Attention Be Healthy Providers
Posted on December 27, 2011
Below is a message from the MA Department of Public Health/WIC regarding a recent change to the state contract formula:
As of October 1st Massachusetts WIC changed the state contract formula from Nestle /Gerber Good start/Good Start Soy to Enfamil PREMIUM Infant and Enfamil ProSobee formulas. These formulas will no longer be identified as special formulas requiring medical documentation. We have also added /changed a few Non-Contract formulas to the WIC formulary. I have attached the MA WIC formula listing for you to share with the appropriate staff/providers as these changes will affect the types of prior approvals that will be requested from medical providers.
Many of our local programs have recently reported when the MassHealth/WIC participant’s medical provider request Gentlease or Enfamil A.R. through MassHealth’s PCCP or MCO’s the DME (Denmark)/MCO has informed the MassHealth/WIC member to go back to WIC for these formulas. Enfamil Gentlease and Enfamil A.R. are non-contract formulas on WIC and will be treated as any other special formula. The local WIC programs will continue to guide the MassHealth/WIC participant back to the members plan to submit a prior authorization for any metabolic, or non-contract formula.
WIC will continue to provide the 1st month of formula, until the prior authorization is approved.
