MedicaidAdministrativeMedium impact
Acute Inpatient Hospital Bulletin 204: Discharge Planning to Support Certain Family Assistance Members in Need of Long-Term Services and Supports
MassHealth·MA · Family Medicine, Internal Medicine, General Practice·Provider Bulletin
Effective date
May 1, 2025
We identified it
Jun 18, 2026
Summary
MassHealth has created a new Family Assistance LTSS Pathway effective May 1, 2025, allowing certain hospitalized Family Assistance members to access expanded long-term services. Hospitals must now conduct MDS-HC assessments and complete NF Level of Care Forms for qualifying members who need community long-term services or nursing facility stays longer than the Family Assistance coverage limits.
Action Required
Immediately for admissions after May 1, 2025: Hospital discharge planning teams must conduct MDS-HC assessments and complete NF Level of Care Forms for MassHealth Family Assistance members requiring community LTSS (PCA, AFC, GAFC, day habilitation, ADH) or long-term nursing facility stays. Submit required documentation to Disability Evaluation Services (DES) and assist patients with FA LTSS Pathway applications. Monitor Eligibility Verification System (EVS) to verify coverage upgrades to Standard or CommonHealth.