Eligibility Updates & Reminder of HCWG this Wednesday


Reminder: Health Care Working Group meeting this Wednesday January 24, 3-4:30 pm.

It should already be in your calendar (4th Wed of the month)

Join Zoom Meeting https://us06web.zoom.us/j/89190732365?pwd=b0FUaFNhTFAzeEJZNzlVYmhGSEJHdz09


·Redetermination update

·New Doula benefit

·MassHealth issues for new arrivals in EA Shelter

·New Fair Hearing Pre-Hearing Resolution Process

·Language access

2024 Eligibility Updates

2024 FPLs. Published in Fed Reg Jan 17, 2024. In 2024 100% FPL for a family size of one  increases from $1215 to $1255 per mo. 2024 FPLs take effect in MassHealth on March 1, 2024.

2024 SSI amounts take effect Jan. 1, 2024. DLC’s 2024 SSI Table is here.  MassHealth income standards for the Home and Community Based waiver programs and PACE are based on 300% of the SSI Federal Benefit Rate and take effect January 1. The 2024 rate for these programs for one person increases from $2742 per mo to $2829 per mo.

Effective March 1, 2024 there will no longer be an asset test for the Medicare Savings Program! These changes are now in the regulations at 130 CMR 519.010 and 519.011.

Effective with coverage starting Jan. 1, 2024, the upper income limit for ConnectorCare has increased from 300% FPL to 500% FPL. The Health Connector uses the 2023 FPLs for coverage in 2024.  Also new for ConnectorCare are federal rule changes one of which automatically grants a 60-day extension to the current 90 days permitted for a consumer to resolve an income verification issue before facing a reduction or loss of the advance premium tax credits.

12-months MassHealth continuous eligibility for children and youth under 19 takes effect Jan 1, 2024 pursuant to federal law. MassHealth also extended 24 months continuous eligibility for people the homeless in Dec 2023 and 12-month continuous eligibility for people released from incarceration in April 2023 pursuant to the 1115 demonstration. The agency expects to release written guidance about all three types of continuous eligibility sometime in January 2024.

More translations: The following MassHealth forms and publications previously only available in English and Spanish are now translated into Simplified Chinese, Brazilian Portuguese, Haitian-Creole and Vietnamese: Authorized Rep Designation form, Permission to Share Info form, Member Book (under 65/MAGI), Senior Guide (65 & over/non-MAGI), Fair Hearing Form.

There is a new e-submission option for older adults to report a change to MassHealth:

If you are 65 or olderyou can fill out the MassHealth Report a Change Form online or mail or fax the form to us.

System Release 28 (Dec 2023)

In the news…

Governor Healey releases her FY 2025 budget on Jan 24, 2024. In Dec she announced 9C cuts in the FY 2024 budget including $294,000,000 from the 4000-0700 MassHealth Fee for Service account. According to the Administration the MassHealth cut was largely based on decreased utilization forecast for FY 2024 not on any reduction in eligibility standards or covered benefits. The 9C cuts will hurt MassHealth members on TAFDC who will lose the promised increase in cash benefits.

Steward Health System which owns 10 hospitals in MA and as of July 2023 had 127,000 MassHealth members enrolled in its ACO is in trouble. Two of its hospitals are temporarily closed, Norwood hospital due to flooding in 2020 and Brockton hospital due to a fire in 2023. In December 2023 it announced plans to close Mt. Sinai Rehab Hospital in Stoughton by April 2024. The Globe reports more bad news on the horizon in 2024.

Steward Health Care’s financial issues could spell catastrophe for the state

By Jessica Bartlett Globe Staff,Updated January 19, 2024