MassHealth Member Eligibility Redetermination Data Sharing for Home Care Program Consumers: PI-23-06
PI-23-06 MassHealth Member Eligibility Redetermination Data Sharing for Home Care Program Consumers 6.1.2023
Pending Services Referral and Provider Search Process: PI-23-01 and supplemental documents
PI 23-01 Pending Services Referral and Provider Search Process Pending-service-provider-provider-search-9.28.2021 Pending Service Referral and Provider Search Business Rule 9.24.21 User Guide Services Pending Providers Report – R01 – First Public Draft 9-20-2021
ELIGIBILITY FOR HOME CARE PROGRAM FOR ADULT FOSTER CARE AND GROUP ADULT FOSTER CARE MEMBERS PI-23-02
PI 23-02 HC eligibility for AFC GAFC members 4.7.2023
Revised Cost Share Table for the Home Care Program 2023
2023 Home Care Cost Share PI 23-04 Final March 27 2023
Program Instruction (PI) 22-01 Provider Service Rates
PI 22-01 Provider Service Rates
PI-21-01: Cost-Share Program Instruction 2021
This Program Instruction (PI), number PI-21-01, transmits the Financial Eligibility Guidelines that take effect on May 1, 2021 for the Home Care Program, and sets out the voluntary co-payment, cost sharing, and over-income co-payment schedules. Cost-Share PI 2021 3.9.21 PDF
Revised Cost Share Table for the Home Care Program
This Program Instruction (PI) transmits the Financial Eligability Guidelines that take effect on Februry 1, 2014 for the Home Care Program, and sets out the voluntary co-payment, cost sharing, and Respite Care co-payment schedules. Please click the link below for the actual guide and schedule. Download PI-14-02 Revised Cost Share Table for the Home Care […]
Requirements for Comprehensive Screening and Service Model Activities (CSSM)
The purpose of this Program Instruction is to issue requirements for Aging Services Access Points (ASAPs) in the performance of Comprhensive Screening and Services Model (CSSM) program related activities. This Program Instruction requires all ASAPs to adopt a specified management and staffing model and protocols to perform CSSM-related activities.
Review of Pre-Admission Screen & Record Review – PASRR Requirements prior to Authorization of MAssHealth Pmt. of NF Services
The purpose of this Program Instruction is to clearly delineate the practice for PASRR documentation review by ASAP Clinical Assessment Eligability (CAE) staff when approving pre-admission and post admission assessments in NF. This is being presented in order to improve NF compliance with PASRR to prevent inappropriate NF admissions for those indivduals with a diagnosis […]
Retrospective Cinical Eligibility Determinations for Discharged & Deceased MassHealth Members
The Executive Office of Elder Affairs is issuing this Program Instruction (PI) to modify requirements for clinical eligability determinations for authorization of MassHealth payment of nursing facility services. This PI modifies instructions contained in PI-09-02. All other requirements of PI-09-02 not referenced in this PI remain in effect. For full details please click on the […]