As part of its program integrity and oversight activities, MassHealth routinely audits participating providers to ensure compliance with applicable regulations and to assess whether services rendered were medically necessary, appropriate, and consistent with professionally recognized standards of care. MassHealth reminds providers of their obligation to comply with the Recordkeeping and Disclosure requirements set forth at 130 CMR 450.205. Providers must submit requested medical records within the required timeframe. Failure to do so may result in sanctions pursuant to 130 CMR 450.238.
For questions or concerns:
LTSS providers, please contact the LTSS Provider Service Center at (844) 368-5184 or support@masshealthltss.com.
All other providers, please contact MassHealth at (800) 841-2900 or provider@masshealthquestions.com.