MedicaidPrior AuthHigh impact
All Provider Bulletin 413: Interoperability - Prior Authorization Process Changes for the MassHealth Medical Benefit
MassHealth·MA·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
MassHealth is implementing faster prior authorization processing times effective January 1, 2026 - standard requests must be processed within 7 calendar days (down from current timeframes) and expedited requests within 72 hours. Deferral periods are shortened from 21 days to 14 days, and new expedited request options will be available in the provider portal.
Action Required
By January 1, 2026: Billing team must update prior authorization workflow to ensure all MassHealth medical benefit requests include complete documentation to avoid deferrals. Monitor the Provider Online Service Center (POSC) for new expedited prior auth option. Check prior auth status more frequently due to shortened 14-day deferral response time. Attend December 2025 MassHealth information sessions to learn about system updates.