Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth	
	MassHealth
	Nursing Facility Bulletin 126
	September 2004 

	TO:	Nursing Facilities Participating in MassHealth

	FROM:	Beth Waldman, Medicaid Director 

RE:	Reinstatement of Payment for Medical Leave-of-Absence (MLOA) and Non-Medical Leave-of-Absence (NMLOA) Days

Background	The final state budget for fiscal year 2005 reinstates MassHealth coverage of, and payment for, medical and non-medical leave-of-absence (MLOA and NMLOA) days.  The benefit coverage, effective for dates of service on or after July 1, 2004, is 10 MLOA days per episode, and a total of 10 NMLOA days per 12-month period beginning with the first NMLOA day.  All of these covered days will be paid at the facility’s lowest case- mix rate.

Regulation and	MassHealth has initiated actions necessary to reinstate payment for
System Changes	these days.  MassHealth intends to complete all necessary regulation and system changes as quickly as possible and intends to pay for MLOA and NMLOA days retroactively to dates of services on and after July 1, 2004.  

As advised by Transmittal Letter NF-47 (issued August 2003), providers must include MLOA and NMLOA days on all applicable claims.  Once the system changes and regulation amendments are in place, providers will receive a retroactive payment from MassHealth for leave-of-absence days included on claims. 

Discontinue Billing		Any provider collecting payments for MLOA and NMLOA days on and Other Payers 			after July 1, 2004, from other sources, such as residents and family  
members, must discontinue this practice immediately and refund all      payments from the payer source promptly. 

Bed-Hold Payment	Bed-hold payments for MLOA and NMLOA days will be made for dually
Process for Dually	eligible members during the course of their Medicare or another insurer’s
Eligible Members		benefit period.  If the member is not already coded for long term care,
facilities must send the bed-hold claim with a cover letter to MassHealth, Attn: Bed-Hold Claims, 600 Washington Street, Boston, MA  02111.

	

Medication Handling	      	Nursing Facility Bulletin 120 (issued July 2001), instructed providers 
During Temporary		about the handling and storing of medications while an individual is
Absences 			temporarily absent from the facility for medical and non-medical
	reasons.  Providers must continue to comply with this requirement.

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