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Business Rule

MassHealth Family Assistance Clinical Assessment & Eligibility (CAE) Screenings Business Rule

Effective November 1, 2021, MassHealth updated policy guidance to expand coverage for members who are eligible for Family Assistance. MassHealth members covered by Family Assistance who require a nursing facility stay have a pathway to be eligible for both a short-term stay and/or long-term care. Additionally, MassHealth members covered by Family Assistance may also be […]

Community Transition Liaison Program (CTLP)

Business Rules Transition of CSSM Care Enrollments to CTLP Care Enrollments Business Rule – June 2023 CTLP Documentation Requirements in AD Business Rule September 2023 CTLP E-Invoicing & Team Expense Account Business Rule 8.15.25 Business Rule – National Standards for Culturally and Linguistically Appropriate Services (CLAS) FINAL Other Guidance CTLP Enrollments and Terminations Report User […]

FALL RISK IDENTIFICATION, PREVENTION, EDUCATION AND REVISED FALLS PROTOCOL (PI-22-06)

PI 22-06 Falls Protocol Attachments FINAL 12.20.22 PI 22-06 Falls Protocol FINAL 12.20.22 Falls Protocol Business Rule 2.14.2023 User Guide Fall Risk Identification and Intervention Final 6.1.2023 2021-NCOA-FP_6Steps_Infographic_Cape Verdean Creole 2021-NCOA-FP_6Steps_Infographic_Chinese Simplified 2021-NCOA-FP_6Steps_Infographic_Chinese Traditional 2021-NCOA-FP_6Steps_Infographic_English_4-16 2021-NCOA-FP_6Steps_Infographic_English_Arabic 2021-NCOA-FP_6Steps_Infographic_Haitian Creole 2021-NCOA-FP_6Steps_Infographic_Khmer 2021-NCOA-FP_6Steps_Infographic_Korean 2021-NCOA-FP_6Steps_Infographic_Portugese_4-30 2021-NCOA-FP_6Steps_Infographic_Russian 2021-NCOA-FP_6Steps_Infographic_Spanish_4-30 2021-NCOA-FP_6Steps_Infographic_Vietnamese 2  

Home Care Program (HC) Referral & Intake Tracking

Aging Services Access Points (ASAPs) are required to track referrals made to the Home Care program and the outcomes of these referrals. A specific Activity & Referral (A&R), HC Program Referral & Intake, has been added to SAMS and shall be utilized for tracking of Home Care Referrals. Home Care Program (HC) Referral & Intake […]

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