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Medical Policy Updates Per New State Mandates

Blue Cross Blue Shield of Massachusetts recently updated its medical policies for the treatment of Lyme disease and treatment of HIV-associated lipodystrophy, in response to two new mandates that were recently signed into Massachusetts law.

Chapter 183 of the Acts of 2016 (Effective 7/1/2016)–An Act Relative to Long-Term Antibiotic Therapy for the Treatment of Lyme Disease. Mandates coverage for long-term antibiotic therapy for a patient with Lyme disease, when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient's symptoms, diagnostic test results, or response to treatment.

Chapter 233 of the Acts of 2016 (Effective 11/08/2016)–An Act Relative to HIV-Associated Lipodystrophy Treatment. Mandates coverage for medical and drug treatments to correct or repair disturbances of body composition caused by HIV-associated lipodystrophy syndrome including, but not limited to, reconstructive surgery, other restorative procedures, and dermal injections or fillers for reversal of facial lipoatrophy syndrome.

These policy changes were applied to all fully insured and self-insured medical plans except Medicare Advantage, as a one-day change.

If you have any questions, please contact your account executive.

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