The chart below identifies updates to our Pharmacy program. For additional details, refer to the Pharmacy Medical Necessity Guidelines page on our Point32Health provider website, where you can find the policies that detail coverage criteria for our Harvard Pilgrim and Tufts Health Plan lines of business.
| Updates to existing prior authorization programs
Visit the Pharmacy Medical Necessity Guidelines page on our Point32Health provider website for details. |
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| Drug/policy | Plan & additional information | Eff. date |
| Neupro | Tufts Health RITogether | 6/1/2024 |
| Non-Formulary Exceptions | Harvard Pilgrim Commercial, Tufts Health Plan Commercial, Tufts Health Direct | 6/1/2024 |
| Ongentys, tolcapone
COMT Inhibitors |
Tufts Health RITogether | 6/1/2024 |
| Drug status changes | ||
| Drug/policy | Plan & additional information | Eff. Date |
| Eucrisa
Quantity Limit Exceptions |
Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct
Quantity Limitations will be added to Eucrisa |
6/1/2024 |