UnitedHealthcare Community Plan of Massachusetts
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.
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Serious Reportable Events and Provider Preventable Conditions Requirements
Serious Reportable Events (SRE) and Provider Preventable Conditions (PPC) must be reported to UnitedHealthcare Community Plan of Massachusetts at Critical_Incident_SCO@uhc.com.
Billing requirements and claim submission guidance for Federally Qualified Health Centers
Use this guide to ensure you’re following compliance requirements, billing correctly and avoiding common billing errors.
State news, bulletins and alerts
- 06.22.2026 - Medicaid: Updates to weight loss and obesity drug coverage
- 05.28.2026 - Medicaid: Weight loss and obesity drug coverage update
- 03.31.2026 - Serious Reportable Events and Provider Preventable Conditions requirements
- 02.20.2026 - Medicaid: Prior authorization, HCPCS coding and subscriber ID changes
- 02.20.2026 - Medicaid: What you need to know about recent dual-eligibility changes
- 02.10.2026 - 2026 D-SNP updates for Senior Care Options, One Care members
- 04.24.2025 - Zepbound and phentermine added to preferred drug list
News your way
Get news related to your role, specialty, health plan and state. When you subscribe to Network News, you can update your preferences to select what news you receive and how often.
Resources
Credentialing and attestation
For questions about credentialing and attestation, connect with us through chat 24/7 in the UnitedHealthcare Provider Portal.
Join our network
Join us in our commitment to simplifying the health care experience and delivering access to high-quality care. Become part of a network of health care professionals and facilities committed to helping people live healthier lives and making the health care system better for everyone.
To get started, select your entity type below.
Facility/hospital-based providers, group/practice providers and individually contracted clinicians
Learn about requirements for joining our network.
Behavioral health providers
Learn how to join the Behavioral Health Network, review Community Plan Behavioral Health information or submit demographic changes at Community Plan Behavioral Health.
Home- and Community-Based Services providers
Home- and Community-Based Services (HCBS) providers interested in joining the MassHealth network may request credentialing by contacting ma_cs_cc@uhc.com. Providers must submit a completed application and ensure all required information — including licensure and National Provider Identifier (NPI) number details is current. Upon approval, providers will be contracted and may begin serving members
Medicaid Managed Care Rule
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.
Member information: Current medical plans, ID cards, provider directories, dental and vision plans
Visit uhccommunityplan.com/MA for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.
Member plan and benefit information can also be found at uhccommunityplan.com/MA and member.uhc.com/communityplan.
CommunityCare
The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare feature in the UnitedHealthcare Provider Portal, which allows you to:
- Identify Medicaid recipients who need to have their Medicaid recertification completed and approved by the state in order to remain eligible to receive Medicaid benefits
- See a complete list of all members, or just members added in the last 30 days
- Export the roster to Microsoft Excel
- View most Medicaid and Medicare Special Needs Plans (SNP) members’ plans of care and health assessments
- Enter plan notes and view notes history (for some plans)
- Obtain HEDIS® information for your member population
- Access information about members admitted to or discharged from an inpatient facility
- Access information about members seen in an emergency department
For help using CommunityCare feature on the UnitedHealthcare Provider Portal, please see our quick reference guide. If you’re not familiar with UnitedHealthcare Provider Portal, visit our portal resources page.
Reporting health care fraud, waste and abuse
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 844-359-7736 or visit uhc.com/fraud to report any issues or concerns
UnitedHealthcare Senior Care Options plan
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 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.
Disclaimer
If UnitedHealth Group 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.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).