Important Administrative Information (IAI) is a quarterly mailing that delivers the latest news about Blue Cross Blue Shield of Massachusetts products and services to employers and consultants.
Submit Gag Clause Prohibition Compliance Attestation by December 31, 2023
In compliance with the Consolidated Appropriations Act (CAA) Prohibition on Gag Clauses provision, we’ve removed all gag clauses from our provider contracts. As required by the CAA, self-insured accounts must submit a compliance attestation by December 31, 2023. Fully insured accounts don’t need to take any action as we’ll submit attestations on their behalf. Learn more.
Announcing the Enhanced ahealthyme®' Platform
Learn about the launch of the upgraded ahealthyme®' wellness platform with enhanced features that make it easier for your employees to improve their physical, mental, and social health. Learn more.
Quality Care Dosing Limits Have Increased for Select Medications
To give doctors greater flexibility when prescribing certain controlled substances, we’ve doubled the quality care dosing limit for select medications. The change applies to plans that have pharmacy coverage through Blue Cross Blue Shield of Massachusetts and use the Blue Cross formulary. Learn more.
Mammograms for Adult Members at Any Age
All HMO, PPO (including POS and EPO), and Indemnity plan members are covered for at least one preventive-care mammogram screening per year, without age restriction, when ordered by a doctor. This benefit is $0 cost share to members for in-network services. Learn more.
Introducing Blue 20/20 PLUS
Starting July 1, 2023, with the new Blue 20/20 PLUS enhanced coverage, members can get greater savings on their vision care. They will get enhanced benefits of a $0 eye exam copay and additional frame allowance. Learn more.
New Neonatal Intensive Care Unit (NICU) Program Begins September 1, 2023
Starting September 1, 2023, we’ll be working with ProgenyHealth®´, an independent health care company dedicated to maternity and infant health, to provide Neonatal Intensive Care Unit (NICU) utilization management and care management services for eligible commercial members. Learn more.
Effective October 1, 2023, Upcoming Changes to the Standard Control with Advanced Control Specialty Formulary
Effective October 1, 2023, CVS Caremark®', an independent company that administers your pharmacy benefits on behalf of Blue Cross Blue Shield of Massachusetts, is updating their formulary (list of covered medications) for select self-insured plans (500+) with the Standard Control with Advanced Control Specialty Formulary. Learn more.
We’ve Completed Submission of the CAA Prescription Drug Data Collection (RxDC) Report (2022 Reference Year)
In accordance with the Consolidated Appropriations Act of 2021, we have successfully submitted plan sponsors’ 2022 Prescription Drug Data Collection Report, based on benefits that Blue Cross administers and available data. Learn more.