Legislation Updates

Bulletin Issued for Massachusetts Requiring Use of Universal PA Form

Aug 16, 2016  |  Jessica Behrendsen

CoverMyMeds has been anticipating for several months the State of Massachusetts was going to move forward with the adoption of a universal prior authorization (PA) form for medications.

On August 8, the Department of Insurance (DOI) issued a bulletin that contained the content of the medication PA form that is to be used by providers and carriers in the State of Massachusetts.

By November 9, Massachusetts providers and carriers must begin utilizing this form when requesting and processing medication prior authorization.

CoverMyMeds has been involved in the stakeholder and adoption process, providing input on the PA and electronic prior authorization (ePA) process, form content and associated clinical criteria.

It’s important to note that any entity that is already using the National Council for Prescription Drug Programs (NCPDP) SCRIPT Standard for ePA is already utilizing the required data elements found on the adopted form and in compliance with the Massachusetts legislation. If you have not already gone down the path of ePA implementation, it’s a good time to take that into consideration. As always, ePA is the most efficient way to process medication prior authorization and the best way to stay compliant with any industry PA legislation.

For questions or additional information reach out to Kim Diehl-Boyd of our Government Affairs team at kdiehlboyd@covermymeds.com.

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