Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth

	Eligibility Operations Memo 08-11
	July 1, 2008


TO:	MassHealth Eligibility Operations Staff

FROM:	Russ Kulp, Director, MassHealth Operations

RE:	MassHealth Operations Enhanced Business Workflow
		

Introduction
Federal regulations require MassHealth to conduct annual eligibility reviews. 
MassHealth Operations is implementing an enhanced business workflow plan to 
support this requirement. The details of the plan are outlined in this memo.

CPU Responsibilities
Starting on May 19, 2008, MassHealth is selecting Health Safety Net (HSN) cases 
for review. HSN members will receive a unique eligibility review form (ERV-9) 
that is color coded brown and has “HSN” printed in the upper right “For Office 
Use Only” block. These reviews will be processed at the Central Processing Unit 
(CPU). Eligibility Operations Memo (EOM) 08-10 covers the process of this 
initiative.

MEC Responsibilities	Beginning May 19, 2008, an increased number of 
households will be selected to receive an annual Eligibility Review (ERV-5) 
form. These households include
*	MassHealth only—waiver-population cases;
*	Commonwealth Care-only cases; and
*	a new profile select, mixed cases (combination of MassHealth, Commonwealth 
Care, and HSN members).

These cases will be processed by the MassHealth Enrollment Centers (MECs).

Beginning in June 2008, MER senior profile selects will be enhanced to select an 
increased number of households. These eligibility review forms (MER) forms will 
continue to be processed by the appropriate MEC.

(continued on next page)

Change for Intake VC1
To support the MassHealth Operations business enhancement effort, changes have 
been made to the MA21 member notices system. These changes, effective May 19, 
2008, are intended to redirect verifications from the MECs to the Central 
Processing Unit (CPU). This change applies to verifications resulting from the 
submission of a new Medical Benefit Request (MBR).

VC1 notices sent to applicants submitting MBRs (paper and electronic) will 
instruct applicants to send verifications to the following address:
		EOHHS
		P.O. Box 290810
		Charlestown, MA  02129.

The following contact numbers will be listed on the VC1:
         phone: 1-800-841-2900
         TTY: 1-800-497-4648 for people with partial or total hearing loss 
         fax: 617-241-3299.

Note: Verifications resulting from annual reviews (ERVs) will continue to be 
directed to the appropriate MEC, with one exception, the HSN-only annual review. 
Please see EOM 08-10 for information about the HSN-only annual review.

After an application has been approved or denied, the responsibility for case 
maintenance will move to the appropriate MEC. The address and phone numbers on 
subsequent maintenance VC1s will change to the MEC.

Earned Income Verifications
Effective immediately, eligibility workers should begin accepting one pay stub 
rather than sending out a VC1 for a second wage stub to verify earned income. 
This change is intended to reduce the volume of VC1s generated and will further 
support MassHealth Operations enhanced business workflow. There will be updates 
to MassHealth regulations and publications, including applications and ERVs, to 
reflect this change.

Questions
If you have any questions about this memo, please have your MEC designee contact 
the Policy Hotline.