MassHealth has announced the next phase of Electronic Visit Verification implementation: a transition from compliance monitoring to claims denials, or hard edits, when submitted claims do not match EVV visit records. For providers, this marks a significant operational shift. What has largely been a compliance exercise will now directly affect reimbursement.

To support this transition, MassHealth is offering live training sessions for Fee-for-Service providers in Home Health, Group Adult Foster Care, and ABI/MFP waiver programs. These sessions are designed to help providers understand what to expect, avoid common pitfalls, and prepare their teams before denials begin.

What’s Changing

Under the upcoming requirements, claims must align with EVV data. If a visit captured in EVV does not match the claim submitted, the system may deny payment. These hard edits represent a move toward tighter program integrity and increased accountability, but they also create financial risk for agencies that are not fully prepared.

Why This Matters

For many agencies, EVV has been an administrative burden. Now, it becomes a revenue cycle issue. Missed clock-ins, incorrect service codes, timing mismatches, or incomplete records can all create problems when claims are matched against EVV data.

Agencies should use this time to review internal workflows, confirm staff expectations, and make sure billing and clinical operations are aligned.

MassHealth Training Sessions

• Session 1: April 30, 2026, 10:00–11:00 AM ET
  Overview of the hard edits transition, provider expectations, and best practices to help ensure visits align with claims.
• Session 2: June 4, 2026, 2:00–3:00 PM ET
  Recap of the hard edits transition and review of key support resources.
• Session 3: June 25, 2026, 2:00–3:00 PM ET
  Final reminder session ahead of the hard edit transition.

MassHealth has indicated that the live sessions will be recorded and made available for providers who are unable to attend.

Support and Resources

• EVV Technical Support: Submit a request through Sandata On-Demand or call 833-511-0164.
• Massachusetts EVV Program Questions: Email EVVfeedback@mass.gov.
• MassHealth LTSS Provider Support: Email support@masshealthltss.com or call 1-844-368-5184.

Bottom line: Agencies should treat this transition as both a compliance and revenue cycle priority. Attending one of the MassHealth training sessions, or reviewing the recordings when available, is a practical step to reduce disruption and protect claims payment as hard edits move forward.