Message Text – February 2024

MassHealth Provider Remittance Advice

The messages listed below may be general All Provider messages, applicable to several provider types or services, or provider specific. 

You can request a copy of a prior message by:

• Emailing [e-mail]
• Sending a letter to

  MassHealth Customer Service
  P.O. Box 278
  Quincy, MA 02171

• Calling MassHealth Customer Services at [phone],
  Hours: Monday through Friday 8 a.m. to 5 p.m.

02/27/2024

ADJUDICATED CLAIM PAYMENT TIMELINE

Please note that starting March through the end of May 2024, MassHealth will gradually return to the traditional 2-4 week lag between claim adjudication and payment that was in place prior to March 2020, reaching pre-pandemic payment timing by early June. Independent Nurse, Doula, Fiscal Intermediary Services (PCA), Nursing Facility and Rest Home providers will remain on their current payment schedule. Providers are advised to refer to the remittance advice for claim payment, suspensions, and denial details to reconcile their accounts properly.

If you have questions, please contact MassHealth at [e-mail] or [phone].  LTSS providers should contact the MassHealth LTSS Provider Service Center at [phone] or [e-mail].

UPDATES TO 101 CMR 361.00: RATES FOR CONTINOUS SKILLED NURSING AGENCY SERVICES AND INDEPENDENT NURSING SERVICES

EOHHS has proposed amendments to 101 CMR 361.00: Rates for Continuous Skilled Nursing Agency Services and Independent Nursing Services, which can be viewed here: http://tinyurl.com/4h64kc28.

The proposed amendments include an average 33% rate increase for services provided by registered nurses (RNs) and an 11% rate increase for services provided by licensed practical nurses (LPNs). Additionally, the proposed amendments establish a high-tech rate add-on, available for nurses who serve members with tracheostomy, ventilator, and or central line care needs. The proposed high-tech rate add-on is $2/15-minute unit, or $8/hour. The high-tech rate add-on increases rates on average by 41% for RN rates and by 21% for LPN rates.

EOHHS is holding a public hearing on the proposed amendments on March 8, 2024 from 9:30am to 11:30am. A copy of the Notice of Public Hearing and links to register to testify at the public hearing can be found here: http://tinyurl.com/5t3p9387.

If you or your agency has questions regarding this communication, please contact the LTSS Provider Service Center at [phone] or [e-mail].

INVITATION TO MASSHEALTH PROVIDER LISTENING SESSION - 130 CMR 418 SUBSTANCE USE DISORDER PROGRAMS REVIEW

MassHealth is initiating a review of regulation 130 CMR 418.000 (http://tinyurl.com/yck3tkv6), which establishes the program requirements for the treatment of substance use disorders provided by public and private substance use disorder treatment programs reimbursable under MassHealth.

To ensure that our review process reflects the diverse perspectives and experiences of our stakeholders, we are hosting a virtual Provider Listening Session:

Date: March 14, 2024

Time: 10:00 AM - 11:00 AM

Location: Virtual via Zoom - Please note that registration is required to participate. You can register for the session using the following link: http://tinyurl.com/4pdawpa7

This listening session offers the opportunity to share valuable insights and information that you believe MassHealth should consider during the program regulation review process. While it differs from a formal public hearing, we highly value your input, and this session is designed to allow us to hear your perspectives.

Comments provided during this session will not automatically become a part of the official public hearing process. A separate public hearing will be scheduled at a later date for this regulation, during which providers can submit official testimony.

For those unable to attend the listening session or who wish to provide more detailed information, MassHealth welcomes written feedback. Please email any written submissions to [e-mail] by Friday, March 15, 2024.

MEDICARE PART B CROSSOVER CLAIM ADJUSTMENTS FOR GROUND AMBULANCE SERVICES

MassHealth has identified that certain Medicare crossover claims for ground ambulance services with dates of service on or after 1/1/2024 were not priced appropriately. To rectify this, on 2/14/2024, MassHealth implemented system updates in MMIS. The impacted Medicare crossover claims have been adjusted and will appear on this and subsequent remittance advices.

If you have questions regarding this message, please contact MassHealth at [e-mail] or [phone].

UPDATE FOR QUARTERLY DRUG CODE RATES EFFECTIVE JULY 1, 2023

MassHealth has completed the rate updates for the July 1, 2023 Quarterly Drug codes. The impacted claims will be reprocessed and/or adjusted and will appear on a future remittance advice.

If you have questions, please contact MassHealth at [e-mail] or [phone].

