Message Text – March 2024

MassHealth Provider Remittance Advice

The messages listed below may be general All Provider messages, applicable to several provider types or services, or provider specific. 

You can request a copy of a prior message by:

• Emailing [e-mail]
• Sending a letter to

  MassHealth Customer Service
  P.O. Box 278
  Quincy, MA 02171

• Calling MassHealth Customer Services at [phone],
  Hours: Monday through Friday 8 a.m. to 5 p.m.

03/26/2024

FINAL NOTICE - MASSHEALTH POSC PRIMARY USER DESIGNATION CLEAN UP

You have only 6 days to take advantage of this one-time opportunity for your organization to modify its Primary User designations by completing a survey no later than March 31, 2024. Once you have completed the survey, MassHealth will update the Primary User and Backup Primary User and remove the Primary User designation and the Manage Subordinates permission from any other user currently listed under your organization’s PID/SL(s). This includes all linked users and those user IDs created by your organization.

This summer MassHealth plans to update the Provider Online Service Center (POSC) to allow only 2 users to function as the Primary User for each PID/SL. This change is being made to align with the Primary User policy. If your organization has determined that the Primary User designations must be updated before then, please complete the survey by March 31. The survey is available here: https://forms.office.com/g/nYNPPSxAQp.

Primary User designations and ineffective management of access of information could allow staff and affiliate organizations to continue accessing the provider’s information and enable users to submit transactions on behalf of a provider after they have left employment or after their contract was terminated.

Please review the MassHealth Primary User Policy here: http://tinyurl.com/4cysd32p

All-Provider Bulletin 377 is available here: https://www.mass.gov/lists/all-provider-bulletins

For additional questions or concerns:

Dental providers, please contact Dental Services at [phone]; TTY: [phone].

LTSS providers, please contact the LTSS Provider Service Center at [phone] or [e-mail].

All other providers, please contact MassHealth at [phone] or [e-mail].

CHANGE HEALTHCARE CYBERSECURITY INCIDENT - PROVIDER TRAINING

On February 21, 2024, Change Healthcare identified a cybersecurity incident. We understand that MassHealth health plans and providers may use Change Healthcare or one of its related entities (e.g., Emdeon, Caprio, McKesson, etc.) as their billing intermediary, prescription clearing house, claims clearing house, and/or Electronic Data Interchange (EDI) vendor. We strongly encourage all providers with systems connections to Change Healthcare to disable those connections immediately and investigate evidence of compromise if they have not done so already. MassHealth is committed to the health of our members and will work with providers who are impacted to ensure services can continue to be provided.

If you are a provider impacted by this incident and want to explore the alternative methods that are available, we strongly encourage you to attend one of the following Office Hour training sessions. We will review the options and provide the necessary steps and time frames to use these alternative methods. MassHealth will also provide information for those providers who may require financial assistance. Register here: https://tinyurl.com/mt5s6yvm

Tuesday, March 26th              10am-11am, 2pm-3pm

Thursday, March 28th            10am-11am, 2pm-3pm

Friday, March 29th                 10am-11am, 2pm-3pm\

Please note more training sessions may be added in the future, or a copy of the presentation will be made available to review at any time on the MassHealth Provider Training Portal: https://masshealth.inquisiqlms.com/Default.aspx.

If you are a provider impacted by this incident and need help verifying member eligibility or submitting claims, please contact MassHealth at [phone], TDD/TTY: 711. LTSS providers should contact the LTSS Provider Service Center at [phone].

UPDATE FOR QUARTERLY DRUG CODE RATES EFFECTIVE JANUARY 1, 2024

MassHealth has completed the rate updates for the January 1, 2024 Quarterly Drug codes. The impacted claims will be reprocessed and/or adjusted and will appear on a future remittance advice.

If you have questions, please contact MassHealth at [e-mail] or [phone].

03/19/2024

15 DAY NOTICE - MASSHEALTH POSC PRIMARY USER DESIGNATION CLEAN UP

You have only 15 days to take advantage of this one-time opportunity for your organization to modify its Primary User designations by completing a survey no later than March 31, 2024. Once you have completed the survey, MassHealth will update the Primary User and Backup Primary User and remove the Primary User designation and the Manage Subordinates permission from any other user currently listed under your organization’s PID/SL(s). This includes all linked users and those user IDs created by your organization.

This summer MassHealth plans to update the Provider Online Service Center (POSC) to allow only 2 users to function as the Primary User for each PID/SL. This change is being made to align with the Primary User policy. If your organization has determined that the Primary User designations must be updated before then, please complete the survey by March 31. The survey is available here: https://forms.office.com/g/nYNPPSxAQp.

Primary User designations and ineffective management of access of information could allow staff and affiliate organizations to continue accessing the provider’s information and enable users to submit transactions on behalf of a provider after they have left employment or after their contract was terminated.

Please review the MassHealth Primary User Policy here: http://tinyurl.com/4cysd32p

All-Provider Bulletin 377 is available here: https://www.mass.gov/lists/all-provider-bulletins

For additional questions or concerns:

Dental providers, please contact Dental Services at [phone]; TTY: [phone].

LTSS providers, please contact the LTSS Provider Service Center at [phone] or [e-mail].

All other providers, please contact MassHealth at [phone] or [e-mail].

03/12/2024

REPROCESSING CLAIM DENIALS FOR MEDICARE ADVANTAGE MEMBERS

MassHealth is aware that certain claims were erroneously denied for edit 2502 “Member covered by other insurance” on services that should have bypassed TPL editing for Medicare Advantage members. The denials occurred on claims billed with codes 92592 through 92595, A0130, A0170 or A4927 adjudicated from 2/1/2024 through 2/26/2024. The issue causing these denials was corrected on 2/27/2024 in production, and the affected claims have been reprocessed and will appear on this and subsequent remittance advices.

