Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111

MassHealth
All Provider Bulletin 107
December 1999

TO:      All Providers Participating in MassHealth

FROM:      Mark E. Reynolds, Acting Commissioner

RE:      YEAR-2000 UPDATE

Year-2000 Date Change      The Division would like to update providers on the actions it has taken to ensure continued and uninterrupted operations in the year 2000, and to inform providers of what they should do in the unlikely event that a disruption occurs.

The Division began updating its computer systems and otherwise preparing for the date change in 1996.  Since that time, the Division has remained committed to the smooth transition of all its systems and operations in the year 2000.  In addition to system changes, the Division made considerable efforts to keep providers informed of its year-2000 preparations and to inform providers about what they should be doing to prepare.  The Division’s outreach includes a provider bulletin issued in July 1999, liaisons with various provider associations, and numerous informational meetings with providers to address year-2000 issues.

The Division is confident that all its systems are now year-2000 compliant, and that it is well prepared to transact business on and after December 31, 1999.

Service Delivery                 The Division’s highest priority in addressing the year-2000 issue is to ensure that its members are not adversely affected by unanticipated service interruptions.  Our members must continue to receive the excellent care the Division has always relied upon you to provide.

In the event of a disruption to the Division’s business operations or systems, the Division has a comprehensive plan in place to ensure that providers continue to receive timely decisions on prior authorization requests.  Providers should continue to follow the normal process for submitting requests for prior authorization.

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MassHealth
All Provider Bulletin 107
December 1999
Page 2

Planned Shut-Down           To ensure a smooth transition, the Division plans to shut down the
And Restart of POPS          Pharmacy On-line Processing System (POPS) at about 12:00 noon on Friday, December 31, 1999, and then bring the system back into full operation no later than 8:00 A.M. on Saturday, January 1, 2000.

Pharmacies that need to fill prescriptions during any planned or unplanned outage of POPS must follow standard operating procedures for filling 72-hour emergency prescriptions.

No Interruption of              The Division expects the Recipient Eligibility Verification System (REVS)
Service for REVS               to remain operational without interruption during the New Year’s weekend, except for the daily 30-minute downtime window at about
2:00 A.M. on January 1, 2000, for regular system maintenance.  In the unlikely event of a REVS outage, providers must make every effort to verify member eligibility using all available REVS access methods.  These resources include PC access, the point-of-sale (POS) device, the automated voice response (AVR), and the eligibility operator.

It is possible that even if your usual route of access to REVS is unavailable, others may be operational.  Beginning on January 1, 2000, the EDS Help Desk at 1-800-462-7738 will have a recorded message that will explain what access methods are available.  If you are unable to
verify eligibility at the time you provide the service, after exhausting all available verification options, make a copy of the member’s MassHealth card, and annotate the date, time, and results of your attempted verification.

If an unanticipated prolonged outage of REVS occurs, the Division plans to use temporary MassHealth cards to facilitate a member’s access to services.  Providers should direct members who need a temporary MassHealth card to the MassHealth Enrollment Center at
1-888-665-9993, or the MassHealth Customer Service Center at
1-800-841-2900.  As with any temporary MassHealth card, providers should make a copy of the card, and keep the copy in their records as proof of eligibility.

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MassHealth
All Provider Bulletin 107
December 1999
Page 3

Claims Processing             The Division expects its claims-processing system will be able to process
and Payment                     claims on and after January 1, 2000, and that providers will continue to be paid promptly for covered services provided to eligible MassHealth members.

During the last two weeks of December, the Division intends to accelerate the payment of electronic claims to minimize the impact on providers of any potential disruptions in January.  Remember, however, that an increase in your cash intake in December may mean that you receive less cash in January, since your claims will have already been paid.  It is important to plan accordingly.

The Division is prepared to exercise its emergency-payment procedures in the event of a prolonged outage that prevents the timely processing of MassHealth claims.

Claims Processing             If you experience problems submitting your MassHealth claims because
Issues                               of year-2000 issues, don’t wait until it becomes a crisis.  Contact the Unisys Provider Services Department to discuss options that may be available to you.  The telephone numbers are printed later in this bulletin.

More Information               For more information about the Division’s year-2000 preparations, read
All Provider Bulletin 105, dated July 1999.  This bulletin is available on the
Division’s Web site at www.state.ma.us/dma.  The Division will update its Web site with new information about any year-2000 contingencies if necessary.  The Division will also use the telephone systems of its contractors to disseminate information about additional year-2000 contingencies.  In the unlikely event of telephone service interruptions, the Division will seek other methods of communication, including updates to its Web site, and communications with various provider associations.

Questions                         If you have any questions about this bulletin, contact the Unisys Provider
Services Department at (617) 628-4141 or 1-800-325-5231.

Disclosure                         This bulletin is a year-2000 readiness disclosure notice pursuant to the
Year 2000 Information and Readiness Disclosure Act, Public Law
105-271.  This bulletin is not a legally binding representation, warranty, or indemnity, and should not be construed as a representation that there will be no service disruptions as a result of the year-2000 date change.