Request hardship exception

If the application fee presents a significant financial hardship, you can submit a hardship exception request.

MassHealth Customer Service Center for Providers

The Details of Request hardship exception

What you need for Request hardship exception

You will need to provide documentation to support your request, which may include:

  • Historical cost reports
  • Recent financial reports such as balance sheets and income statements
  • Cash flow statements
  • Tax returns
  • And more

Other factors for hardship exception include:

  • Considerable bad-debt expenses
  • Significant amounts of charity care or financial help furnished to patients
  • Presence of substantive partnerships (involving clinical, financial integration) with those who tailor medical care to a mostly low-income population
  • Whether you receive considerable amounts of funding through disproportionate share hospital payments

How to request Request hardship exception

  1. Download the Hardship Exception Request form
  2. Fill out the form.
  3. Attach any necessary supporting documentation.
  4. Mail the completed form and documentation with your provider application to

MassHealth Provider Enrollment
P.O. Box 121205
Boston, MA 02112-1205

      For OLTSS providers, mail to 

MassHealth LTSS
P.O. Box 159108
Boston, MA 02215

Next steps for Request hardship exception

Possible decisions

We will review your hardship request first. If we approve your request, we will forward it to the Centers for Medicare & Medicaid Services (CMS) for review. CMS will then notify us about the status of your request, and we will notify you of CMS’s decision. We cannot process your enrollment application until a decision has been made on your hardship request.

If your hardship exception request is approved, we will process your provider application. We will send a final determination of your application to the business address listed on it.

If MassHealth or CMS denies your request, you may not appeal this decision. We will notify you of the denial and give you 10 business days to pay the application fee. We cannot process your provider enrollment application until you pay the fee.

If you don't pay the fee within 10 business days, your application will be denied. You may resubmit your application, along with an application fee, at any time.

Downloads for Request hardship exception

Contact for Request hardship exception

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