Responsibilities of Providers

(A) A Provider that conducts or oversees for screening of a woman who has given birth within six month for postpartum depression is mandated to report data regarding such postpartum st screening on an annual basis by March 1 for the previous calendar year using a method specified in 105 CMR 271.004(C). (B) A Provider that is part of a Provider group or a Provider Organization may report through such Provider group or, at the discretion of their Provider Organization, through such Provider Organization. (C) A Provider shall report to the Department using one of the following methods of reporting: (1) Directly through submission of an annual report to the Department no later than March 1st for the previous calendar year using a form or electronic format specified by the Commissioner and in accordance with guidelines issued by the Commissioner; or (2) Indirectly through submission of reportable claims to Carriers on an ongoing basis in accordance with applicable guidelines issued by the Commissioner, in consultation with the Center for Health Information and Analysis, regarding requisite code(s), mechanisms and deadlines for the reporting. A reportable claim means a claim for screening services delivered by a Provider to a postpartum patient during a given calendar year for which an annual report would be otherwise be due for submission to the Department under 105 CMR 271.004(A). A Provider that submits reportable claims to Carriers in accordance with 105 CMR 271.004(C)(2) is encouraged to submit reportable claims to third-party administrators (TPA) or administrative service-only organizations (ASO) when such TPA or ASO permits the claims to be reported in accordance with the Commissioner's applicable guidelines. (D) A Provider that performs postpartum depression screening utilizing only screening tools identified by the Commissioner and that submits reportable claims to Carriers in accordance with applicable guidelines issued by the Commissioner shall be deemed to have satisfied its mandated reporting requirements under 105 CMR 271.004(A) and shall not be required to submit an annual report to the Department under 105 CMR 271.004(C)(1). (E) A Provider that utilizes a screening tool not identified by the Commissioner must submit an annual report to the Department under 105 CMR 271.004(C)(1). (F) A Provider that does not submit reportable claims to Carriers must submit an annual report to the Department under 105 CMR 271.004(C)(1).