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

July 2015

Reminder: Naloxone Available Without Member Cost Sharing 

In response to the current opioid addiction crisis, Massachusetts governor Charlie Baker established the Opioid Working Group, which issued some recommendations last month. Among them is a call to increase the affordability of the prescription medication naloxone by eliminating copayment requirements for this drug. Harvard Pilgrim already covers naloxone without member cost-sharing.

Naloxone — which is known as an opioid antagonist — is used to counter the effects of opioid overdose. Naloxone can be administered nasally or by injection. Harvard Pilgrim covers both generic naloxone syringes and vials at no member cost share on our Premium and Value formularies with a quantity limit of 4 units per 30 days. Naloxone syringes are most commonly used with an atomizer attachment for nasal administration.

If you would like more information about Harvard Pilgrim pharmacy programs and medication policies, please visit our Pharmacy website.

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ICD-10 Information Available Online

Reminder: Now Offering GIC POS and HMO Products


Genetic Testing Medical Policy Updated

New Medical Policy for Urine Drug Testing

Coverage of Oral Devices for Obstructive Sleep Disorder

Update: Outpatient Rehabilitative Therapies Policy

Acute Pain Management and Safe Opioid Prescribing

Reminder: Naloxone Available Without Member Cost Sharing

Vivitrol as Part of a Substance Abuse Treatment Plan

P&T Committee Updates

Specialty Pharmacy Program Updates

Medicare Quality Improvement: Reducing Preventable Readmissions

Diabetes Outreach Program for Medicare Advantage Members


Payment Policy Update: Coverage of CPT 99211

Payment Policy Update: Counseling Risk Factor Reduction


Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator