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Health-Law-Announcements's Blog

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

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.

1. MassHealth Renewals

Extension to Oct 16 for people with disabilities.

On August 1, 2015, the Office of Medicaid notified over 30,000 households containing at least one member with a disability that they had to submit a reapplication by Sept 15, 2015 in order to remain eligible for MassHealth.

This reapplication deadline applies to over 60,000 individuals.

We learned today that the number of reapplications filed to date is on the low side. Termination notices will not go out on 9-15; there will be at least a short grace period. But terminations will happen. Over 200,000 people were terminated in July.

1. MassHealth Renewals.

MassHealth is about half-way through the process of renewing eligibility for 1.2 million beneficiaries before the end of 2015.

Renewals for People with Disabilities Underway-Workaround needed for some adults

MassHealth just released preliminary results on the first 500,000 MassHealth beneficiaries to have their eligibility renewed in the new computer eligibility system. It's attached.

The positive spin is that 80% of people who were required to reapply, responded in some way, and that of those who completed an application 83% were still eligible for MassHealth.

1. MassHealth is about half-way through its renewal process for 1.2 million members.  

Fallon Total Care, one of the plans contracted with MassHealth and the Centers for Medicare and Medicaid Services (CMS) to provide One Care as part of the Massachusetts capitated Financial Alignment Demonstration, has decided that they will be leaving One Care as of September 30, 2015. Fallon Total Care provides One Care coverage in Hampden, Hampshire, and Worcester counties to approximately 5,475 individuals.

LANGUAGE ACCESS CONFERENCE:  Beyond Service, Toward Empowerment

Every day in Massachusetts limited English proficient (LEP) individuals face countless barriers when accessing needed public services and navigating the legal system. Changing demographics and increasingly diverse immigrant and refugee populations profoundly impact the way our state’s institutions meet the needs of our most vulnerable communities. 

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