Health Announce: Nov. 12, 2024

11/13/24

Good Afternoon!

Yesterday was Veterans Day. First dedicated to honor the Veterans of World War I, Veterans Day was initially observed as Armistice Day and marked the moment in 1918 when hostilities between the Allied Nations and Germany stopped – on the 11th hour of the 11th day of the 11th month. After World War II, Congress changed the name to Veterans Day to honor all Veterans and recognize their service and sacrifice.

Approximately 4.3% of Massachusetts residents are Veterans; 28.2% of Veterans have a disability; and 6.2% of Veterans earn income below the poverty line. Massachusetts Veterans in need of legal assistance on eviction/homeless prevention, accessing financial and medical benefits, or securing equitable divorce, among other things, can find legal resources here. Other state programs and benefits for Massachusetts Veterans can be found here.

Topics for this week’s Health Announce:

  1. Time Change! Wednesday’s My Ombudsman Program listening session now at 11 am.

  2. Commonwealth Care Alliance’s One Care and SCO enrollment freeze continues.

  3. Significant provider network changes to Health Connector members enrolled in Tufts Health Direct.

  4. Last Health Care Workgroup meeting of 2024 to be held on Wednesday, December 11.

Be well, 

Jennifer Hotchkiss Kaplan

Senior Health Law Attorney

Massachusetts Law Reform Institute

Time Change! Wednesday’s My Ombudsman Program listening session now at 11 am.

This Wednesday, November 13, 2024, from 11:00 am to 12:30 pm, MassHealth is hosting an online, public listening session about the My Ombudsman Program.  The contract will be going through a re-procurement, and MassHealth seeks stakeholder feedback and ideas about the My Ombudsman Program. Specifically, MassHealth provided the following questions for stakeholders to consider:

  • Have you heard of My Ombudsman?

  • What has worked well with the My Ombudsman program?

  • What could be improved?

  • Or, in general, what are the most important parts or characteristics of an ombudsman program to keep in mind moving forward?

  • Should potential bidders be limited to community-based organizations, as now?

  • Should MassHealth keep the name, “My Ombudsman”?

We encourage advocates to attend the listening session and comment, specifically on the advantages to keeping the contract with non-profit, community-based organizations. The link to the listening session can be found here.

Commonwealth Care Alliance’s One Care and SCO enrollment freeze continues.  

As of November 1, 2024, there have been no new enrollments for the One Care and Senior Care Options (SCO) plans provided through Commonwealth Care Alliance (CCA) for the indefinite future.  Members currently enrolled in CCA One Care and SCO plans should not experience any issues accessing plan services. Individuals interested in One Care and SCO can enroll in one of the other plan providers. 

MassHealth is closely monitoring the situation, and no problems are anticipated. If advocates do hear of any issues, such as CCA members having trouble accessing services, please send an email with the details to Jeni Kaplan, jkaplan@mlri.org.

Significant provider network changes to Health Connector members enrolled in Tufts Health Direct.

Last week, Tufts Health Direct announced that as of January 1, 2025, its Health Connector members will no longer have access to hospitals and providers in the UMass Medical Center network or the Boston Children’s Hospital network.  Current Tufts Health Direct Health Connect members have the option of (1) remaining with Tufts Health Direct and finding new providers or (2) switching to a new plan that covers UMass Medical Center and/or the Boston Children’s Hospital during the current open enrollment period. To avoid any interruption in care provided within the UMass Medical Center network or the Boston Children’s Hospital network, members will have to complete the open enrollment process and pay the first premium on the new plan by December 23, 2024.

Last Health Care Workgroup meeting of 2024 to be held on Wednesday, December 11.

The November and December Health Care Workgroup (HCWG) meeting will be combined into one HCWG meeting, to be held on Wednesday, December 11, 2024, at 3 pm.  If you have any topics or issues you’d like to put on the agenda, please let me (jkaplan@mlri.org) or Kate (ksymmonds@mlri.org) know.