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.
Tufts Health Plan is making some updates to our payment policies related to the submission of professional claims for services provided via telehealth, and also reprocessing certain previously denied claims to be reimbursed, in accordance with MassHealth’s MCE Bulletin 95.
Effective April 1, 2023, Tufts Health Together–MassHealth MCO Plan and ACPPs, in conjunction with the other Medicaid managed care organizations (MCOs) in the Commonwealth, will be utilizing MassHealth’s Unified Formulary for pharmacy medications and for select medical benefit drugs.
Effective April 1, 2023, Tufts Health Together–MassHealth MCO Plan and ACPPs will be utilizing MassHealth’s Unified Formulary for pharmacy medications and for select medical benefit drugs, and pharmacy coverage and criteria for Tufts Health Together consequently will mirror that of MassHealth.
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.
Tufts Health Plan has updated the notification requirement for acute behavioral health services updated from two to three business days for Tufts Health Plan Massachusetts Commercial products, Tufts Health Together, Tufts Health Unify and Tufts Health SCO.