Commonwealth of Massachusetts

Executive Office of Health and Human Services

Office of Medicaid

www.mass.gov/masshealth

MassHealth

Home Health Agency Bulletin 56

March 2020

TO: Home Health Agencies Participating in MassHealth

FROM: Amanda Cassel Kraft, Acting Assistant Secretary for MassHealth [signature of Amanda Cassel Kraft]

RE: Temporary Expansion of Home Health Aide Services

Introduction

In light of the state of emergency declared in the Commonwealth due to the 2019 novel Coronavirus (COVID-19) outbreak, MassHealth is introducing additional flexibilities for the provision of home health aide services to MassHealth members who have an existing prior authorization for Personal Care Attendant (PCA) services.

As described further in this bulletin, for the duration of the state of emergency declared via Executive Order No. 591, MassHealth will permit home health agencies to provide home health aide services to MassHealth members with an existing prior authorization for PCA services when a member is experiencing a disruption in receipt of PCA services due to COVID-19.

This bulletin shall remain effective for the duration of the state of emergency declared via Executive Order No. 591.

Authorization of Home Health Aide Services with a Personal Care Attendant Prior Authorization

A MassHealth member with a prior authorization for PCA services may utilize the prior authorization for PCA services to receive home health aide services from a MassHealth participating home health agency when the member determines that she or he is experiencing a disruption in receipt of PCA services due to COVID-19.

Referral Process

Personal Care Management agencies will inform MassHealth members currently authorized to receive PCA services that they may self-refer to a MassHealth home health agency for home health aide services if they require home health aide services for the delivery of personal care needs because of a disruption in their receipt of PCA services due to issues related to COVID-19.

Amount of Authorized Home Health Aide Hours

The home health agency may provide home health aide services to a MassHealth member with an existing prior authorization for PCA services up to the number of weekly hours authorized in the member's prior authorization for PCA services, minus the amount of any PCA services the member continues to receive. It is the obligation of the home health agency to coordinate the delivery of home health aide services with any PCA services the member continues to receive.

Assessment for Services

When a member requests home health aide services pursuant to this bulletin, the home health agency shall obtain the member's PCA documentation from the LTSS Provider Service Center (see information below) and then assess the member to determine the member's home health aide needs and whether the member requires any skilled nursing needs. The home health agency needs to conduct an initial assessment of the member pursuant to MassHealth Home Health Agency requirements established in 130 CMR 403.00. The assessment may be provided via Telehealth as per All Provider Bulletin 289.

Training Requirements for Individuals Providing Personal Care Attendant-Only Home Health Aide Services on Behalf of a Home Health Agency

Pursuant to 42 CFR 484.80(i), an individual providing personal care attendant-only home health aide services on behalf of a home health agency does not need to meet the home health aide training and certification requirements required under 42 CFR 484.80. The individual only needs to meet the training requirements established by the state for personal care services and demonstrate competency in the personal care services the individual is required to furnish.

Coordination of Services

The home health agency must coordinate home health aide services with any PCA services the member continues to receive. It is the home health agency's responsibility to document its coordination of services with the PCA services a member is receiving in the home health plan of care.

Required Documentation

The home health agency must obtain the following documentation from the MassHealth LTSS Provider Service Center for each member it provides home health aide services pursuant to this bulletin:

• A copy of the member's prior authorization approval for personal care attendant services.

• A copy of the member's PCA evaluation that is signed by the member's physician, nurse practitioner, or physician assistant. Note: MassHealth will consider this evaluation sufficient for billing purposes for home health aide services provided pursuant to this bulletin.

Rates of Payment

Payment to a home health agency for home health aide services provided pursuant to this bulletin will be in accordance with the rates for home health aide services established under 101 CMR 350.

Service Codes

Home health agencies must use the following service codes when billing MassHealth for home health aide services provided pursuant to this bulletin.

G0299/G0300: Nursing care visit for temporary emergency PCA services

99509: Home health aide visit for temporary emergency PCA services

Do not list the prior authorization number on the claim for home health services billed pursuant to this bulletin.

MassHealth Website

This bulletin is available on the MassHealth Provider Bulletins web page.

To sign up to receive email alerts when MassHealth issues new bulletins and transmittal letters, send a blank email to join-masshealth-provider-pubs@listserv.state.ma.us. No text in the body or subject line is needed.

Questions

For questions or assistance on completing a spending plan, email your inquiry to FY19SupplementalBudget@mass.gov. The MassHealth LTSS Provider Service Center is also open from 8 am to 6 pm ET, Monday through Friday, excluding holidays. LTSS Providers should direct their questions about this letter or other MassHealth LTSS Provider questions to the LTSS Third Party Administrator (TPA) as follows:

Method	Contact Information for MassHealth LTSS Provider Service Center
Phone	Toll-free (844) 368-5184
Email	support@masshealthltss.com
Portal	MassHealthLTSS.com
Mail	MassHealth LTSS PO Box 159108 Boston, MA 02215
Fax	(888) 832-3006
LTSS Provider Portal	Trainings, general Information, and future enhancements will be available at www.MassHealthLTSS.com.