Personal Care Attendant (PCA)

MassHealth has started posting fair hearing decisions on its website. As of February 2024, there are over 2400 decisions from July -Sept 2023 currently posted with a filtering feature by topic. 

This May 2022 updated memo by MLRI provides contact information for MassHealth's Third Party Administrator for certain Long Term Services and Supports (LTSS), Optum. Optum began making prior authorization decisions for PCA and certain other LTSS services in the summer of 2017. The updated…

This complaint seeks judicial review of the MassHealth Board of Hearings' final decision denying the appellant a fair hearing to contest a 50% reduction in her PCA hours because the reduction had been requested by  the  personal care management agency (PCM)  and approved…

Pursuant to a Jan 2019 record request, we obtained a copy of two subregulatory documents developed by MassHealth regarding Personal Care Attendant (PCA) services. Neither document is new, but both are currently in use at least as of Jan 2019. One is the Time for Task Guidelines, dated 11-16-11,…

This is a redacted Complaint seeking judicial review of the Board of Hearings final action denying the appellant's motion to vacate the dismissal of his appeal. The issue was whether he had good cause for his failure to appear. His counsel, Nancy Lorenz of GBLS, reports that the agency agreed to…

MassHealth has proposed rules to exclude only family members who are legally liable for the support of the MassHealth recipient, such as a spouse or the parent of a minor child,  from being personal care attendants.  This is a liberalization of the current rule which excludes family members who are…