SWH NY Q4-2021 PA Code Matrix – Medicare
SWH NY Q4-2022 PA Code Matrix – Medicaid
- On 1/01/2022, Tempus Unlimited will become the only Fiscal Intermediary serving the MassHealth PCA and MFP Self-Directed Waiver Programs.
- All consumer-employers and PCS who DO NOT CURRENTLY use Tempus Unlimited as their FI must complete and return their paperwork no later than December 17, 2021. Click on the link above to download detailed information.
At Senior Whole Health of Massachusetts, we value you as a provider in our network. That’s why we work hard to provide you with the resources you need to help care for our members.
Provider Manual – updated October 2021, in accordance with Executive Order 14042, Ensuring Adequate COVID Safety Protocols for Federal Contractors
2021 Pharmacy & Prescription Drug Materials
Frequently Used Forms
Online Request for Medicare Part D Redetermination
Online Request for Medicare Part D Prescription Drug Coverage
Prescription Coverage Determination Form (PDF)
Medicare Reconsideration Request Form
Medicare Redetermination Request Form
Part D Formulary (September 2021)
Part D Formulary Change Chart (September 2021)
SCO Formulary (September 2021)
Prior Authorization Criteria (September 2021)
Changes to Prior Authorization Requirements (Effective May 1, 2021)
Medical pharmacy drugs (J-Code) requiring Prior Authorization List (updated May 1, 2021)
Quick Reference Guide to High Risk Medications and their Alternatives
COVID-19 Provider Webinars
To view information & materials for past and upcoming Provider Webinars
How to build resilience and adaptive skills during the pandemic
Tips for caring for the emotional health and wellness of you and your family during these uncertain times. Learn more.
If you missed the live webinar, the recording is posted here.