Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth	
	MassHealth
	Transportation Bulletin 14
			May 2004

	TO:	Transportation Providers Participating in MassHealth

	FROM:	Beth Waldman, Medicaid Director  

	RE:	Administrative Simplification for Claims Requiring Attachments

Introduction	MassHealth is committed to improving its business relationship with the provider community.  In keeping with the administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), MassHealth has streamlined both the HIPAA electronic and paper claims processes.

Current Procedures	Currently, air-ambulance providers must submit a medical necessity form with their MassHealth claims for transportation services.  This requirement will be changing for both paper and HIPAA electronic claims with dates of service on or after June 1, 2004.

New Procedures	MassHealth has reviewed its requirements for attachments, and will be allowing air-ambulance providers to maintain the medical necessity forms in the office rather than submitting them to MassHealth with the claim.  MassHealth has not eliminated the requirement for these attachments.  Providers are still required to complete the form and maintain it with the member’s medical record.  

Providers of air-ambulance services must continue to submit all other attachments required under transportation regulations.

Ongoing Compliance	Periodically, MassHealth may ask providers to verify the completion of attachments.  In cases where MassHealth reviews reveal provider noncompliance with attachment requirements, MassHealth may seek to pursue recovery of overpayments and to impose 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.