The State Organization Index provides an alphabetical listing of government organizations, including commissions, departments, and bureaus.
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The Affordable Care Act (ACA) Section 6401
Section 6401(b) of the Affordable Care Act (ACA) includes requirements related to Ordering, Referring, and Prescribing (ORP) providers. If MassHealth requires a service to be ordered, referred, or prescribed, then ACA Section 6401(b) requires that
There are other circumstances in which a nonbilling provider's NPI may also be required on claims in order to comply with HIPAA version 5010 billing requirements. To fulfill these requirements, MassHealth began enrolling qualified ORP nonbilling providers in June 2015.
When the ACA ORP requirements are fully implemented, MassHealth will deny claims for certain health care services requiring an order, referral, or prescription from a physician or other health care professional unless the ordering, prescribing, or referring provider’s individual NPI is included on the claim and that provider is actively enrolled with MassHealth, at least as a nonbilling provider.