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


MassHealth 
All Provider Bulletin 108 
February 2000 

TO: All Providers Participating in MassHealth 

FROM: Mark E. Reynolds, Acting Commissioner 

RE: Medicare Part B Crossover Claims Update 

Background

The purpose of this bulletin is to inform providers of the Division’s position 
regarding the repricing of Medicare Part B crossover claims. 

All Provider Bulletin 104, dated March 1999, informed providers that the 
Division would pay Medicare Part B crossover claims up to the Division’s 
maximum allowable amount less any Medicare payment, or the 
coinsurance and deductible amount, whichever is less. 

Payment Change

In November 1999, the legislature changed the policy and is requiring the 
Division to pay the full coinsurance and deductible for Medicare Part B 
crossover claims. The earliest date the Division can obtain federal approval for 
this change is October 1, 1999. 

The Division is requesting a supplemental budget appropriation to fund the 
change effective October 1, 1999. Therefore, the change in payment methodology 
will be implemented retroactively for claims with dates of service on or after 
October 1, 1999, when the legislature makes funding available. 

Claims Processing 

Providers should continue to submit crossover claims as they already do and 
should not submit claims for the higher crossover payment amounts until further 
notification is issued. The Division will notify providers of the process by 
which crossover claims will be processed retroactively for claims with dates of 
service on or after October 1, 1999. 

Questions

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