Commonwealth of Massachusetts Executive Office of Health and Human Services Division of Medical Assistance 600 Washington Street Boston, MA 02111 MassHealth All Provider Bulletin 110 June 2000 TO: All Providers Participating in MassHealth FROM: Jean C. Sullivan, Acting Commissioner RE: Medicare Part B Crossover Claims Update Background The purpose of this bulletin is to inform providers of the change in pricing for Medicare Part B crossover claims. Since May 1999, the Division has been paying 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. In November 1999, the legislature changed the policy and required the Division to pay the full coinsurance and deductible for Medicare Part B crossover claims. All Provider Bulletin 108, dated February 2000, informed providers that once the Division received a supplemental appropriation to fund the change and systems changes were complete, the Division would pay the full coinsurance and eductible for Medicare Part B crossover claims with dates of service on or after October 1, 1999. Payment Change The Division has now received a supplemental appropriation and in July will be paying the full coinsurance and deductible for Medicare Part B crossover claims effective for dates of service on or after October 1, 1999. Claims Processing Changes are being made to the crossover processing system to allow Medicare Part B crossover claims to pay the full coinsurance and deductible. Providers should continue to submit crossover claims as they do currently. In July, the Division will reprocess previously paid Medicare Part B crossover claims and those denied for edit 280 “Medicare payment exceeds Medicaid max” with dates of service on or after October 1, 1999. Providers should not resubmit any crossover claims. MassHealth All Provider Bulletin 110 June 2000 Page 2 Questions If you have any questions about the information in this bulletin, please contact the Unisys Provider Services Department at (617) 628-4141 or 1-800-325- 5231.