Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid 600 Washington Street Boston, MA 02111 www.mass.gov/masshealth MassHealth Vision Care Bulletin 13 October 2006 TO: Vision Care Providers Participating in MassHealth FROM: Beth Waldman, Medicaid Director RE: MassHealth Essential to Cover Visual Analysis by Optometrists Background MassHealth Essential members are eligible for eye exams and related treatment services. However, the types of providers from whom MassHealth Essential members could receive these benefits have been limited. Expansion of MassHealth will soon expand the types of providers from whom MassHealth Vision Care Essential members may receive covered vision benefits. This bulletin Providers concerns only services for MassHealth Essential members and does not apply to any other MassHealth coverage type. Effective for dates of service on or after November 1, 2006, covered visual analysis for MassHealth Essential members—which includes eye exams and supplementary testing—may be provided by an optometrist participating in MassHealth. Visual analysis services provided by physicians and ophthalmologists participating in MassHealth have been covered for MassHealth Essential members since the inception of this eligibility category. Please note that there will be no change to the range of vision benefits for which MassHealth Essential members are eligible. This bulletin affects only the types of providers who may bill MassHealth for covered vision services for MassHealth Essential members. Vision coverage for MassHealth Essential members consists of visual analysis, including eye exams and supplementary testing services. MassHealth Essential members are not eligible for the provision or dispensing of ophthalmic materials such as eyeglasses, contact lenses, or other visual aids. Questions If you have any questions about the information in this bulletin, please contact MassHealth Customer Service at 1-800-841-2900, e-mail your inquiry to providersupport@mahealth.net, or fax your inquiry to 617-988-8974.