At the June 14, 2021 meeting, the Harvard Pilgrim Pharmacy and Therapeutics Committee reviewed several medications and made formulary coverage decisions.

There are many excellent support tools and resources that Harvard Pilgrim recommends if you are experiencing physician burnout.

Harvard Pilgrim’s partner Optum/United Behavioral Health is offering a series of free continuing education sessions for health care providers interested in learning about pertinent topics in behavioral health.

Effective Aug. 1, 2021, Harvard Pilgrim will require prior authorization for the medication Evkeeza (HCPCS code C9079: injection, evinacumab-dgnb, 5 mg) for members of our commercial plans.

Starting Sept. 1, 2021, Harvard Pilgrim will offer Virtual Choice HMO in Maine, New Hampshire, and Connecticut — and will offer SimplyVirtual HMO in Massachusetts starting Jan. 1, 2022 (pending regulatory approval).

Effective for dates of service beginning Aug. 27, 2021, Harvard Pilgrim is updating our commercial Implantable Neurostimulators Medical Policy.

Cosela, Margenza, and Trodelvy will now require prior authorization through Oncology Analytics when used for oncology purposes for members of Harvard Pilgrim’s commercial and StrideSM (HMO) Medicare Advantage plans.

The short training videos on our Provider Training and Events page offer step-by-step guidance around common transactions to make doing business with us easier than ever, and we’ve recently added a new video.

Harvard Pilgrim is updating our commercial New Technology Assessment and Non-Covered Services Medical Policy, effective for dates of service beginning Sept. 1, 2021, to include certain services and technologies as non-covered.

Harvard Pilgrim is making updates concerning cervical or vaginal screening and HPV testing to our commercial Gynecology Payment Policy, effective for dates of service beginning Sept. 1, 2021.

Harvard Pilgrim now covers Oxlumo (HCPCS code J0224: Injection, lumasiran, 0.5 mg), with prior authorization, for members of our commercial plans.

Harvard Pilgrim Health Care and Tufts Health Plan are pleased to announce that our combined organization will be known as Point32Health.