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

April 2013

New Massachusetts Mandate for Oral Chemotherapies


In January, Massachusetts Governor Deval Patrick signed into law a bill that affects the member cost sharing for oral medications used to treat cancer. The new law requires insurers to cover oral chemotherapies on a basis no less favorable than coverage applied to intravenously administered or injected cancer medications.

As a result, for plans other than Best Buy HSA plans, Harvard Pilgrim will now be covering oral medications for cancer treatment obtained at a pharmacy at no charge to members. For Best Buy HSA plans, the in-network deductible that pertains to intravenously administered or injected cancer medications will also apply to oral chemotherapies.

The new mandate applies to fully-insured plans purchased or renewed on or after January 1, 2013, and Harvard Pilgrim is currently working to implement this change for fully-insured groups. Members enrolled through self-insured plans may not be subject to this mandate.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network and Product Development

Joann Peck,
Manager, Network Planning and Administration

Annmarie Dadoly,
Editor

Kristin Edmonston,
Production Coordinator