02/20/2024

40 DAY NOTICE - MASSHEALTH POSC PRIMARY USER DESIGNATION CLEAN UP

MassHealth has extended a final one-time opportunity for all organizations to modify their Primary User designations by completing a survey no later than March 31, 2024. MassHealth will update the Primary User and backup and remove the Primary User designation and the Manage Subordinates permission from any other user currently listed under your organization’s PID/SL(s). This includes all linked users and those user IDs created by your organization.

If your organization has determined that the Primary User designations must be updated, please complete the survey by March 31. The survey is available here: https://forms.office.com/g/nYNPPSxAQp.

Please note: Primary User designations and ineffective management of access of information could allow staff and affiliate organizations to continue accessing the provider’s information and enable users to submit transactions on behalf of a provider after they have left employment or after their contract was terminated.

Please review the MassHealth Primary User Policy here: http://tinyurl.com/4cysd32p

All-Provider Bulletin 377 is available here: http://tinyurl.com/3j9pajtj

For additional questions or concerns:

Dental providers, please contact Dental Services at [phone]; TTY: [phone].

LTSS providers, please contact the LTSS Provider Service Center at [phone] or [e-mail].

All other providers, please contact MassHealth at [phone] or [e-mail].

02/13/2024

RELEASE OF GRANT SOLICITATION FOR GRANT OPPORTUNITY FOR “BEHAVIORAL HEALTH MOBILE APPLICATIONS”

EOHHS has released a grant opportunity for behavioral health outpatient MassHealth providers. The grant, “Behavioral Health Mobile Applications”, can be found on the COMMBUYS website, Bid # BD-24-1039-EHS01-ASHWA-97688, at http://tinyurl.com/484yc8uv. All responses to the Grant Solicitation are due no later than 03/04/2024 by 3:00 pm and must be submitted via the portal which can be found at https://maanfgrants.force.com/s/loginpage. EOHHS is asking that the Grant Solicitation be shared with provider networks to try to increase the number of responses. Please refer to the documents posted on COMMBUYS for further instruction.

If you have questions, please contact MassHealth at [e-mail].

UPDATED DATA COLLECTIONS FORMS

PLEASE NOTE: EOHHS has updated the email address on both the Provider Enrollment and Existing Provider Modification Data Collection (DC) Forms posted to Mass.gov. The email address [e-mail] has been discontinued and will no longer accept emails.

The new email address is: [e-mail]. MassHealth has updated the DC Forms to reflect the new email address. Providers must send the Existing Provider Modification DC Form to the new email address listed on page 2 of the updated form.

For additional questions or concerns:

LTSS providers, please contact the LTSS Provider Service Center at [phone] or [e-mail].

All other providers, please contact MassHealth at [phone] or [e-mail].

UPDATED ELIGIBILITY FOR MASSHEALTH CSN LOAN REIMBURSEMENT PROGRAM

The Continuous Skilled Nursing (CSN) Loan Repayment program through the MA Repay Program has updated its eligibility requirements. As of now, eligible nurses providing CSN services to MassHealth members may qualify for up to $35,000 in student loan repayments if they have graduated from an accredited nursing school after January 1, 2018. Applications are open and will be accepted on a rolling basis. For more information and eligibility requirements, go to www.marepay.org.

If you have questions, please contact the LTSS Provider Service Center at [phone] or [e-mail].

02/06/2024

NURSE DIRECTORY ENROLLMENT INFORMATION; ENHANCE YOUR PROFESSIONAL VISIBILITY

The Community Case Management (CCM) Nurse Directory is up and running, being accessed by CCM members and families. It gives independent nurses a unique opportunity to enhance their professional visibility and connect with potential CCM members and families.

The primary goal of the Nurse Directory is to serve as a centralized platform, connecting members seeking and nurses offering Continuous Skilled Nursing (CSN) services. Our goal is to get 100% participation. This directory is designed to be easily accessible to our CCM members and their families.

If you haven't already, we encourage you to register and add your profile to this directory. Even if your availability for new cases is limited now, having your profile listed is important. You can effortlessly switch your status from "available" to "unavailable" as your schedule changes.

Enrolling is a straightforward process. Go to https://ccmnursedirectory.org/ to create an online profile, complete it with your information, and, when completed it becomes activated. The following link offers a “step-by-step” guide to enrolling for independent nurses: http://tinyurl.com/yjrhn88d

Thank you to those who have already enrolled. We extend our appreciation and suggest you log on frequently to stay up to date.

Should you have questions or require help regarding the directory, please feel free to reach out to [e-mail]. MassHealth is committed to responding to your queries within 48 hours.

Date published:	February 5, 2024