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Network Health

Pharmacy Updates

Pharmacy updates effective April 2, 2012

  • Step care therapy updates

Preferred Drug List Updates

Preferred Drug List changes effective April 2, 2012

  • Products added 
  • Products now requiring prior authorization 
  • Products now requiring step care 
  • Products no longer requiring prior authorization
  • Products with quantity limit changed or added

Searchable Drug List Member Care

Coordinate care to improve patient outcomes

We recognize that more than one provider may contribute to the care of your Network Health patients. We strongly encourage providers, particularly primary care and behavioral health providers, who are caring for Network Health patients to share relevant information regarding diagnoses, medication, and/or treatment to help improve medical outcomes.

Fluoride varnish for young Network Health Together patients

Oral health is essential to a patient's overall health and well-being. We count on our pediatricians to be the first line of defense in detecting whether a Network Health Together® (MassHealth) patient is at risk for dental caries disease, since a pediatrician is often the first clinician to examine a young patient's mouth.

No co-payments for preventive services

Network Health would like to remind you that federal law prevents you from charging co-payments for preventive services.

Searchable Drug List Partner Profile

Affordable family care from Community Health Programs

Community Health Programs of Berkshire County takes pride in providing accessible health care and services to improve the health and well-being of its patients, particularly families without financial resources or health insurance.

Searchable Drug List What's New

Do you know what languages your patients speak?

We support your efforts to communicate effectively and deliver appropriate health care services to the diverse populations you serve. You can now access our List of Member Languages by Service Area, which tells you the languages most frequently spoken by Network Health members in your area.

Learn what you need to know about our new Medical Security Plan

As you may have heard, on January 1, 2012, we began offering Network Health Extend, our Medical Security Program Direct Coverage plan, to eligible individuals receiving unemployment insurance through the Massachusetts Department of Unemployment Assistance.

Payment policy updates

Between December 1, 2011 and February 29, 2012, Network Health updated or added the following payment policies:

  • Nurse Practitioner as Primary Care Provider Payment Policy
  • E/M Services (Modifier 25) Payment Policy
  • Out-of-state Payment Policy: Full-time, Dependent Students Ages 18 – 26 (Network Health Extend)

Searchable Drug List Reminders

How your patients can benefit from complex care management

Our complex care management program can help your Network Health patients with complex conditions avoid unnecessary complications and minimize additional disabling conditions.

MassHealth requires employee screening

As you know, the federal government may exclude some of your employees from providing services for federal health care programs such as MassHealth.

Referral requirement for primary care providers

As a reminder, some primary care providers are responsible for requesting referrals for their patients who need to get specialty services. Before providing care, specialists should check which Network Health members require a referral, or the status of an existing referral request.

Your patients’ rights and responsibilities

We want our members to take an active role in their health care. Please communicate your statement of patient rights and responsibilities to your Network Health patients, and document in their medical records that you have done so.

Searchable Drug List We're Here For You

Meet Marcos Sprovieri, relations manager

Marcos SprovieriMarcos Sprovieri is our relations manager serving the central, southern, and western regions of Massachusetts. When he started as a community relations representative at Network Health seven years ago, Marcos supported the efforts of community groups to educate members about their Network Health plan. Now, as a provider relations representative, Marcos advocates for providers, facilitating the resolution of any unexpected issues.


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Provider Update is our quarterly publication of updates relevant to our provider network and serves to amend our Provider Manual.

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