Back to Insights and Updates for ProvidersJune 2025

Update on referral requirement for home health agency care

Tufts Health Plan Senior Care Options  |  Tufts Medicare Preferred

In the November 2024 issue of Insights and Updates for Providers, Point32Health announced a number of benefit changes for the 2025 plan year for our Tufts Medicare Preferred and Tufts Health Plan Senior Care Options members, including a new requirement that referrals be obtained for home health agency care.

We want to offer an update concerning this change: In response to feedback from our provider partners, effective for dates of service beginning June 15, 2025 a provider/discharging facility order will satisfy this referral requirement. No additional referral from the patient’s primary care physician will be needed to initiate home health agency care.

Point32Health aims to provide our members with the best care in the most appropriate setting while minimizing any unnecessary administrative burden on the providers in our network who deliver that care. We hope this update helps to alleviate concerns and better facilitate efficient coordination of care processes.