Aug 17, 2022 Health Update & Save the Date for HCWG Zoom Meeting on Aug 24

Important health provisions in the Inflation Reduction Act (IRA) signed into law on Aug 16, 2022:

·        IRA extends the more generous premium tax subsidies originally enacted by ARPA for 2021 and 2022 for another three years. This will protect people on ConnectorCare with income of 300% FPL or less and those with higher incomes from seeing a significant rise in their insurance costs in 2023. It will also ease the transition for people moving from MassHealth to the Health Connector after the Public Health Emergency ends.

·        IRA will also reduce drug costs for Medicare beneficiaries over time including by authorizing HHS to negotiate rebates for the Medicare Pt D drug benefit, and, starting in 2025, limiting total out of pocket costs for Pt D drug coverage to $2000.

·        More information here.

Sec Becerra signals extension of COVID-19 Public Health Emergency (PHE) by not yet giving the states’ the promised 60 days advance notice that it will end Oct 15, 2022 (or the curious incident of the HHS Secretary in the night).

On Aug 1, 2022 MassHealth stopped downgrades from one type of MassHealth to another with fewer benefits

·        In preparation for future unwinding and Open Enrollment 2023, MassHealth will not only be protecting MassHealth members from losing all MassHealth coverage during the COVID 19 PHE, it will no longer be reducing the benefits for people who now qualify for a different “tier” of MassHealth benefit with fewer benefits.

·        MassHealth authorized these changes between “tiers” despite the COVID-19 coverage protection in a policy announced last year.

·        The new policy was implemented Aug 1, 2022 and we are told updated Eligibility Operations Memos will be released shortly. MassHealth tells us they do not intend to apply this change in policy retroactively.

MassHealth received clarification from CMS that the Economic Incentive payments (EIP) from the IRS during COVID 19 will not be countable assets at any time.

·        There is a federal statute providing that benefit programs should not treat tax credits like the EIP as countable income and should not treat these payments as assets for at least 12 months from receipt. In August 2021 MassHealth announced that in addition to that exclusion,  it would not count the EIP as an asset for the duration of the PHE. At the same time, it asked CMS for an emergency state plan amendment to not count the EIP as an asset for the duration of the PHE, and to not count certain other payments either.

·        On July 29, 2022 CMS acted on the request. According to MassHealth, CMS determined that the EIP should never be treated as an asset during the PHE or afterwards under existing law, therefore it approved only the requests related to other payments. 

·        MassHealth will be releasing written guidance on all this soon.

CMS partially approved the June 2021 amendments to the current 1115 Demonstration on Aug 11, 2022

·        CMS authorized payment of Medicare Part B premiums for MassHealth Standard members with income of 135-165% FPL, and

·        Managed care community support programs for people who were formerly incarcerated.

·        MassHealth extended postpartum coverage from 60 days to 12 months eff April 1, 2022 (See, MassHealth Eligibility Ops Memos 22-09 and 22-07) and withdrew its amendment request to implement this sooner as moot.

·        Other requests including an amendment to authorize payment of Medicare Part B premiums for CommonHealth members with income over 135% FPL with no asset test are still under review according to CMS.