Message Text – May 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.

05/14/2024

MASSHEALTH ENDING SPAN BILLING FOR INDEPENDENT NURSE SERVICES

MassHealth is updating its billing system to no longer allow for span billing for Independent Nurses starting July 1, 2024. Span billing refers to the practice of submitting claims in which the claim does not distinguish individual dates of service. MassHealth is ending the allowance for span billing in order to improve provider billing compliance.

For claims submitted on or after July 1, 2024 any attempt to use span billing in the claim submission will result in a denial, citing error code “938: PROCEDURE CODE CANNOT BE BILLED WITH A DATE SPAN.” Instead, Independent Nurses who want to submit claims for multiple dates of service will need to distinguish each date of service and associated continuous skilled nursing (CSN) units on individual claim lines.

MassHealth has created a Job Aid which explains, step-by-step, how to submit claims without using span billing. This Job Aid can be accessed on the provider portal at the following link: https://tinyurl.com/2f9wpmpf.

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

PSYCHIATRIC DAY TREATMENT (PDT) CLAIMS REPROCESSED

New rates of payment for psychiatric day treatment center services H2012 and H2012-U1 became effective on 3/1/2024. These updated rates were implemented systematically on 4/26/2024. All claims submitted as of this date should pay at the rates defined in 101 CMR 307. Claims submitted during this interim period have been reprocessed as of 5/1/2024 to pay at the updated rate.

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

UPDATE FOR QUARTERLY DRUG CODE RATES EFFECTIVE APRIL 1, 2024

MassHealth has completed the rate updates for the April 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].

05/07/2024

INDEPENDENT NURSE BULLETIN 18 - CSN LIMIT OF HOURS

MassHealth has posted Independent Nurse Bulletin 18, which updates the limit for continuous skilled nursing (CSN) hours an independent nurse may provide in a 24-hour period as established at 130 CMR 414.409(C): Limit of Hours. The bulletin updates the limit of CSN hours an independent nurse may provide, by describing specific scenarios in which an independent nurse may provide up to 16 hours of CSN services in a 24-hour period. MassHealth will update the independent nurse regulations at 130 CMR 414.000 Independent Nurse to reflect these changes.

If you have questions regarding this guidance, please contact the LTSS Service Center at [phone] or [e-mail].

REMINDER: COMPLIANCE WITH MASSHEALTH'S ROBOTICS PROCESSING AUTOMATION (RPA) POLICY

Reminder: MassHealth requires that any/all providers, business partners, and relationship entities (henceforth, “organizations”) that utilize Robotics Processing Automation (RPA) tools (AKA “bots”) on MassHealth’s Medicaid Management Information System (MMIS) Provider Online Service Center (POSC) register the bot and request approval from MassHealth prior to the implementation of any bot technology.

If your organization is using RPA tools on the POSC without MassHealth approval that is a violation of the policy, and you must bring your organization into compliance as soon as possible!

RPA is the use of software automation to perform high-volume, repetitive, labor-intensive online tasks that previously required humans to perform. RPA involves robotic rules-based decision making to simulate human interaction with digital systems and software.

For more information regarding the RPA policy and the approval process, refer to All Provider Bulletin 345 at All Provider bulletins.

If you have questions regarding this RPA policy, please contact MassHealth at [e-mail].

VIRTUAL GATEWAY MULTIFACTOR AUNTHENTICATION (MFA)

The Executive Office of Health and Human Services (EOHHS) Virtual Gateway (VG) has been communicating that Multifactor Authentication (MFA) will be implemented effective May 19, 2024. All Provider Online Service Center (POSC) users will be required to set up MFA to be able to continue accessing the POSC via the VG.

EOHHS has added a resource assistance page to mass.gov regarding the changes.  You may access the page at Virtual Gateway Resource Assistance for Providers and State Agency Staff.

The VG notified all active VG users on Saturday April 27, 2024, outlining general information and instructions on setting up MFA. The sender was: [e-mail]. The next message is scheduled for Monday, May 6 to all active VG users announcing upcoming changes and providing more details on how to prepare for MFA.

It is imperative that all POSC users ensure the email address associated with their Virtual Gateway account (User ID) is up to date as this email address will be used to set up multifactor authentication and must be an exact match to the email associated with the VG account.

Please note: MFA and the VG terms and conditions require that a unique email address be associated to a single VG account. If your email address is associated with more than one VG User ID, you will be notified separately by the Virtual Gateway with instructions on how to prepare for May 19.

Prior to the implementation, please ensure that your organization completes the following:

• All users review and ensure that the email address associated with their VG User ID is unique and is not duplicated with any other VG User ID that is currently used;
• The Primary User must coordinate with users to ensure that each user only has a single, unique VG User ID and must eliminate multiple User IDs currently assigned to the same individual;
• The Primary User must coordinate with users to ensure that “common” named User IDs that are being shared amongst staff are eliminated; each User ID that is created and assigned to an individual must always include a first name and a last name.

Please refer to the April 27, 2024 email or go to Executive Office of Health and Human Services-Virtual Gateway (state.ma.us) to update your email address by using the “Manage My Account” function.

For additional questions or concerns:

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].

UPDATED MASS.GOV PROVIDER LANDING PAGES

MassHealth has recently made changes to the layout of the Information for MassHealth Providers page on Mass.gov in order to improve the provider experience. Individuals who visit Mass.gov will now find changes to the Information page at Information for MassHealth Providers. These updates include a more streamlined design for providers who are applying to MassHealth for the first time, as well as providers that already participate in the program.

Please visit Mass.gov often, as we continue to make updates to provider material.

Date published:	May 6, 2024