FAQs - MassHealth Cost Reports

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Last updated: 3/10/2024

Answers:


What does the MassHealth program have to do with Medicaid? 

"MassHealth" is just the name used for Medicaid in Massachusetts, so it is actually Medicaid.

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When is my MassHealth cost report due? 

Each year, these deadlines change based on CHIA's schedule.  Each report type has a different due date.  Updates are available on the CHIA website and on our MassHealth page as they become available.

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Where do I submit my MassHealth (Massachusetts state) cost report? 

NSR, SNF, REA, and MGT cost reports will be filed online, via the new CHIA system.  Submitting documentation should be emailed to the following email address:  [email protected].  ADH, AFC, GAFC, and other relevant reports should be emailed together with supporting documentation to [email protected].

How do I register for the online system? 

In order to register and receive login credentials, you must download, complete, sign, and email both the Business Security Agreement and CHIA INET User Agreement forms below to [email protected].

New users whose agencies are already registered need only submit the CHIA INET User Agreement form.
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What needs to be submitted for the NSR report? 

The following items need to be filed with your cost report:

  1. The actual cost report is filed online:  https://chiasubmissions.chia.state.ma.us
  2. Financial statements or external verification - this should be one of the following (in order of preference): audited, reviewed, or compiled financial statements prepared by a Certified Public Accountant (CPA), certification from a CPA not related to the principal owners or partners of the agency verifying that the data reported on the cost report is accurate and valid, unaudited financial statements, or copies of tax returns filed with the IRS for the cost reporting year.  Email this in PDF format to [email protected]
  3. If there are any differences between the financial statements and the cost report, file a reconciliation.   Email this in PDF format to [email protected]
  4. The Center for Health Information and Analysis (CHIA) may request additional documentation supporting the cost report, certified the same way the initial data needs to be certified.  Email this in PDF format to [email protected]
  5. A complete copy of the Medicare cost report - for Home Health Agencies (HHA).  Email this in PDF format  to [email protected]
  6. Fixed-Term Travel Employee Disclosure Form for agencies that provided the services of fixed-term travel employees.  Follow the link below to complete the FTTED reporting requirements.
    http://www.chiamass.gov/assets/docs/p/nsr-cost-reports/2019/NSR-orgname-2018-travel.xlsx

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How do I create the file for submission to CHIA?

For NSR reports, you no longer need to create a file to submit, since the cost report is now filed online.  For ADH reports, you need to press the create submission button on the last page of the template.  For AFC and GAFC reports, just submit the actual cost report file.

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What if I can't complete the MA state cost report on time? 

You may request a one time, two week extension for filing.  You must submit a request in writing or via email to: [email protected]. The request must explain a good reason ("just cause") for why you need the extension and must be received at CHIA by the due date.

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What are the penalties for not filing or filing a falsified report? 

Agencies who do not file the report may be subject to a fine and a court order to withhold payments. The penalties for not filing may also include (but are not limited to) a reduction in the agency's rates, removal of the agency from the list of eligible agency's, or revocation of the agency's registration.

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I just opened/ bought my facility or my facility had very little MassHealth activity this year.  Do I still need to file a cost report? 

The following facilities are exempt from filing a cost report:

  • For SNF reports, contact [email protected], as their requirements vary from the below
  • Any agency that was in business or owned by the current owner(s) for fewer than 6 months during the cost report year.
  • A TNS (Temporary Nursing) agency that only employed fixed-term travel employees as defined in 101 CMR 345.00: Temporary Nursing Services.   However the TNS must file the Fixed-Term Travel Employee Disclosure Form.
  • Any HHA or CNS which has earned less than $50,000 in net revenues from MassHealth for the fiscal year for which the cost report is filed (e.g., 01/01/18 - 12/31/18) may not need to file.  

If you believe that your agency qualifies for an exemption, you must fill out the exemption form and email it to [email protected].

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My facility operates on multiple sites.  How many reports do I need to file?

If your facility operates on multiple sites but has only one MassHealth provider number, it must file one report.  If it operates at multiple sites and had multiple provider numbers, you may either file one cost report or multiple cost reports.  If you choose to file multiple cost reports, you must make sure that shared expenses are correctly allocated between your different sites.

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My facility operates as both an HHA and a CSN.  How many reports do I need to file?

You must file two reports - one for the HHA and one for the CSN.

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