As you may have seen, the MassHealth Pharmacy Program recently released a prescriber e-letter outlining changes effective April 1, 2025 to coverage of rapid-acting insulin products.
The communication details that prior authorization is required as of April 1 for all MassHealth members — including members of our Tufts Health Together plans — prescribed insulin Aspart, to encourage the use of cost-effective short-acting insulin agents.
Prescribers are encouraged to consider transitioning patients from insulin Aspart to insulin Lispro if clinically appropriate, which will continue to be covered without prior authorization on the MassHealth Drug List. To switch a patient for treatment on or after April 1, 2025, please keep in mind that you will need to write a new prescription for insulin Lispro.
If transitioning to insulin Lispro would not be clinically appropriate and your patient needs to continue on insulin Aspart, please submit a prior authorization request for medical necessity review, including documentation of an appropriate diagnosis and inadequate response, adverse reaction, or contraindication to insulin Lispro.