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Breaking: Beacon Audit Activity Suspended, Effective Immediately

March 2, 2018 04:49 PM
Important_notice
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Breaking: Beacon Audit Activity Suspended, Effective Immediately

 

We are happy to inform our MaMHCA members that our advocacy has paid off. Working with our allies we have finally tipped the scales enough that MassHealth has now taken definitive action and are stopping Beacon's current audit activities. Yesterday, MassHealth issued a memo to managed care organizations who use Beacon as their behavioral health subcontractor. Highlights are below. You can read the letter from MassHealth on our Member's Section Here. Thank you to MassHealth for taking decisive action.

ALL audits are to be paused immediately until 10/1/18 or upon further notice from MassHealth.

  • Beacon/Nokomis will suspend all recoupments (clawbacks) that have been noticed but not yet recovered from providers until providers are given an opportunity to submit documentation [see below].
  • All clinicians will be provided a standardized document to attest the times of their session in lieu of a timestamp for any notes that were audited and will have until 9/1/2018 to complete this.
  • If you have already paid a recoupment (clawback) to Beacon, or were docked pay for future sessions as a result of missing a timestamp, you will be repaid after you have submitted the appropriate documentation as outlined above.

In addition, MAMHCA will now have a regular seat at the table with Beacon, MassHealth, the MCOs, and several other provider groups to discuss future internal processes or changes when it comes to billing (and other matters) - and come to common agreement about what are reasonable expectations of the provider and payer communities. These meetings will begin in about 2 weeks.

Thank you for your persistence with Beacon/Nokomis, and your calls and emails to us at MaMHCA.  Your reports of difficulties helped us to clearly relay the serious problems with this audit process to MassHealth, and other stakeholders. We hope that this decision by MassHealth will provide the reprieve you all have been seeking.  

Please reach out to Midge, Betsy, Joe or Evan​ at MaMHCA with questions you have moving forward.

 

Please read the official document from EOHHS to the MCOs:  Link to MCO Document on Official Letterhead

 

 

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