Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
www.mass.gov/masshealth
	MassHealth
	Acute Inpatient Hospital Bulletin 141
	October 2011




	TO:	Acute Inpatient Hospitals Participating in MassHealth

	FROM:	Julian J. Harris, M.D., Medicaid Director 

      RE:       Address Change for the Notification of Birth (NOB-1) Form 



Background	There is a change in the processing of Notification of Birth (NOB-1) forms. 
Effective October 1, 2011, please mail all copies of the NOB-1 form to 
100 Hancock Street, 6th Floor, Quincy, MA 02171.


NOB-1 Processing	We have updated the NOB-1 form to reflect the new address. Forms sent 
to the former address will be forwarded to the new address. You may also 
continue to use the old forms to deplete supplies. Whenever possible, 
please provide the actual name of the child.


Questions	If you have any questions about this change, 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.