News Center

Reminder: As we announced in the Oct. issue of Network Matters, as of Jan. 1, 2022, Harvard Pilgrim Health Care is no longer offering StrideSM (HMO) Medicare Advantage plans in Massachusetts and Maine. We continue to offer StrideSM in New Hampshire. Massachusetts StrideSM members had the opportunity to enroll in Tufts Medicare Preferred, which has earned 5 out of 5 stars from the Centers for Medicare and Medicaid Services (CMS) for an unprecedented 7th year in a row — and 7 of 10 former Massachusetts StrideSM members chose a Tufts Medicare Preferred plan for coverage this year. You can access coverage information for these members via the Tufts Health Plan provider portal.


 

Network Matters

May 2022
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Highlights

GIC Product Updates Effective July 1

The 2022-2023 plan year for Harvard Pilgrim and the Group Insurance Commission’s (GIC’s) Primary Choice HMO and Independence Plan POS begins on July 1, 2022.

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Prior Authorization for Tezspire and Vygart

Harvard Pilgrim will require prior authorization for coverage of the medications Tezspire and Vygart, both recently approved by the Food and Drug Administration (FDA), effective for dates of service beginning May 16, 2022 for Commercial members.

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Anterior Vertebral Body Tethering Medical Policy

Harvard Pilgrim has developed a Commercial medical policy for medical necessity and prior authorization review of anterior vertebral body tethering (VBT) procedures, which are a non-fusion surgical option for the treatment of idiopathic scoliosis.

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