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COVID-19 Health Update

Health Update April 22, 2020

Social Determinants COVID-19 Update: More help available

  • Housing: Eviction/Foreclosure Moratorium Bill enacted April 20, 2020! –Among other protections it prevents eviction for non-payment of rent or for other causes that do not affect the health or safety of others, but does not relieve tenants from the obligation to pay rent. It also protects owner-occupied properties with 4 or fewer units from foreclosure. The protections end in 120 days or 45 days after the end of the emergency period (whichever is sooner). More information here.

Money

Unemployment income. The Dept. of Unemployment Assistance is now taking applications from workers not normally entitled to unemployment who lost work due to COVID-19 (Pandemic Unemployment Assistance). More information on How To Apply for PUAMore information on Unemployment Insurance

Tax rebates. Non-filers who receive Social Security, SSI or VA benefits will now automatically get one-time IRS “economic impact payment” (stimulus rebate)-but those eligible for added $500 for a qualifying child under age 17 must complete non-filer tool ASAP to receive $500 in 2020. More information here

Food & Nutrition- Massachusetts Pandemic EBT-Extra Food Benefit for Children –starting in late April families with school age children on SNAP or receiving free or low cost meals will be mailed EBT cards to use to buy food. More information on applying for SNAP & other help with food.

Eligibility for MassHealth, Health Safety and the Health Connector 

New applicants

Expanded use of self-attestation to supply proof needed at application. In an April 7, 2020 Eligibility Operations Memo, MassHealth announced that “effective immediately” it will be accepting self-attestation of most eligibility factors including income and assets for both the HIX/ACA-3 and MA-21/SACA-2 applications. 

·         What does MassHealth mean by self-attestation?  Applicants who are required to send proof can send a sworn statement attesting to the facts to be proved such as the amount and source of current income and assets. Applicants should also be able to supply proof by calling Customer Service and attesting to the facts over the telephone. MassHealth has told us it plans to supply more detailed guidance and a template for sworn statements soon. Meanwhile, there are existing affidavits to prove state residence or 0-income at the end of the Member Forms posted here which applicants can use as a model for preparing sworn statements.  

·         What this means for our patients and clients

o   Effective April 7, 2020 any applicant in pending status should at least be able to submit a simple sworn statement of the information needed to complete an application and obtain an eligibility determination. Those who can’t do this should be able to attest by telephone. Applicants should no longer have eligibility held up while trying to get third-party proof with all the practical difficulties of doing that during the emergency period.

o   We are still urging MassHealth to accept the sworn statements on the application itself as a sufficient self-attestation.

o   These new policies also apply to the Health Safety Net

·         Why doesn’t self-attestation apply to proof of citizenship and immigration status?  The rules on proof are usually left to state Medicaid agencies, but proof of citizenship or an eligible immigration status is federally regulated. Under federal rules, waiting for proof of citizenship or immigration status should not hold up an eligibility determination.  If an applicant’s statements can’t be immediately verified by data matching, the Medicaid agency must make a decision based on the sworn application and allow 90 days for US citizenship or immigration documents to be submitted.  According to CMS, during the COVID-19 emergency, US citizens and eligible immigrants cannot have their Medicaid benefits terminated for failing to supply proof by the deadline; they are protected by the moratorium on Medicaid terminations.

·         What does this mean for ConnectorCare? This new policy does not apply to ConnectorCare, but under the rules that apply to the Health Connector, waiting for proof should not hold up an eligibility determination.   If an applicant’s statements can’t be immediately verified by data matching, the Health Connector must make a decision based on the sworn application--except if data shows an applicant is already insured by Medicare or Medicaid-- and allow 90 days for proof to be submitted. During the COVID-19 emergency, the Health Connector will not terminate or reduce subsidized insurance benefits for failing to supply proof by the deadline. 

Table showing how MassHealth & the Health Connector treat new payments authorized by the CARES Act

·         The one-time IRS Recovery Rebate/Stimulus Payment/Economic Incentive Payment is not counted as income and, for 12 months after receipt, is not counted as an asset

·         The $600 per week added payment from the Dept. of Unemployment Assistance under the CARES Act is not counted as income by MassHealth but is counted by the Health Connector in determining eligibility for ConnectorCare and Premium Tax Credits.

·         Any other unemployment compensation payments are counted as income by both MassHealth and the Health Connector

Current members

·         MassHealth, Health Safety Net and CMSP members are protected from losing coverage during the COVID-19 emergency. For more information on the termination moratorium, see the document posted here with links to the MassHealth policy, federal law and two sets of FAQs from CMS.  Anyone enrolled on March 18 or later is  protected unless someone moves out of state, dies or asks that their benefits end. No closing based on returned mail, increased income, nonpayment of premiums, turning 65 and not meeting the asset test, turning 21 and no longer meeting the income test, failure to return paperwork by deadlines, etc

·         The Health Connector will not terminate coverage or increase costs based on failure to return information by a deadline. However, this is not full protection. The Health Connector will still act on reported changes even if it means termination of coverage or increase in costs. 

·         Both MassHealth and the Health Connector have policies for granting a premium waiver based on financial hardship. MassHealth will be applying its procedures more liberally during the emergency period. Anyone who was terminated from MassHealth before March 18 for nonpayment of premiums and cannot be reinstated until addressing the arrearage should call MassHealth Customer Services about a premium hardship waiver. Anyone having difficulty keeping up with current premiums in either MassHealth or the Health Connector, should call that agency’s Customer Service. 800-841-2900 (MassHealth) or 877-623-6765 (Health Connector).

Access to Services

MassHealth fee for service and managed care and ConnectorCare plans have liberalized policies on access to services in many ways including coverage for COVID-19 testing and treatment with no cost-sharing, expanded use of telehealth services, procedures for extending expiring authorization periods, authorizing a 90 day supply of prescribed medicine, payment for out of network services for COVID-19 related emergency room and inpatient services and more.

 

Help applying for and enrolling in coverage

·         Enrollment Assisters have more options for obtaining client/patient signatures to accommodate working remotely. See March 30 Assister Guidance We are waiting for updated Guidance eliminating the requirement of an additional confirming email

·         New Health Connector resources for the unemployed: Social Media Tool Kit to help spread the word; a new webpage with all the information someone would need to get into coverage after having lost employment/employment-based coverage. Flyers

in English, Spanish, Portuguese, and Chinese.

 

 

These and other changes are summarized in our google doc

 
 
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