UnitedHealthcare Community Plan of Massachusetts Homepage
Enroll with MassHealth today to keep billing privileges and avoid termination
Federal law now requires all managed care entity (MCE) network providers to enroll with MassHealth.
To fulfill these requirements, all health care professionals contracted with UnitedHealthcare Community Plan of Massachusetts must enroll with MassHealth within 120 days of this notification. This will prevent billing delays and termination from the network.
We know you don't have time to spare, so we put all the UnitedHealthcare Community Plan resources you need in one place. Use the navigation on the left to quickly find what you're looking for. Be sure to check back frequently for updates.
The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:
Promote quality of care
Strengthen efforts to reform the delivery of care to individuals covered under Medicaid and Children’s Health Insurance Plans (CHIP)
Strengthen program integrity by improving accountability and transparency
Enhance policies related to program integrity With the Medicaid Managed Care Rule, CMS updated the type of information managed care organizations are required to include in their care provider directories.
When you report a situation that could be considered fraud, you’re doing your part to help save money for the health care system and prevent personal loss for others. If you suspect another provider or member has committed fraud, waste or abuse, you have a responsibility and a right to report it.
Taking action and making a report is an important first step. After your report is made, UnitedHealthcare works to detect, correct and prevent fraud , waste and abuse in the health care system.
Call us at 1-844-359-7736 or at uhc.com/fraud to report any issues or concerns.
UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan)
Our UnitedHealthcare® Connected plan is for adults ages 21 - 64 with disabilities who are eligible for both Medicare and MassHealth.
UnitedHealthcare Senior Care Options Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, and may include transportation to medical appointments and vision exams. Members must have Medicaid to enroll.
Health Insurance Portability and Accountability Act (HIPAA) Information
HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.
Integrity of Claims, Reports, and Representations to the Government
UnitedHealth Group requires compliance with the requirements of federal and state laws that prohibit the submission of false claims in connection with federal health care programs, including Medicare and Medicaid. View our policy.
If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. To see updated policy changes, select the Bulletin section at left.