MassHealth Formula Shortage Update

Families across the country, including in Massachusetts are facing challenges accessing infant formulas. These challenges are related to the February recall of certain Abbott infant formulas, the resulting increased demand for other brands of formula, and supply chain issues related to the COVID-19 pandemic. The Commonwealth is proactively addressing these short-term issues to help families access safe, healthy feeding options for their infants. 

The Executive Office of Health and Human Services, with DPH and MassHealth, has been taking immediate steps with the U.S. Department of Agriculture (USDA) and other federal agencies and suppliers to help families to access formula during this shortage.

DPH has received three federal regulatory waivers from USDA that provide additional flexibility in response to the shortages such as: (1) covering other formula brands (other than Abbott) without medical documentation, (2) covering varying container sizes previously not covered and (3) retailers’ ability to exchange recalled formulas purchased with WIC benefits for similar formula products. As a result, Massachusetts WIC has added 8 more formula brands and a total of 68 new formula products/can sizes that are now covered by WIC benefits. 

As a reminder, MassHealth covers formula for members when it is medically needed (e.g., allergies, nutrient absorption syndromes, feeding tubes, etc.)

MassHealth has waived prior authorization for formula at pharmacies, and both MassHealth and the Division of Insurance (DOI) and are directing health plans to waive any prior authorization for formula needed for medical reasons. MassHealth has also put flexibilities in place that allow durable medical equipment (DME) providers to provide formula to members prior to an administrative approval and streamlined the administrative approval process.

MassHealth has released the attached guidance to providers and managed care plans, outlining all of the items above, as well as more general information about access to formula.

More information can be found here: https://www.mass.gov/service-details/formula-update-for-masshealth-members---unpublished?auHash=F_E6zQ8OAQiNVPvO2__c-qQWN57Pp3-5JBreo9_ugjs

If families are experiencing challenges locating standard formula, they should contact their local WIC office, the 800- number on the back of their WIC Card, or by email towicinfo.dph@massmail.state.ma.us