Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111
www.mass.gov/dma	
	MassHealth
Acute Outpatient Hospital
Bulletin 10
	September 2003

	TO:	Acute Outpatient Hospitals Participating in MassHealth

	FROM:	Douglas S. Brown, Acting Commissioner

	RE:	Administrative Simplification Claims Requiring Attachments

Introduction	MassHealth is committed to improving its business relationship with providers.  In keeping with the administrative simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, a requirement for claims attachments has been modified to facilitate claims adjudication.

Current Procedures	Currently, MassHealth requires the Certificate of Payable Abortion form (CPA-2) to be submitted by providers who submit claims for abortion services.  This requirement will be changing for paper and electronic claims with dates of service on or after October 16, 2003.

New Procedures	MassHealth will now permit providers to maintain the CPA-2 on file in their office rather than submitting the attachment with the claim for adjudication.  The requirement to complete this attachment is not being removed and continues to be in full force and effect.  Providers are still required to complete and maintain this form as required by MassHealth regulations.

All other attachments required under acute outpatient hospital regulations, including but not limited to other forms and invoices, must continue to be submitted for claims adjudication.  Please refer to All Provider Bulletin 125, dated September 2003, for information on the new procedures for submitting paper attachments with electronic claims.
	
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Ongoing Compliance	Periodically, the Division may ask providers to verify the completion of attachments kept on file.  In cases where the Division reviews have revealed provider noncompliance with the recordkeeping requirements of 130 CMR 450.205(A) through (C), the Division may pursue any legal remedies available to it, including but not limited to recovery of overpayments and imposing sanctions in accordance with the provisions of 130 CMR 450.234 through 450.260.

Questions	If you have any questions about this bulletin, please contact MassHealth Provider Services at 617-628-4141 or 1-800-325-5231.