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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

December 2017

Methadone Maintenance Benefit Change in Massachusetts


Like many other U.S. states, Massachusetts continues to be plagued by a severe opioid epidemic. Recognizing this, Harvard Pilgrim is updating our benefit for in-network coverage of methadone maintenance.

Beginning Jan. 1, 2018, methadone maintenance will be covered in full for members of all non-HSA fully insured plans in Massachusetts, and it will be covered in full after the deductible is met for members of all Massachusetts fully insured HSA plans. This benefit change aligns with the Massachusetts Association of Health Plans’ recommendation that health plans in the state provide full coverage for methadone maintenance.

The change is for in-network coverage only; Harvard Pilgrim’s PPO and POS plans in Massachusetts and elsewhere will continue to apply the existing out-of-network cost sharing for methadone maintenance.

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HPHCURRENT EVENTS

New Monthly Publication Date for Network Matters

New Policy: Maximum Dosages for Medical Drugs

Webinar for Genetic Testing Authorization for Medicare Members

New Medicare Beneficiary Identifier Coming in 2018

Methadone Maintenance Benefit Change in Massachusetts

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Changes to Premium Formulary for 2018

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OFFICE ASSISTANT

Keep Panel Status and Demographic Information Up to Date

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Senior Vice President, Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator