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News and notifications

Medication Administration Visits (MAV) codes
ACO home health providers: Our claims system has been adjusted and is now accepting Medication Administration Visits (MAV) codes T1502 and T1503. Effective August 14, 2019, providers may start submitting claims for these service codes. These MAV codes require prior authorization. Previously denied claims due to “not a covered benefit” are being processed retroactive to March 1, 2018. Please contact your Provider Relations Representative if you have any questions.

July 2019 Connection newsletter

  • Magellan Rx Management 
  • Healthy Outlooks mailer 
  • Summit ElderCare® survey results 
  • NaviCare Model of Care training 
  • Support for NaviCare® members with COPD and asthma 
  • PA for specialist visits for Summit ElderCare 
  • Pharmacy and therapeutics formulary changes 
  • Clinical Practice Guidelines update 
  • Behavioral Health services for children and adolescents 
  • Coding updates

Fallon will collaborate with HCAS plans to streamline directory data updates (7/16/2019)
Watch for more information in upcoming issues of the Connection newsletter.

MassHealth 834 technical guidance (pdf, 3/8/2018)

MassHealth continuity of care transition for ACO/MCO plans (3/1/2018)

MassHealth ACO FAQ 1/4/2018
Beginning March 1, 2018, MassHealth members will have more options for getting care, including MassHealth Accountable Care Organization (ACO) Partnership Plans.

Verify or update your practice information  9/20/2017
Your practice information appears in our provider directories. Keeping your information current helps ensure that patients can locate and contact your practice.

Provider Directory requirements from CMS and NCQA 9/10/2017
The Centers for Medicare & Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA) have enacted requirements that health plans engage providers in reviewing and maintaining provider directory information.

More news and announcements

Have questions?

Contact your Provider Relations Representative: