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Health Updates

August 18, 2021 Health Updates

On Aug 18, 2021 MassHealth Released Its Draft 1115 Waiver Renewal Proposal for Comment

MassHealth has operated under a comprehensive 1115 demonstration since 1997 affecting most of its members under age 65. The current demonstration period expires in June 2022 and MassHealth will be submitting a proposal to extend the 1115 Demonstration this fall. On August 18, it released the draft proposal for comment. The Demonstration, if approved by CMS, will govern the design of the MassHealth program for the next 5 years. 


EOHHS will accept comments on the proposed 1115 Demonstration Extension through 5pm on September 20, 2021.


The proposed Extension; information on public listening sessions on September 9 and September 15; details on where to submit comments; and additional relevant information are available at:


More to come on key issues for comment. This is a link to eligibility & access recommendations submitted to MassHealth by MLRI, GBLS, and HLA in April 2021, prior to release of its draft proposal.  

On August 13, 2021 CMS released additional guidance to the state Medicaid agencies about resuming normal operations after the Public Health Emergency (PHE) ends

The updated guidance makes two welcome changes to earlier guidance released by the prior administration in Dec 2020. The updated guidance extends the time states have to resume normal operations from 6 months to 12 months, and no longer allows states to simply issue adverse decisions based on redeterminations made during the PHE  Specifically, the updated guidance

  • Extends the timeframe for states to complete pending eligibility and enrollment work to up to 12 months after the PHE ends.
  • Requires states to complete a redetermination of eligibility after the PHE for all beneficiaries prior to taking any adverse action.

On Aug 13, 2021 MassHealth announced that it will not be counting IRS stimulus payments received more than 12 months ago as countable assets during the national public health emergency (PHE).

The announcement is posted here. The PHE is expected to continue until the end of the year. 

When helping anyone subject to an assets test to apply or renew their eligibility who appears to have assets in excess of the $2000/$3000 ceiling, check to see if they still have any amounts left from the three rounds of stimulus payments and be sure these amounts are not counted toward the resource ceiling.