The Massachusetts Health Care Training Forum (MTF) sends out regular email updates on current program and policy information, meeting notices, learning opportunities and other relevant information and resources.
For more information about the Provider Services notices (manage claims and payment information), please visit MassHealth Provider Remittance Advice Message Text.
Provider Directory Self-Service Update – Coming January 2026
Effective January 30, 2026, Provider Directory update requests will be available through MassHealth Provider Self-Service. Providers are required to maintain accurate profiles and update their Directory information whenever changes occur. This update allows providers to modify details such as telehealth availability, languages spoken, accessibility accommodations, website URL, and whether they are accepting new patients. CMS… Continue Reading Provider Directory Self-Service Update – Coming January 2026
Claims Reprocessed for July 2025 Subchapter 6 Code Updates
MassHealth is updating the Service Codes and Descriptions (Subchapter 6) of the Physician and Acute Outpatient Hospital Manual to incorporate drug codes as well as HCPCS/Current Procedural Terminology (CPT), as applicable. MassHealth updated its system to reflect the changes effective for dates of service on or after July 1, 2025. All affected claims will be… Continue Reading Claims Reprocessed for July 2025 Subchapter 6 Code Updates
Commonwealth of Massachusetts Accounting System Upgrade
The Commonwealth of Massachusetts is upgrading its accounting system in mid-January. This upgrade is expected to impact claim payment for two cycles but will not impact provider’s ability to submit transactions through MMIS. There is no need to adjust claim submission during this time, but please plan for the adjusted payment schedule described below. Payments… Continue Reading Commonwealth of Massachusetts Accounting System Upgrade
MMIS System Outage Notice – Sunday, January 11, 2026
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, January 11th, 2026, from 4:00 PM to 10:00 PM. MAP, CBHI, MeNoB, member and eligibility web services and Netreveal predictive modeling application servers will also be impacted. We apologize for any… Continue Reading MMIS System Outage Notice – Sunday, January 11, 2026
Updates to the Medicare Savings Program (MSP) Application
The Medicare Savings Program (MSP) helps eligible Medicare beneficiaries pay their Medicare costs. MSP is not insurance plans. They are programs that help lower Medicare premiums and other healthcare costs, including prescriptions. You can apply by completing and submitting the December 2025 version of the Medicare Savings Program (MSP) application. Due to updates from federal… Continue Reading Updates to the Medicare Savings Program (MSP) Application
Increases to MassHealth Premium Billing Amount
As of January 1, 2026, MassHealth is increasing monthly premium billing amounts by 10%. MassHealth expects the increase is between $2 – $10 per month for members with countable income of over 150% of the Federal Poverty Level (FPL). Starting in March of 2027, MassHealth will increase premium billing amounts yearly by the same percentage… Continue Reading Increases to MassHealth Premium Billing Amount
Update: Advancing Interoperability and Improving Prior Authorization Processes
Effective January 1, 2026, prior authorizations (PAs) for the medical benefit will be adjudicated as outline below: Standard PA requests: A decision will be provided within seven calendar days from the date received, provided all necessary documentation is included. Expedited PA request: A decision will be provided within 72 hours when the member’s clinical condition… Continue Reading Update: Advancing Interoperability and Improving Prior Authorization Processes
Winter 2026 Know Your Rights Presentation 3.0
Presented by the MA Office for Refugees and Immigrants (ORI) Know Your Rights 3.0 is an in-depth and comprehensive review of rules regarding ICE enforcement beyond basic warrant requirements. Learning Objectives: It will include topics such as (1) understanding when ICE may be required to show a warrant, (2) overview of the rules regarding when ICE… Continue Reading Winter 2026 Know Your Rights Presentation 3.0
Edit 2016 Updated Error Message Description
Error message for edit 2016 has been updated to clarify denied claims where a member is enrolled in PACE/SCO. The updated message is 2016 MEMBER COVERED BY SCO/PACE PLAN – MUST BILL SCO/PACE. Providers are reminded to bill the SCO/PACE plan for services. For questions or concerns: LTSS providers, please contact the LTSS Provider Service… Continue Reading Edit 2016 Updated Error Message Description
Plan of Care Submission Requirements
Starting January 1, 2026, independent nurses (INs) who are seeking a prior authorization (PA) to work with a Community Case Management (CCM) member for the first time must submit a copy of a signed plan of care to the member’s CCM clinical manager in order to receive their PA for continuous skilled nursing (CSN) services.… Continue Reading Plan of Care Submission Requirements