RETRO RATE ADJUSTMENTS FOR HOSPICE PROVIDERS
Please be advised that the most recent remittance advice (RA) may contain rate adjustments resulting from the certification of revised Federal Fiscal Year 2023 rates (October 1, 2022) by the Executive Office of Health and Human Services. See MassHealth Administrative Bulletin 22-23 at https://www.mass.gov/lists/2022-eohhs-administrative-bulletins.
Please review this RA for accuracy. Proposed corrections must be submitted to the MassHealth LTSS Provider Service Center within 30 days from the date of this RA at firstname.lastname@example.org or by calling (844) 368-5184. For more information, refer to the POSC job aid “View Remittance Advice Reports” on the Job aids for the Provider Online Service Center (POSC) web page at https://tinyurl.com/y95aaqjk.
For questions, please contact the MassHealth LTSS Provider Service Center at email@example.com or call (844) 368-5184.
NURSING FACILITY PROVIDERS UPCOMING TRANSITION TO MDS 3.0 ON OCTOBER 1, 2023
Given the increasing medical complexity of the nursing facility population, on October 1, 2023, MassHealth will transition to a Patient Driven Payment Model (PDPM) by utilizing the CMS Minimum Data Set (MDS 3.0) tool.
MassHealth has updated its 270/271 Eligibility Inquiry and Response HIPAA Companion Guide to align with the upcoming MDS transition. Providers may view the Companion Guide at https://www.mass.gov/lists/masshealth-hipaa-companion-guides. Over the upcoming months, MassHealth will be providing updates about Trading Partner testing, other minor MassHealth HIPAA Companion Guide updates, and detailed provider instructions in future communications.
If you have questions regarding this guidance, please contact the LTSS Provider Service Center at (844) 368-5184 or firstname.lastname@example.org.
MASSHEALTH CSN OVERTIME REQUEST PROCEDURES
MassHealth published Home Health Agency Bulletin 81 (“Bulletin 81”) and Continuous Skilled Nursing (CSN) Agency Bulletin 9 (“Bulletin 9”), effective January 1, 2023, which describe how home health and CSN agencies may request and get prior authorization for agency CSN overtime rates on a permanent basis.
If you have questions regarding this guidance, please contact the LTSS Provider Service Center at (844) 368-5184 or email@example.com
MASSHEALTH ROBOTIC PROCESS AUTOMATION (RPA) POLICY AMENDMENT
MassHealth is amending its Robotics Processing Automation (RPA) Policy (hereinafter, the “Policy”). Effective March 13, 2023, the Policy will be amended as follows:
Section 1. RPA Registration
Section 1.II.a will be amended to implement the following requirement:
Organizations must submit the Stage II registration request to MassHealth within 90 days of MassHealth’s issuance of the Stage I preliminary approval number. If the Stage II request is not received within 90 days, MassHealth’s approval of the previously submitted Stage I registration request (and the associated approval number) will be revoked. Once a Stage I registration request is revoked, any organization that still intends to request approval to use bots on the POSC will be required to restart the registration process by completing and submitting a new MassHealth RPA Stage I Registration Form.
Section 4. Monitoring, Enforcement and Compliance
Section 4.II.a.iii will be amended to replace the term “mutually agreed upon timeframe” with “timeframe allotted by MassHealth”.
Please note: If your organization is currently using RPA tools on the POSC and you have not requested approval from MassHealth you are out of compliance with the RPA policy and must submit a registration request to MassHealth at firstname.lastname@example.org immediately. Organizations that violate the RPA policy will be subject to enforcement which will include the termination of the relevant User ID/s.
If you have any questions regarding this RPA policy modification, please contact MassHealth at email@example.com. You may view the current MassHealth Robotics Processing Automation (RPA) Policy at https://www.mass.gov/doc/rpa-policy-0/download.
|Date published:||February 6, 2023|
|Last updated:||February 13, 2023|