Point32Health and Foundation Medicine, Inc. previously expanded access to comprehensive genomic profiling (CGP) for Harvard Pilgrim Commercial members and Tufts Health Plan Commercial members, and that coverage now also applies to Tufts Health Together, Tufts Health RITogether, and Tufts Health Direct members.
Federal regulations require that providers who render services for Medicaid members are screened by and enrolled with the appropriate state Medicaid agency. If you have not yet completed this enrollment/screening process for your applicable patients, please do so.
Please refer to this chart to review updates to pharmacy prior authorization programs applicable to Harvard Pilgrim Health Care and Tufts Health Plan products.
In accordance with recent action by the Rhode Island Executive Office of Health and Human Services, Tufts Health Plan is issuing a rate increase retroactive for dates of service on or after July 1, 2022 for certain pediatric claims for Tufts Health RITogether.
In alignment with a rate increase implemented by the Rhode Island Executive Office of Health and Human Services, Tufts Health Plan will automatically reprocess any claims submitted for personal care services between July 1, 2022 and Jan. 25, 2023.