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
	All Provider Bulletin 116
	July 2002

	TO:	All Providers Participating in MassHealth

	FROM:	Wendy E. Warring, Commissioner

	RE:	HIPAA Eligibility and Response Transaction 270/271

Important Information	This bulletin contains very important information about the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  One of the enclosed documents may require an authorized signature.  Please be sure to share this information with all the appropriate people in your organization.

A Brief Summary of	HIPAA was enacted to streamline the administration of health care and to 
HIPAA 	protect the security and privacy of patient information.  HIPAA applies specifically to electronic transactions.  Under HIPAA, payer-specific (local) codes are eliminated.  Patients will have access to their protected health information, which will be safeguarded against unauthorized access.

Trading Partner	All MassHealth providers must sign a document called a MassHealth 
Agreements 	Trading Partner Agreement before they can conduct standard HIPAA transactions with the Division.  By signing the Trading Partner Agreement, you agree — among other things — to comply with the terms of your provider agreement, to bear costs associated with submitting transactions to us, and to conform to other related documents applicable to the transactions you wish to conduct. 

	The Trading Partner Agreement does not replace your current provider agreement.  It is in addition to your provider agreement.

	You will need to sign a MassHealth Trading Partner Agreement only once, even if you wish to use more than one standard HIPAA transaction.
You will have an opportunity to sign a Trading Partner Agreement prior to the implementation of each HIPAA transaction.

	

New Web-Based	In July, the Division will implement MassHealth WebREVS, which enables 
Eligibility Verification	you to access the MassHealth Recipient Eligibility Verification System 
Option 	(REVS) via the Internet.  WebREVS is a HIPAA-compliant Eligibility Inquiry/Response Transaction (also known as a 270/271 transaction).  This is the first Web-based application for MassHealth and the first to meet HIPAA standards.  WebREVS allows you make single eligibility inquiries similar to using a point-of-sale device.  If you would like to start using WebREVS to conduct your eligibility inquiries, you must sign the enclosed Trading Partner Agreement and return it to the following address:  

		EDS
	ATTN:  MassHealth Provider Services
		155 Federal Street, 6th Floor
		Boston, MA  02110

	Once the Trading Partner Agreement is received, EDS will contact you with additional information and instructions for WebREVS.

	Also attached is a Specifications Addendum for the Eligibility Inquiry/Response Transaction (270/271).  The Specifications Addendum applies immediately to WebREVS.  A notice will be sent later about using updated PC software to access REVS via the Internet.  Please note that you may still use other non-Web-based methods to verify member eligibility, such as the point-of-sale (POS) device.

	If you do not plan to use WebREVS, do not sign the enclosed Trading Partner Agreement, but please note that if you plan to use other electronic transactions (such as electronic claims submission), you may be asked at a later date to sign a Trading Partner Agreement.  Providers submitting electronic claims will be required to have a signed Trading Partner Agreement on file no later than October 16, 2003.  However, until further notice, your current electronic transactions are not affected and can continue as usual.

Note:  The Trading Partner Agreement refers to an Intermediary Authorization Rider, which does not apply to the 270/271 transaction.

Future Communications	In the upcoming months, the Division will announce the availability of
About HIPAA	other standard HIPAA transactions and will distribute the associated documents.  Please remember that you need to sign the Trading Partner Agreement only once.

For more information about HIPAA, visit the following Web sites: www.cms.gov/hipaa and www.mass.gov/dma.

	

Questions	If you have specific questions about the Trading Partner Agreement or Specifications Addendum for the Eligibility Inquiry/Response Transaction, please contact EDS Provider Services at 1-800-462-7738.