Health-Law-Announcements's Blog

Many provisions of Chapter 258, a 2014 law addressing access to substance use recovery services are taking effect in 2015.

1. An updated provider bulletin from MassHealth clarifies that pursuant to the new law, effective Oct 2015, neither MassHealth nor its managed care plans can require prior authorization for acute treatment e.g. admission to a detox facility or for clinical stabilization services . The treating clinician's judgment on medical necessity rules at least for acute care and  the 1st 14 days of clinical stabilization.

1. Attached and posted in the health section of masslegalservices.org is an updated version of MLRI's paper summarizing the immigrant eligibility rules in MassHealth and the Connector. The rules have not changed since January 2014. The revisions are attempting yet again to make incomprehensible rules comprehensible. Still bewildered? Please let Vicky know for future revisions.

1. Substance use disorder services 

Last year a state law improving substance use disorder services was enacted (c. 258 St. 2014). A provision requiring MassHealth & MassHealth managed care plans to cover detox and up to 14 day crisis stabilization services without prior authorization took effect on Oct 1, 2015.

On August 1, 2015, the Office of Medicaid notified over 30,000 households containing at least one member with a disability that they had to submit a reapplication by Sept 15, 2015 in order to remain eligible for MassHealth.

This reapplication deadline applies to over 60,000 individuals.

We learned today that the number of reapplications filed to date is on the low side. Termination notices will not go out on 9-15; there will be at least a short grace period. But terminations will happen. Over 200,000 people were terminated in July.