MassHealth recently issued a Nursing Facility Bulletin, advising providers that in compliance with federal requirements it will be applying retroactive decreases to the Patient Paid Amounts (PPA) for MassHealth members who were residents of a nursing facility between 4/1/2020 and 11/30/2020 and who saw an increase in their PPA during that time. As a result, facilities will need to adjust their MassHealth claims for the same time period to account for this retroactive decrease and must provide appropriate refunds to members. To ensure that facilities are issuing appropriate refunds, reporting requirements have been established. For more details click here.
As a reminder, the freeze on PPA increases was lifted on May 17, 2021.
If you need help navigating these adjustments and reporting requirements, please contact SHG Client Relations Director Ashley Shudan by email at firstname.lastname@example.org.