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
	Podiatrist Bulletin 13
	September 2003

	TO:	Podiatrists Participating in MassHealth

	FROM:	Douglas S. Brown, Acting Commissioner

	RE:	Administrative Simplification for Claims Requiring Attachments

Introduction	MassHealth is committed to improving its business relationship with providers.  In keeping with the administrative simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, a requirement for claims attachments has been modified to facilitate claims adjudication.

Current Procedures	Currently, MassHealth requires the Podiatry Life and Safety Letter to be submitted by providers who submit claims for podiatry services.  This requirement will be changing for paper and electronic claims with dates of service on or after October 16, 2003.

New Procedures	MassHealth will now permit providers to maintain the Podiatry Life and Safety letter on file in their office rather than submitting it with the claim for adjudication.  The requirement to obtain and maintain this letter is not being removed and continues to be in full force and effect according to MassHealth regulations.  Providers are still required to obtain a letter to certify that the services being provided are necessary for the life and safety of the member.

	All other attachments required under podiatry regulations, including but not limited to other forms and invoices, must continue to be submitted for proper adjudication of claims.  Please refer to All Provider Bulletin 125, dated September 2003, for information on the new procedures for submitting paper attachments with electronic claims.
	
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Ongoing Compliance	Periodically, the Division may ask podiatry providers to verify that they have obtained the Life and Safety Letter.  In cases where the Division reviews have revealed provider noncompliance with the recordkeeping requirements of 130 CMR 450.205(A) through (C), the Division may pursue any legal remedies available to it, including but not limited to recovery of overpayments and imposing sanctions in accordance with the provisions of 130 CMR 450.234 through 450.260.	

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