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Health-Law-Announcements's Blog

The latest health law updates for advocates and social service providers in Massachusetts.

Much higher premiums tied to plan choices even for the very poor

Bad news from the Connector at yesterday's board meeting. Since the Connector started offering coverage in 2006, its enrollees below the poverty level, like MassHealth enrollees, have been able to choose from any available managed care organization (MCO) with no premium charge. No more. People at all income levels will still have access to at least one "affordable" MCO -- for people below 150% FPL, affordable means no member premium contribution--but other choices may mean substantially higher premiums.

A lot has been going on this summer

See earlier health announcements for good news on changes in MassHealth MCO standards for approving drugs that can cure Hepatitis C (effective August 1) and a new state law mandating MassHealth (and insurance) coverage for lipodistrophya side effect of early HIV treatments (effective November 1).

And now for more news not all of it good.

Treatment for Lipodystrophy: It's Now the Law!

(information from GLAD)

The attached file is the revised MLRI MassHealth Income Chart, reflecting changes in the Health Safety Net that went into effect on June 1st.

A November 2015 federal regulation requires a "transparent data-driven process for states to document whether Medicaid payments are sufficient to enlist providers to assure beneficiary access to covered care and services." MassHealth has developed a draft plan and released it for public comments by August 20, 2016. 

In January, EOHHS announced plans to implement a Managed Care lock-in policy effective October 1, 2016.  This would restrict the ability of MassHealth members to freely change managed care plans. Despite opposition from most consumer, legal aid and disability rights groups, EOHHS is moving full speed ahead to implement this change. 

Proposed rules are posted on the MassHealth website with a publication date of July 20, 2016.  A public hearing is scheduled for Wed. August 10 at 10 am in Boston. Written comments are also due by 5 pm August 10. 

Last night the conference committee report on the state fy 17 budget was announced.  We had been monitoring the committee on the issue of the Health Safety Net cuts.  The Senate had placed a moratorium on the cuts until the Spring of next year, while the House planned to study the cuts.  Both the moratorium and the study were held in conference by the conferees, which essentially means they are dead.  

Last night the Senate adopted a redrafted amendment by Senator Lewis which puts the eligibility cuts in the Health Safety Net off until next April at the earliest.  Here is the amendment language.

Messrs. Lewis, Keenan, Moore and Brady, Ms. L'Italien, Messrs. Donnelly, Eldridge, Rush, Barrett, Montigny, Humason, Timilty, McGee, Boncore, Lesser and deMacedo moved that the proposed new text be amended by inserting after section 77 the following section:-

The Senate Ways and Means budget included $15 million (of the $30 million requested) but did nothing to reverse the harmful eligibility changes scheduled to be implemented June 1st. Senator Lewis has agreed to file an amendment to protect eligibility and preserve full funding for the Health Safety Net.

Please call your Senator today and ask him or her to co-sponsor Senator Lewis's amendment.

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".


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