Provider Services

Updates on the reinstatement of Primary Care Clinician Plan/Primary Care ACO referral requirements, Ordering Referring and Prescribing (ORP) requirements, advancing interoperability and improving prior authorization processes, Standardized Encounter Data Program (SendPro), LTSS, POSC user functionality and homepage refresh, robotics processing automation annual validation, and Payment Error Rate Measurement (PERM) RY2026. Additional Topics:  self-service resources on… Continue Reading Summer 2025 MassHealth Training Forum Provider Updates Presentation

Updates to the mass.gov website, multi-factor authentication, Provider Revalidation, Call Center Improvement Initiatives, Ordering, Referring and Prescribing (ORP) updates, and other vital provider-related resources and updates. Topics: MassHealth Robotics Processing Automation (RPA), Provider Revalidation Automation Pilot, sterilization form, provider bulletins, Long-Term Services and Supports Services (LTSS) Provider Directory, Non-LTSS provider training, Virtual Gateway

Updates on Member Eligibility Redetermination, Ordering Referring and Prescribing Resumption of Claim Denials, a review of the updated Prior Approval policy, New Automated ORP Revalidation process, and other important provider related updates and resources. Topics: data collection forms, Long-Term Services and Supports Provider communications, COVID-19 policy updates, MassHealth provider bulletins