Specifically, EOHHS intends to enter into an Agreement with one or more manufacturers of Continuous Glucose Monitoring Products in accordance with the following specifications and as set forth more fully in the attached Agreement: Rebate offers must be expressed as a final fixed Guaranteed Net Unit Price (GNUP) for each proposed National Drug Code (NDC) for Continuous Glucose Monitoring Products the manufacturer proposes to include as subject to Rebate under an Agreement. With respect to each such Covered Product (each NDC), the GNUP shall be calculated as follows on a per-Unit basis: (i) the Wholesale Acquisition Cost (WAC) (as set forth in EOHHS regulations 101 CMR 331.02) for the Covered Product as in effect on the last day of the calendar quarter that corresponds to the calendar quarter for which the State utilization is reported to the manufacturer, minus (ii) the Rebate. The Agreement covers claims for MassHealth and HSN Patient FFS claims paid through POPS and claims paid to Pharmacies through Participating MassHealth MCEs. EOHHS may, at its option, begin collecting Rebates on FFS claims for the manufacturer’s Covered Products dispensed by Pharmacies and paid through POPS on a different date than it begins collecting Rebates on claims for the manufacturer’s Covered Products dispensed and paid through Participating MassHealth MCEs. The manufacturer must have a strategy in place to ensure the smooth transition of a large number of MassHealth Members and HSN patients to new Continuous Glucose Monitoring Products, as necessary. This strategy must, at a minimum, include providing a dedicated toll-free telephone number and website for its customer service and individualized Continuous Glucose Monitoring Product training, if directed by EOHHS.
