MassHealth recently announced updates to the MassHealth Unified Formulary, which will take effect on Nov. 17, 2025. Tufts Health Together-MassHealth MCO Plan and ACPPs utilizes MassHealth’s Unified Formulary for pharmacy medications and select medical benefit drugs, and providers should be aware that updated coverage and criteria will be available on the MassHealth Drug List on or after the effective date.
Back to Insights and Updates for ProvidersSeptember 2025
MassHealth updates to Unified Formulary
Tufts Health Together - MassHealth MCO Plan and ACPPs
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In this issue:
September 2025- Update on coverage of weight loss medication
- Update on medical record review programs
- New laboratory Payment Policies
- Reminder: Expansion of vendor program and training sessions
- Reminder for SNFs: Submit SC-1 forms to Tufts Health Plan and MassHealth
- ChoiceNet: no tiering changes for 2026
- Billing updates for mental health centers
- Change to HEDIS® specification for breast cancer screening
- Using ICD-10 Z codes to track social drivers of health
- Promoting the flu vaccine
- New 2025 model of care training available
- Metabolic monitoring for patients on antipsychotic medications
- The importance of culturally appropriate health care
- New MassHealth resources for providers
- Coverage changes for Stelara and biosimilars
- Point32Health Payment Policy updates
- Point32Health medical drug program updates
- Pharmacy coverage changes