Aging & Disability for Professionals - Serving Massachusetts Older Adults and People with Disabilities

Year: 2014

Retrospective Cinical Eligibility Determinations for Discharged & Deceased MassHealth Members

The Executive Office of Elder Affairs is issuing this Program Instruction (PI) to modify requirements for clinical eligability determinations for authorization of MassHealth payment of nursing facility services. This PI modifies instructions contained in PI-09-02. All other requirements of PI-09-02 not referenced in this PI remain in effect. For full details please click on the […]

Conditions for Certain Nursing Facility Approvals

The Executive Office of Elder Affairs is issuing this Program Instruction (PI) to clarify requirements regarding the ASAP's role in performing clinical eligability determinations for authorization of MassHealth payment for nursing facility services. This PI modifies instructions previously issued in PI-07-18 and the ASAP RFR section 9.4.1.5.b. Please click on the link below for full […]

Nursing Facility Clinical Eligibility Assessments, Short Term Approval and Noticing Procedures

The purpose of this Program Instruction is to clarify the ASAP's role and responsibility in tracking and conducting clinical eligability assessments for MassHealth members/applicants completed before and after nursing facility adminission, and to issue relevant notices to members/applicants. Any other previously issued instructuions, regardless of the format, are hereby rendered obsolete and replaced by the […]

Retrospective and Conversions Requests Exceeding 90 Days

The purpose of this Program Instruction (PI) is to issue procedures for ASAPs when conducting retrospective clinical eligability assessments for authorization of MassHealth payment for nursing facility services. Any previously issued instructions, regardless of the format, are hereby rendered obsolete and replaced by the requirements in this PI. Please click on the link below for […]

Clinical Eligibility for Home and Community Based Frail Elder Waiver

This information Memorandoum is being issued to clarify the process for ASAPs when determining initial clinical eligibility for consumers identified through the Senior Care Organization (SCO) as potentially eligable for the Home and Community Based Frail Elder Waiver (FEW). Click on the link below for further details.   Download IM-13-03 Clinical Eligibility for Home and […]

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