended, until further 
No Longer Required notice, MassHealth Pharmacy Bulletin 64 (dated March 
for Certain Sleep 2000), which required prior authorization for all medication that is 
Medications FDA-approved for treatment of insomnia. 

Insomnia is a sleep disorder that affects an estimated 60 million 
Americans a year, according to the National Sleep Foundation. 
While many patients with insomnia may be treated effectively 
without the use of drugs, some patients are more effectively 
treated with sedative, sleep-hypnotic medication. In those 
instances where sleep-hypnotic therapy is indicated, research 
findings show that many medications stop working after several 
weeks of continued use. Use of the medication, therefore, should 
be limited to a maximum of two to three weeks. 

List of Drugs 
The following drugs, which were identified in Pharmacy Bulletin 64 
as requiring prior authorization, no longer require it. 

Amobarbital/Secobarbital (Tuinal) Quazepam (Doral) 
Chloral Hydrate (Noctec) Secobarbital (Seconal) 
Estazolam (ProSom) Temazepam (Restoril) 
Ethchlorvynol (Placidyl) Triazolam (Halcion) 
Flurazepam (Dalmane) Zaleplon (Sonata) 
Pentobarbital (Nembutal) Zolpidem (Ambien 

Reimbursement to 
Under some circumstances, members may be eligible to receive 

Members 
reimbursement if they paid out-of-pocket to have an insomnia 
medication filled during the time Pharmacy Bulletin 64 was in 
effect. The enclosed notice describes the circumstances under 
which a member may be eligible for reimbursement. 

Please post the enclosed notice in your pharmacy where 
members can view it easily. 

Questions 
If you have any questions about the information in this bulletin, 
please call the MassHealth Provider Services Department at 

(617) 628-4141 or 1-800-325-5231. 


NOTICE TO MASSHEALTH MEMBERS 


If you were a MassHealth member from March 1, 2000, through 
December 1, 2000, and paid for a refill of any of the sleeping medicines 
listed below because you were told that MassHealth would not cover the 
refill, you may be able to get your money back. To get your money 
back, all of the following must apply: 

• 
The medicine is listed below and was medically necessary for you. 
• 
Your doctor gave you a prescription for the medicine. 
• 
You brought the prescription to a pharmacy, or asked for a refill that 
was allowed on the doctor’s prescription. 
• 
Your doctor or pharmacist told you that MassHealth would not pay 
for the prescription. 
• 
You paid for the prescription yourself. 
To get your money back, send your receipt or pharmacy proof of 
purchase (printout) on or before March 1, 2001, to: 

Division of Medical Assistance 
Pharmacy Unit, 5th Floor 
600 Washington Street 
Boston, MA 02111 

MassHealth will look at your prescription records to make sure that the 
prescription would otherwise have been covered. Some of the reasons 
for noncoverage may be: early refill, ingredient duplication, therapeutic 
duplication, or drug-to-drug interaction. There may be other reasons, 
too. If your money cannot be returned, you will get a letter explaining 
why. 

List of Sleep Medicines 

Amobarbital/Secobarbital (Tuinal) Quazepam (Doral) 
Chloral Hydrate (Noctec) Secobarbital (Seconal) 
Estazolam (ProSom) Temazepam (Restoril) 
Ethchlorvynol (Placidyl) Triazolam (Halcion) 
Flurazepam (Dalmane) Zaleplon (Sonata) 
Pentobarbital (Nembutal) Zolpidem (Ambien) 



MassHealth 
Pharmacy Bulletin ?? 
December 2000 
Page 3