Back to Insights and Updates for ProvidersJune 2024

MassHealth updates to Unified Formulary

Tufts Health Together - MassHealth MCO Plan and ACPPs

MassHealth recently announced the following updates to the MassHealth Unified Formulary, effective Aug. 12, 2024. The table below outlines these changes. Tufts Health Together-MassHealth MCO Plan and ACPPs utilizes MassHealth’s Unified Formulary for pharmacy medications and select medical benefit drugs. Please keep in mind that updated coverage and criteria will be available on the MassHealth Drug List on or after the effective date.

Adding to MassHealth Drug List (MHDL) Adalimumab-ryvk; Adzynma (PA); Eohilia (PA); Filsuvez (PA); Iwilfin (PA, QL); Ogsiveo (PA, QL); Pokonza (PA); Simlandi (PA); trientine 500 mg capsule (PA, QL); Zymfentra (PA)
Adding and updating prior authorization restrictions Align; Alocril; Culturelle; Duavee; Florastor
Updating therapeutic class tables Agents not Otherwise Classified; Anti-Allergy and Anti-Inflammatory Agents – Ophthalmic; Anticonvulsants; Antiemetics, Appetite Stimulants, and Anabolics; Antipsychotics; Gastrointestinal Drugs – Antidiarrheals, Constipation, and Miscellaneous Gastrointestinal Agents; Diabetes Medical Supplies and Emergency Treatments; Enzyme and Metabolic Disorder Therapies; Immunological Agents; Iron Agents and Chelators; Oncology Agents; Osteoporosis and Bone Metabolism Agents; T-Cell Immunotherapies; Thrombocytopenic Agents
Drugs being added to the MassHealth brand name preferred over generic list Minivelle; Oxtellar XR; Pred Forte; Promacta; Tasigna; Vivelle-Dot
Drugs being removed from the MassHealth brand name preferred over generic list Amitiza
Drugs being locked to the medical benefit (utilization management restrictions may apply) Amtagvi; Cosentyx vial; Ibandronate injection; Pamidronate
Removing from MHDL due to product discontinuation Relyvrio

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