If you have questions regarding this message, please contact MassHealth at [e-mail] or [phone]. LTSS providers should contact the LTSS Provider Service Center at [phone] or [e-mail].

CLAIMS PROCESSED FOR 2024 HCPCS/CPT CODE UPDATES

The Centers for Medicare & Medicaid Services (CMS) have revised the HCPCS codes for 2024. MassHealth is updating the Service Codes and Descriptions (Subchapter 6) of the Physician Manual to incorporate those 2024 HCPCS/Current Procedural Terminology (CPT) service code updates, as applicable.

MassHealth updated its system to reflect the 2024 HCPCS/CPT coding changes effective for dates of service on or after January 1, 2024. All affected claims will be reprocessed and will appear on this or future remittance advices.

If you have questions, please contact MassHealth at [e-mail] or [phone].

90 DAY SUPPLY CROSSOVER CLAIMS FOR CPAP SUPPLIES

MassHealth has implemented MMIS system updates to allow reimbursement for 90-day supply for CPAP supplies A7031, A7032, A7033, and A7038. This change only applies to crossover claims with dates of service on or after 3/1/2024.

If you have any questions regarding this message, please contact the LTSS Provider Service Center at [e-mail] or (844)-368-5184.

ADJUSTMENT AND REPROCESSING OF HCPCS CODES A9901 AND K1005

MassHealth has completed MMIS system updates for HCPCS codes A9901 and K1005. The impacted claims have been reprocessed/adjusted and will appear on this or subsequent remittance advices.

If you have questions regarding this message, please contact the LTSS Provider Service Center at [e-mail] or (844)-368-5184.

03/05/2024

UPDATED CSN RETENTION BONUS BULLETIN - EXTENDED DATES OF SERVICE

MassHealth has posted Continuous Skilled Nursing (CSN) Agency Bulletin 18 (http://tinyurl.com/5224bx9b) and Home Health Agency Bulletin 91 (http://tinyurl.com/dj2xmhyc), which extend the eligible dates of service for the CSN Retention Bonus initiative through June 30, 2024. The last billing cycle will be July 2024. The bulletins describe the eligible service quarters and billing cycles, who is eligible for retention bonuses, service commitment requirements, retention bonus amounts, and agency billing procedures.

When billing, please review these bulletins as well as the CSN Agency Billing Instructions for Retention Bonus (http://tinyurl.com/2uf773da) on the MassHealth LTSS Provider Portal.

For questions, please contact the MassHealth LTSS Provider Service Center at [e-mail] or [phone].

UPDATED CSN RETENTION BONUS BULLETIN - EXTENDED DATES OF SERVICE

MassHealth has posted Independent Nurse Bulletin 17 (http://tinyurl.com/2zbe3jaw), which extends the eligible dates of service for the Continuous Skilled Nursing (CSN) Retention Bonus initiative through June 30, 2024. The last billing cycle will be July 2024. The bulletin describes the eligible service quarters and billing cycles, who is eligible for retention bonuses, service commitment requirements, retention bonus amounts, and agency billing procedures.

When billing, please review these bulletins as well as the Independent Nurse Billing Instructions for Retention Bonus (http://tinyurl.com/5sdpcfy4) on the MassHealth LTSS Provider Portal.

For questions, please contact the MassHealth LTSS Provider Service Center at [e-mail] or [phone].

30 DAY NOTICE - MASSHEALTH POSC PRIMARY USER DESIGNATION CLEAN UP

Please note that you have only 30 days left to take advantage of this one-time opportunity for your organization to modify its Primary User designations by completing a survey no later than March 31, 2024. MassHealth will update the Primary User and backup and remove the Primary User designation and the Manage Subordinates permission from any other user currently listed under your organization’s PID/SL(s). This includes all linked users and those user IDs created by your organization.

Please note that this summer MassHealth plans to update the Provider Online Service Center (POSC) to only allow 2 users to function as the Primary User for each PID/SL to further align with the Primary User policy. If your organization has determined that the Primary User designations must be updated before then, please complete the survey by March 31. The survey is available here: https://forms.office.com/g/nYNPPSxAQp.

Please note: Primary User designations and ineffective management of access of information could allow staff and affiliate organizations to continue accessing the provider’s information and enable users to submit transactions on behalf of an provider after they have left employment or after their contract was terminated.

Please review the MassHealth Primary User Policy here: http://tinyurl.com/4cysd32p

All-Provider Bulletin 377 is available here: http://tinyurl.com/3j9pajtj

For additional questions or concerns:

Dental providers, please contact Dental Services at [phone]; TTY: [phone].

LTSS providers, please contact the LTSS Provider Service Center at [phone] or [e-mail].

All other providers, please contact MassHealth at [phone] or [e-mail].

CHANGE HEALTHCARE CYBERSECURITY INCIDENT

On February 21, 2024, Change Healthcare identified a cybersecurity incident. We understand that MassHealth health plans and providers may use Change Healthcare as their billing intermediary, prescription clearing house, claims clearing house, and/or Electronic Data Interchange (EDI) vendor. We strongly encourage all providers with systems connections to Change Healthcare to disable those connections immediately and investigate evidence of compromise if they have not done so already. For more information, review Change Healthcare’s statement on its website: https://status.changehealthcare.com/incidents/hqpjz25fn3n7.

In addition, we are aware that the incident along with related mitigation responses may impact the ability of some providers to review MassHealth member eligibility and submit claims. If you are a provider impacted by this incident and need help verifying member eligibility or submitting claims, please contact MassHealth at [phone], TDD/TTY: 711.

MassHealth is committed to the health of our members and will work with providers who are impacted to ensure services can continue to be provided.

Date published:	March 4, 2024
Last updated:	March 25, 2024