Massachusetts Medical Society: Summary of Health Plan Alignment with MMS Principles

Summary of Health Plan Alignment with MMS Principles

 

 Plan

Met

PartiallyMet

NotMet

 BCBSMA

8

14

7

 CIGNA

4

13

12

 Fallon

6

16

7

 Harvard Pilgrim

3

17

9

 Health NE

1

17

11

 Neighborhood

2

13

14

 Tufts

5

16

8

 Unicare

2

15

12

 

Pay for Performance

 Plan

Met

PartiallyMet

NotMet

N/A

 BCBSMA

13

3

0

0

 Fallon

12

2

2

0

 Harvard Pilgrim

5

2

5

4

 Health NE

4

2

2

8

 Neighborhood

3

3

2

8

 Tufts

3

11

2

0

 

Prior Authorization - Radiology

 Plan

Met

PartiallyMet

NotMet

N/A

  Aetna

13

3

9

0

  BCBSMA

18

1

6

0

  CIGNA

14

5

6

0

  Fallon

13

5

7

0

  Harvard Pilgrim

12

4

2

7

  Health NE

14

8

3

0

  Neighborhood

9

4

5

7

  Tufts

14

4

7

0

  United Healthcare

12

0

6

7

 

Prior Authorization - Antifungals

 Plan

Met

PartiallyMet

NotMet

N/A

  Aetna

14

2

8

1

  BCBSMA

12

3

9

1

 CIGNA

9

6

9

1

  Fallon

12

3

9

1

  Harvard Pilgrim

12

3

9

1

  Health NE*

10

5

8

2

  Neighborhood

10

4

10

1

  Tufts

13

2

9

1

  United Healthcare

9

5

9

2

* N/A for antifungals, for which Health NE does not require prior authorization. Chart measures HNE's alignment of prior authorization programs for other drugs.

 

Share on Facebook

2024 Legislative Update

MMS President Dr. Hugh Taylor and the MMS advocacy team provided a special state legislative update on Oct. 15, 2024. View a recording of this webinar to learn the latest developments from Beacon Hill.

Find Your Legislator

Click here to enter your address and get a list of your federal representatives, state legislators, and your local polling place.

Find Your Legislator »

State and Federal Agencies

State House - Mass. State AgenciesRapid access to relevant resources from State and Federal health care agencies for Massachusetts physicians.

Massachusetts State Agencies
Federal Agencies

Facebook logoLinkedInYouTube logoInstagramThreads

Copyright © 2025. Massachusetts Medical Society, 860 Winter Street, Waltham Woods Corporate Center, Waltham, MA 02451-1411

(781) 893-4610 | General Support: (617) 841-2925 or support@mms.org