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May Health Updates

1. Health Safety Net changes.  The administration has published a final rule with a June 1, effective date to roll back eligibility for the Health Safety Net. Efforts to override the regulatory cuts through legislation are ongoing and are now focused on the Senate which will be coming out with its budget bill in a few weeks time. Yesterday Mass. Senior Action members rallied at the State House asking legislators to "keep us covered".

Links:

A summary of the new rules & effective dates is here:

http://www.masshealthmtf.org/news/announcement-about-health-safety-net-c...

 

ACT Coalition fact sheet: attached

News story on MSAC Rally:https://www.itemlive.com/2016/05/04/seniors-assessment-no-cuts-no-buts/

2. MassHealth 2016 Renewals. After the long effort of transitioning most MassHealth members under age 65 from the old MA-21 eligibility system to the new HIX/hCentive system, in April, MassHealth started annual renewals in the new system. There are a lot of changes in the way renewals will be done in the new system:

  • if a data match allows for auto-renewal, members will not need to take any action to be renewed in the same or better coverage.
  • If a form is needed:
    • it can be completed on line through an individual's account, by telephone, or by completing & returning the paper renewal form. 
    • the form will be pre-populated with the information from the last application.
    • if the form is not returned, and data was available, MH will make a new decision based on the data rather than just terminate coverage for not returning the form.
    • if termination does occur, a person can be reinstated retroactively to the date of termination if the renewal form is returned within 90 days. 
    • people who indicated at application that their preferred language is Spanish should not be renewed until the summer when Spanish notices will be available 

Help is available from 1600 application assisters around the state & MassHealth has scheduled a series of enrollment events.

A summary of how to renew & a schedule of MassHealth enrollment events is here:

http://www.mass.gov/eohhs/consumer/insurance/masshealth-member-info/masshealth-renewal.html

The rules describing the renewal process are at 130 CMR 502.007

3. Health Safety Net expiring for people eligible for ConnectorCare who fail to enroll.

Existing HSN rules provide that if a person is found eligible for ConnectorCare, their HSN coverage is only temporary to allow them time to enroll. If they have not enrolled in ConnectorCare, after 90 days, their HSN will only cover dental. Due to system issues, this rule has only recently been enforced. Over 100,000 people were notified that they had until April 1 to enroll in ConnectorCare or their HSN will drop to just dental.  As of late March 2016, only 19,000 of those 100,000 people had enrolled.

Because the Connector is now in a closed enrollment period, those people who did not enroll by April will not be able to enroll now unless they qualify for a special enrollment period.Special enrollment periods include failure to enroll based on based on misinformation or errors by MassHealth, the Connector, application assisters or navigators. People with limited English who did not get accurate information in their language may have a basis for enrolling late based on errors like this. The denial of a special enrollment period should be in writing and is appealable.

Information about special enrollment periods is available on the Connector's website here:

https://www.mahealthconnector.org/get-started/special-enrollment-period

Going forward, new applicants found eligible for ConnectorCare will have 60 days from being found eligible to enroll, but if they fail to enroll, their HSN coverage will drop to dental 90 days from application.

File Attachment: 
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File HSN General Fact Sheet (1).docx33.96 KB