To allow for system maintenance, the MMIS POSC, Provider Portal, HTS transactions, internal MMIS application, EVS and all eligibility services will be unavailable on Sunday, August 3, 2025, from 4:00… Continue Reading MMIS System Outage Notice – Sunday, August 3, 2025
Ordering, Referring, and Prescribing (ORP) Referring Provider Edit Denials for Pharmacies Billing Durable Medical Equipment (DME) and Home Infusion Services Through the Medicaid Management Information System (MMIS) The ORP referring… Continue Reading Ordering, Referring, and Prescribing (ORP) Referring Provider Edit Denials for Pharmacies Billing Durable Medical Equipment (DME) and Home Infusion Services Through the Medicaid Management Information System (MMIS)
As described in All Provider Bulletin 286 (with updated information provided in All Provider Bulletins 361, 376, 380, and 391), claims submitted to MassHealth for services that require an order,… Continue Reading Reminder of Ordering, Referring, Prescribing (ORP) Provider Requirements
Effective 9/1/2025, the MassHealth Customer Service phone prompts will be changing. Providers will be required to enter their MassHealth Provider ID (PID) to connect with a Customer Service Agent. If… Continue Reading Change in Phone Prompts for Customer Service
On March 20, 2020, as part of MassHealth’s COVID-19 response, the Executive Office of Health and Human Services suspended referral requirements for MassHealth-covered services, including orthotics and prosthetics, for the… Continue Reading Reinstatement of Primary Care Referral Requirements for Orthotics and Prosthetics Services
On March 20, 2020, as part of MassHealth’s COVID-19 response, the Executive Office of Health and Human Services suspended referral requirements for MassHealth covered services for the Primary Care Accountable… Continue Reading Reinstatement of Primary Care Referral Requirements
This message serves as a reminder to providers about the standard RMRP process. In accordance with 130 CMR 450.316(A)(6) and 130 CMR 450.316(F), RMRP will recover MassHealth claim payments for… Continue Reading Retroactive Medicare Recovery Project (RMRP)
Effective October 10, 2024, MassHealth launched two new self-service tools for MassHealth providers: a Provider Enrollment Status tool & a Provider Application Status tool. These web-based tools will assist providers… Continue Reading Self-Service Tools for MassHealth Providers
Effective October 1, 2024, the MMIS and Virtual Gateway (VG) will begin deactivating accounts that have been inactive for more than 12 months. The initial deactivation event will affect accounts… Continue Reading Virtual Gateway Inactive Account Deactivation
Effective Sunday, October 20, 2024, the Virtual Gateway (VG) is implementing changes to ensure that the VG and the recently implemented Multi-Factor Authentication (MFA) profile updates via Azure are synchronized.… Continue Reading Virtual Gateway Multi-Factor Authentication (MFA) Profile Updates & Transition
