HealthLeaders Media November 22, 2021
“[T]here is no guidebook, there is no blueprint, none of us has ever done this before,” says one plan executive.
KEY TAKEAWAYS
– As digital therapeutic products find their first Medicaid reimbursement, manufacturers continue to lead commercialization.
– Payers and PBMs are also forging ahead in the face of federal regulatory delays.
– Stakeholders are using pharmacy or medical benefit coverage, depending on therapy type, service delivery complexity, and contracting constraints.
MassHealth, partnering with Pear Therapeutics, will become the first Medicaid program to reimburse for prescription digital therapeutics (PDT). This first for Medicaid is not a first for Pear and other PDT manufacturers that have pioneered partnerships with multiple PBMs to commercialize digital therapeutics as regulations lag. As vendors, PBMs,...
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