We shared in the February issue of Insights and Updates for Providers that we’ve partnered with Home and Community Care Transitions to oversee certain prior authorization and utilization management review processes for various post-acute care services and home health care services for Tufts Medicare Preferred members in Massachusetts. 

This program is now live as of April 1, 2026, and we want to provide some additional clarity around the timeframe associated with the notification requirement for home health care services.

Notification of start of care required within five days

As we detailed in the original announcement, Home and Community Care Transitions manages the prior authorization and concurrent/continued stay review processes in skilled nursing facility, inpatient rehab facility/acute inpatient rehab facility, and long-term acute care settings, and providers are also required to submit notification of their patients’ start of care for home health care services to Home and Community Care Transitions. 

Please keep in mind that this notification must occur within five days of the start of care for home health care services.

While providers need to notify Home and Community Care Transitions within five days of the start of care to ensure they know the care has been initiated, the services aren’t subject to medical necessity review for the first 30 days. After the initial 30 days of home health treatment, prior authorization will be required through Home and Community Care Transitions, who will perform concurrent review, which includes clinical assessments for continued medical necessity. 

Additional information

You can find additional information about the Home and Community Care Transitions/Tufts Medicare Preferred program, as well as a number of useful resources, on the Home and Community Care Transitions page in the Vendor programs section of Point32Health’s provider website.