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MassHealth services for children with Autism & update on MassHealth renewals

1. Applied Behavior Analysis for MassHealth members under age 21.  ABA providers can apply to MassHealth to enroll as a provider and get prior authorization to provide services NOW. Also, for children and young adults (under 21) enrolled in private insurance with the Partnership for their secondary MassHealth behavioral health services, providers can start billing for co-pays and deductibles for dates of service after May 18.  Starting October 1, ABA services will be available through MassHealth Managed Care Plans and the Partnership.
 
See the attached announcement from the Autism Insurance Resource Center for more information.
 
2. MassHealth Renewals Phase 1: we don't have the numbers yet. 
 
We haven't yet gotten the report on Phase 1: 500,000 MassHealth members were notified to reapply in order to remain eligible for benefits. Initial termination notices went out in April to those who missed the reapplication deadline, but benefits were reinstated & the deadline extended to June 30 to those who came forward and needed more time to reapply. A second set of 14 day termination notices went out to those who were reinstated and missed their new June 30 deadline to reapply. We don't yet have a final tally on how many people successfully reapplied and how many lost coverage in Phase 1 of the reapplication -renewal process.
 
3. MassHealth Renewals Phase 2:Individuals with Disabilities.
 
Phase 2 begins now starting with adults and children with disabilities. The Office of Medicaid has been able to automatically renew eligibility for about 70,000 people relying on data matching with SSA or SNAP. These people were  mailed notices in early July telling them they do not need to take further action unless their situation has changed. 
 
A July 17 upgrade to the new computer system should enable it to make correct program determinations for people known to be disabled --something it has not been able to do up to now.
 
In early August, notices and application forms will be mailed to about 70,000 more people with disabilities who will have 45 days to take action to reapply in the new system in order to keep their benefits. 
 
People on SSI will not be getting any MassHealth renewal notices and so long as they are getting SSI do not need to reapply for MassHealth. (There are about 140,000 SSI recipients under 65 in Massachusetts). People in home and community based waiver programs or any other MassHealth program with an asset test do not need to reapply in the new system, but they may be getting the usual MassHealth renewal form in the old system. Disabled  adults on CommonHealth will not be renewed until next year (2016).
 
In our experience to date when people with disabilities who do not need to reapply in the new system, reapply anyway just to be on the safe side, it makes matters worse. What people with disabilities can safely do in advance of the August mailing is make sure the Office of Medicaid has your current address. If you have an Authorized Representative, make sure the Office of Medicaid has current information about your Authorized Rep. 
 
The attached flyer from Health Care for All explains the renewal process including which people with disabilities will not be required to reapply.  
 
Attached is a sample of the notice going out in July to people with disabilities who don't need to reapply based on a data match with other agencies.
 
Also attached is a sample of the August notice that will go out to people who will need to submit a reapplication.