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Instructions: Please enter all required information in blank spaces provided below and sign the 2026
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How to use or fill out the RY2018 MassHealth Acute Hospital Pay-for-Performance Program Form
Ease of Setup
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the required hospital information in the designated fields, including HOSPITAL NAME, MASSHEALTH PROVIDER ID, and HOSPITAL STREET ADDRESS. Ensure all entries are accurate.
- Continue filling out the CEO NAME and PHONE number. This information is crucial for verification purposes.
- Review the data accuracy and completeness requirements outlined in the form. Make sure you understand what needs to be submitted for compliance.
- In the Measures Exemption section, mark an 'X' in the blank spaces next to any quality measures that do not apply to your hospital for each quarter.
- Finally, ensure that you sign and date the form at the bottom. This certifies that all provided information is true and complete.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2018 | 4.8 Satisfied (88 Votes) |
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