Information about Required Disclosure Forms for MassHealth Managed Care Entities (MCEs)

This page contains information for MassHealth-contracted Managed Care Entities (MCEs) about submitting required disclosure forms.

These forms include the Federally Required Disclosure Form for Entities (Entity FRDF) and the Managed Care Entity Disclosure of Ownership and Control Information Addendum (Addendum). 

This page does not contain information for MCEs about MCE network providers completing required disclosure forms. MCE network providers completing their individual provider FRDFs should work with their MCEs to complete those forms.

Which MCEs must complete the Entity FRDF and Addendum?

The following MCEs will need to complete these forms.

• Accountable Care Organizations (ACOs):
  • Accountable Care Partnership Plans (ACPPs), and
  • Primary Care ACOs (PCACOs)
• Managed Care Organizations (MCOs)
• Behavioral Health Vendor
• One Care Plans, and
• Senior Care Options (SCOs) Plans

What are the Entity FRDF and Addendum?

Entity FRDF

The Federally Required Disclosure Form for Entities (Entity FRDF) is a form MassHealth created for MCEs and certain other entities who provide MassHealth services to submit federally required disclosures. MassHealth providers, MCEs, fiscal agents, and other disclosing entities seeking to provide MassHealth services must disclose information about business ownership and control, business transactions, and criminal convictions. Disclosures include all relevant tax identification numbers (TINs), such as social security number (SSN) or federal employer identification number (FEIN), to ensure proper administration of the MassHealth program. These requirements are set forth in 42 CFR § 438.608 and §§ 455.100-106. MassHealth MCE contracts also require MassHealth MCEs and their material subcontractors to complete and submit Entity FRDFs.

Addendum

The Addendum is a form that MassHealth created to collect information that will be publicly available on its website. MassHealth is required to post on its website certain information about MCE ownership and control. These requirements are set forth in 42 CFR § 438.602(g)(3). MCEs and their material subcontractors are required to complete and submit the Addendum.

Where can an MCE find the Entity FRDF and Addendum?

The Entity FRDF and the Addendum are in the following Additional Resources section.

Additional Resources

Entity FRDF: PDF | Word

Addendum: PDF | Word

How does an MCE submit the Entity FRDF and Addendum?

To submit Entity FRDFs and Addendums to MassHealth securely, MCEs must upload the completed forms to the MassHealth Provider Online Service Center (POSC). Note: Each MCE has a representative who is authorized to use the POSC.

Submitting the Entity FRDF and Addendum on the POSC

1. Log into the POSC using your User ID and Password.

2. In the “Provider Services” panel, select the following options from the menu on the left of the page:

• “Manage Provider Information”
• “Maintain Profile”
• “Update Your MassHealth Profile”

3. Once the “Update Your MassHealth Profile” panel opens, select the Attachments link to open the Attachments panel.

• Select “New Item”
• Select the appropriate MCE from the “PID/SL” dropdown

4. In the “Attachments” panel, select the appropriate “Document Type”: “PEC- Federally Required Disclosures Form (FRDF).”  Select this “Document Type” for uploading both the Entity FRDF and the Addendum.

5. Select the “Browse” button.

6. Search for the file you intend to upload to the POSC. 

7. Select the “Add/Upload” button. The file will appear in the “List of Attachments” panel. Select the New Item button again to add more files (for example, the Addendum).

8. Once the Entity FRDF and Addendum both appear in the List of Attachments panel, select the Submit button to upload the files.

For additional resources on submitting the Entity FRDF and Addendum on the POSC, see:

• Provider Online Service Center (POSC) 
• POSC Frequently Asked Questions

What should MCEs keep in mind as they submit the Entity FRDF and Addendum?

• MCEs must complete all fields in both the Entity FRDF and Addendum and check responses for accuracy. If an MCE does not complete the forms correctly or in their entirety, including providing individual SSNs on the Entity FRDF where requested, MassHealth will notify the MCE. The MCE must then complete and submit new form(s). 
• The information on the Entity FRDF must match the information on the Addendum. If the forms are inconsistent, MassHealth will notify the MCE, and the MCE must complete and submit new form(s). 
• MCEs should submit the Entity FRDF and Addendum during the same submission on the POSC following the above instructions.
• Each MCE’s unique MassHealth Provider Identification Service Location (PIDSL) must have a separate Entity FRDF and Addendum. Also, it is expected that each PIDSL will have a different Managing Employee as defined in the Entity FRDF.
• If additional space is needed, the MCE must copy the form pages of the Entity FRDF or Addendum as instructed.
• The Entity FRDF must be signed by an authorized representative of the MCE.  An authorized representative for the MCE must also include their name in the Addendum in the attestation section. 

When must an MCE submit the Entity FRDF and Addendum?

MCEs must submit Entity FRDFs and Addendums at the times required in 42 CFR § 455.104:

• When submitting a response to a procurement for an MCE contract
• When entering into a new MassHealth MCE contract
• When entering into an amendment to extend or renew an existing MassHealth MCE contract
• Within 35 days after any change in MCE ownership or control as reflected in the Entity FRDF or Addendum  
• MassHealth also requires MCEs submit Entity FRDFs and Addendums at the request of MassHealth.

Where is the information in the Entity FRDF and Addendum displayed and stored?

MassHealth keeps the information that MCEs include on the Entity FRDF, such as SSNs, in its private Medicaid Management Information System (MMIS). Because keeping this personal information private and secure is important, MassHealth created the Addendum to collect information it is required to publicly share on its website. 

Last updated:	March 26, 2024