Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
www.mass.gov/masshealth

MassHealth
Acute Inpatient Hospital Bulletin 148
June 2013

	TO:	Acute Inpatient Hospitals Participating in MassHealth

	FROM:	Julian J. Harris, M.D., Medicaid Director 

	RE:	Submission of Accurate Information on Virtual Gateway (VG) by Providers Using VG

Introduction

Information in this bulletin is for all users of the Virtual Gateway (VG) Common Intake.

Providers that use the VG must ensure that they submit applications that are complete and correct.

Completing MassHealth VG applications fully and accurately helps ensure that eligibility determinations are made timely and that applicants receive the benefits for which they are eligible. VG users must follow MassHealth rules and regulations during the application process and ensure the accuracy of information that is submitted.
										
Reporting Accurate Information

Gather complete information from the applicant. 
	
Only Massachusetts residents may enroll in MassHealth. Be sure to ask if the applicant is living in Massachusetts with the intent to stay permanently or for an indefinite period of time.
Always include all household family group members, whether or not they are applying.
Always include the correct household gross income amount.
Answer all absent parent questions as required.
Generally, children under age 19 should be included as children in their parents’ household. Remember that MassHealth rules state that age 19 is the cut-off age to be considered a child in their parent’s household.
Children under age 19 may apply as head of household (HOH) under certain circumstances, such as if they are married or living independently from their parents.
Applications for community elders must include household assets in situations where there are assets, including checking or savings accounts used for Social Security Administration (SSA) direct deposits.
										
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MassHealth
Acute Inpatient Hospital Bulletin 148
June 2013
Page 2
										
Avoid Application Delays

Things to remember when you begin the application process

Remember to ask the applicant if he or she has ever submitted a MassHealth application and if yes, check the My Account Page (MAP) or the Eligibility Verification System (EVS) to prevent submitting a duplicate.
Be sure to ask appropriate questions of your patients to ensure that the most accurate and complete information is captured.
										
Important Message

Please remember to inform applicants that falsifying or withholding information to obtain benefits could result in fines or criminal penalties.

Every applicant has the right to apply. Even if you may have concerns about conflicting information that was provided, complete the application, and if warranted, make a referral to the MassHealth Operations Integrity Unit Hotline at 877-437-2830.
														
Organizational Responsibilities

When a VG user has left employment, your organization’s VG Access Administrator must immediately complete and submit the VG User Request Form (URF) to VG Customer Service. The user ID must be cancelled to ensure that the former employee will not have continued access to confidential information on MassHealth applicants and/or members.

Employees may not access or submit an application using a former or another employee’s VG user ID. VG user IDs are specific to the person as well as the organization.

If a former employee had access to the MMIS, your organization must contact MassHealth Customer Service at 1-800-841-2900.

If there is a security risk or concern with an existing employee’s access to the VG, you must call VG Customer Service at 1-800-421-0938 (TTY: 617-847-6578 for people who are deaf, hard of hearing, or speech disabled).
										
Available Training 

Additional training is available on best practices for entering MassHealth applications on the VG. Please contact Wanda Montes by phone at 617-847-1289 or via e-mail at wanda.montes@state.ma.us.



Document ends.