MedicaidAdministrativeMedium impact
Nursing Facility Bulletin 193: Discharge and Transition Planning to Support Certain Family Assistance Members in Need of Long-Term Services and Supports
MassHealth·MA·Specialty Services
Effective date
May 1, 2025
We identified it
Jun 18, 2026
Summary
MassHealth has established a new Family Assistance LTSS Pathway effective May 1, 2025, allowing certain Family Assistance members with qualifying hospitalizations to access long-term services and supports. Nursing facilities must now complete specific clinical assessments and submit documentation to help eligible members upgrade to MassHealth Standard or CommonHealth coverage.
Action Required
For admissions on or after May 1, 2025: Nursing facilities must identify Family Assistance members needing long-term services or community LTSS beyond home health. Complete required clinical assessments including obtaining MDS-3.0 assessment, completing NF Level of Care Form, and obtaining Clinical Eligibility Notice from ASAP or managed care entity. Submit documentation to MassHealth contractor DES per Appendices 1-2 guidelines. Monitor Eligibility Verification System (EVS) for coverage upgrades from Family Assistance to Standard or CommonHealth.