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Fwd: MassHealth Update - Friday, 3/24/17

Please see the MassHealth alert below written in High Bureaucratese.  Apparently there was a glitch from an unspecified date that was detected in early March and fixed on March 17 affecting an unspecified number of people being redetermined or under deadlines to return verification documents that resulted in cases being closed without notice. 

The alert says that starting this week, MassHealth will be reinstating benefits back to the date of the no-notice closing and issuing new 14-day advance notices of termination. 

Members (and providers) would have become aware of the problem when members tried to access services and were told by their providers that their MassHealth is no longer active; providers may have also been denied payment for services provided during the no-notice termination period.

According to the alert, anyone affected should have their benefits retroactively restored.  However, the MassHealth alert indicates the glitch was in the notice not the underlying termination decision.  So these members will all need to take action to retain their terminated- restored-soon-to-be-terminated again benefits.

After benefits are restored and an advance notice of termination is mailed...

If a termination is incorrect, members can retain their benefits and avoid gaps in coverage by appealing before the date of the closing. If the termination is for missing information, they should also supply the missing information.

Without an appeal, a member who remains eligible will have benefits restored 10 days prior to the date that MassHealth receives the missing information. However, the member will have to wait for the missing information to be processed before MassHealth takes action.  If the missing information was a redetermination form, an eligible person who returns the missing form within 90 days of termination, should have benefits restored back to the termination date; this rule is at 502.007(C)(2)(b)(iii) and 516.006(C)(2)(b)(iii).

Please let us know if your clients affected by this glitch have trouble getting benefits restored. 

Vicky

---------- Forwarded message ----------
From: MA Health Care Training Forum <mtf@umassmed.edu>
Date: Fri, Mar 24, 2017 at 2:38 PM
Subject: MassHealth Update - Friday, 3/24/17

MassHealth Notice Issue in the HIX

Earlier this month, MassHealth learned of an issue with the HIX system that caused certain notices to not get generated for batch actions (not affecting online user activities).  As a result, MassHealth proactively stopped all related batch processes until this issue was researched and fixed. Batch processes include mass redetermination and RFI closings and approvals.

The system was fixed on March 16th and these processes are back in production. 

MassHealth is now working on generating notices for members impacted prior to the system fix. This work includes reinstating coverage for the members who did not receive a termination notice.  This will restore benefits back to the date of the HIX closing. These reinstatements should complete early next week. We will then re-initiate the closing with the appropriate notice and 14-day appeal timeframe.

We apologize for any inconvenience this may have caused our members. 

Sincerely,

MassHealth