CommercialPrior AuthMedium impact
Pharmacy coverage changes
Harvard Pilgrim Health Care·Endocrinology, Dermatology, Family Medicine +1 more·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jun 20, 2026
Summary
Tufts Health plans are implementing new step therapy requirements for diabetes supplies and dermatology medications. Non-formulary continuous glucose monitors like Dexcom will require a 90-day trial of Freestyle Libre first, and Vtama cream will require a trial of Zoryve cream for plaque psoriasis.
Action Required
Before July 1, 2026: Update prior authorization procedures for Tufts Health Direct and Tufts Health RITogether plans. Providers must document 90-day Freestyle Libre trial before requesting Dexcom G6/G7 continuous glucose monitors, and document Zoryve cream trial before prescribing Vtama for plaque psoriasis. Update EMR templates to include these prerequisite trials in documentation.