Submitted by Health-Law-Anno... on 12/10/2021 - 9:55am.
Thanks to those of you who participated in Wednesday's Health Care Working Group meeting. We're passing on info related to several of the agenda items at that meeting:
1. Extension of reply deadline on EOHHS Equity RFI to Jan 15, 2022
2. Copy of Kara's slide deck on gender-affirming care
3. Priority fair hearing issues -the top three from a long list
1. One item on the agenda was the EOHHS RFIs on member engagement & health equity accountability --I'm happy to report EOHHS just posted an extension of the deadline to reply. The new deadline is Jan 15, 2022. https://www.commbuys.
com/bso/external/bidDetail. sdo?docId=BD-22-1039-EHS01- EHS01-68839&external=true& parentUrl=close
2. At the meeting, Kara Hurvitz of HLA provided a great overview of access to gender affirming care for MassHealth members --her slides are attached. Thank you Kara!
3.We also went over a long list of questions, problems, and recommendations related to the fair hearing process. Time was short but we had a good discussion & these are my notes on what seemed to be the consensus on the top three priority fair hearing issues. We'll let you know when we get a date for the long-awaited meeting with MassHealth on fair hearing issues.
- Continuing a longer appeal period after the COVID emergency period ends. (Current state rule only allows 30 days. Temporary COVID policy since April 2020 allows 120 days). Many examples of need for more time e.g. PCA consumers who didn't realize a "modification" was a reduction in hours until their PCAs tell them they are not getting paid. Many of us also supplied examples in written comments on the proposed extension of the 1115 which did not mention the appeal period..
- A more reasonable standard for granting requests for rescheduling a hearing. Many examples of need e.g. pro se appellant needing more time to find legal aid, legal aid first retained shortly before hearing date, agency delay supplying case file for review before hearing. Also several people cited policies in DTA and SSA that either allowed one reschedule as a matter of course or had more liberal policies on what constitutes good cause.
- Readily available information on where and how to obtain the case file from the many different MassHealth agents making decisions subject to appeal. Many examples of difficulty identifying the entity that has the case file, determining the kind of release or authorization form it requires to release a case file, and getting a case file that is complete and in adequate time to prepare for a hearing.