Posted on September 27, 2019
Back in May of 2019, we announced Health New England was providing our Fully Funded Commercial members with a new pharmacy savings tool called Rx Savings Solutions. This tool will help these members save money and better manage their prescription costs. If one of our members decides to take the opportunity to save, Rx Savings […]
Posted on September 27, 2019
As part of Health New England’s commitment to provide ways on keeping health care costs down for our members, our Medicare Advantage product line is changing our pharmacy benefits manager from Castia Rx to OptumRx®. Beginning January 1, 2020, OptumRx will administer prescription drug benefits for our Medicare Advantage members. New ID Card Issued to […]
Posted on November 20, 2018
As of 1/1/19, Inflectra will replace Remicade as the new preferred product for Health New England. This change affects our Commercial and Medicaid members. Members currently on Remicade will be required to try Inflectra (first-line) and Renflexis (second-line) before they can continue Remicade. Prior approval through MagellanRx is required on all three of these products. […]
Posted on May 9, 2018
Health New England’s 2018 formularies are available on healthnewengland.org. We encourage Providers to utilize the online formularies, which are accessible to all users without a login or password. The online formularies are updated throughout the year as changes are made. We have three formularies, one for each line of business – Commercial, Medicare Advantage and […]
Posted on January 24, 2018
Dear Providers – As a friendly reminder, Health New England requires prior authorization before prescribing short-acting opioids through OptumRx. This has been in effect since January 1, 2017. You can access the following medication request form to request authorization here. This form can be faxed directly to OptumRx at 1-800-550-9246.
Posted on December 7, 2017
The following chart defines the changes to the Be Healthy/Medicaid prescription drug coverage, effective 1/1/2018. These changes are included in members’ coverage notices.
Posted on December 7, 2017
Health New England’s formularies can be accessed on healthnewengland.org using the “Find a Drug” tool at the top of the page. The online formularies are updated throughout the year as changes are made. We have three formularies, one for each line of business – Commercial, Medicare Advantage and Be Healthy/Medicaid. Each formulary includes the tier […]
Posted on December 7, 2017
Because CPT code 90756 (Flucelvax ccIIV4) is not effective until 1/1/18, Health New England will require this flu shot to be billed with HCPCs code Q2039 for dates of service up to and including 12/31/17. For dates of service on or after 1/1/18, this flu shot should be billed with 90756. This applies to both […]
Posted on June 29, 2017
Health New England’s formularies can be accessed on healthnewengland.org using the “Find A Drug” tool at the top of the page. The online formularies are updated throughout the year as changes are made. We have three formularies, one for each line of business – Commercial, Medicare Advantage and Be Healthy/Medicaid. Each formulary includes the tier […]
Posted on May 30, 2017
The chart below defines the changes to the Be Healthy/Medicaid prescription drug coverage, effective 07/01/2017. These changes are included in the members’ coverage notice. Be Healthy/Medicaid Prescription Drug Coverage Step Therapy drug changes effective July 1, 2017: For Health New England (HNE) to cover the Step Therapy drugs listed here, you first must try the corresponding First […]