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Nursing Facility Bulletin 197: Updates to Transition to CMS OBRA MDS 3.0 Assessments for Nursing Facility Fee-for-Service Payments
MassHealth·MA · Geriatrics·Specialty Services
Effective date
Jan 26, 2026
We identified it
Jun 18, 2026
Summary
MassHealth has updated nursing facility payment requirements, transitioning from Management Minutes Questionnaire (MMQ) to CMS OBRA MDS 3.0 assessments for determining resident acuity and fee-for-service payments. This bulletin supersedes previous guidance and outlines new assessment schedules, submission requirements, and payment determination processes.
Action Required
By January 26, 2026: Nursing facilities must ensure all MDS assessments include both MassHealth provider ID and MassHealth member ID for payment processing. Billing teams must verify MDS assessment data import into MMIS using weekly reports (ELG-402 Success Report and ELG-404 Error Report available every Wednesday). Submit modified MDS assessments for any missing or incorrect member information following CMS RAI Manual Chapter 5.7 guidelines. Follow new assessment schedules: admission within 14 days, quarterly within 92 days, and annually within 366 days.