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Health-Law-Announcements's Blog

The latest health law updates for advocates and social service providers in Massachusetts.

Not wasting any time, or even waiting for the beginning of the next fiscal year, the Baker Administration has come out with draft regulations at http://www.mass.gov/eohhs/docs/eohhs/eohhs-regs/hsn-613-redline.pdf  which dramatically cutback on  Health Safety Net free-care for the poor.

The Governor'€™s FY 2017 Budget Proposal: Preliminary Analysis of Selected Cash and Nutrition Assistance, Child Care, Child Welfare, Health Care, Homelessness Services, Housing, State Earned Income Tax Credit and Legal Services Items

On January 27, 2016, Governor Baker released his budget proposal for fiscal year 2017 (FY 17), which is referred to as House 2. MLRI offers this preliminary analysis of selected budget topics impacting low-income residents of the Commonwealth.

Download MLRI's preliminary analysis from this link:

Attached in English and Spanish is a notice of 4 upcoming enrollment events where people needing to apply or reapply/renew MassHealth coverage can get in-person help from MassHealth and Connector staff and certified enrollment assisters.  If your organization serves people in Worcester, Dorchester, Hyannis or Malden, please consider posting the flyer in your waiting room and/or distributing it to community groups with which you work.
 
  • Jan. 21 Worcester
  • Jan. 27 Dorchester
  • Feb 4 Hyannis

Apologies for the long post, a lot is happening in the world of eligibility and enrollment in MassHealth and ConnectorCare. As always please let Neil Cronin or Vicky Pulos at MLRI know how these changes are affecting your clients.

Four new enrollment events in Jan and Feb 2016: in person help from MassHealth and Connector staff to apply, re-apply and enroll in Worcester, Dorchester, Hyannis and Malden

Happy New Year to Health Advocates Everywhere,

We will be sending out an update on Open Enrollment, the MassHealth Renewal-Reapplication process and other developments soon.
 

Many provisions of Chapter 258, a 2014 law addressing access to substance use recovery services are taking effect in 2015.

1. An updated provider bulletin from MassHealth clarifies that pursuant to the new law, effective Oct 2015, neither MassHealth nor its managed care plans can require prior authorization for acute treatment e.g. admission to a detox facility or for clinical stabilization services . The treating clinician's judgment on medical necessity rules at least for acute care and  the 1st 14 days of clinical stabilization.

Today is the first day of open enrollment for people who are already enrolled through the Connector and want to change plans in 2016 and for people who want to obtain new coverage through the Connector for 2016.  Open enrollment is for people who don't already have coverage through MassHealth, Medicare or an employer and want to purchase a nongroup plan either through the Connector or directly from a health insurance company.

1. Attached and posted in the health section of masslegalservices.org is an updated version of MLRI's paper summarizing the immigrant eligibility rules in MassHealth and the Connector. The rules have not changed since January 2014. The revisions are attempting yet again to make incomprehensible rules comprehensible. Still bewildered? Please let Vicky know for future revisions.

Attached are the updated Federal Poverty Standards for the Connector Programs (Connector Care and Qualified Health Plans) for the Open Enrollment period beginning November 1st .

The actual effective date for eligibility purposes is January 1st, but enrollment for January starts in November.

1. Substance use disorder services 

Last year a state law improving substance use disorder services was enacted (c. 258 St. 2014). A provision requiring MassHealth & MassHealth managed care plans to cover detox and up to 14 day crisis stabilization services without prior authorization took effect on Oct 1, 2015.

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