Comments on Proposed MassHealth 1115 Amendments

In August 2023 MassHealth proposed 8 amendments to the current 1115 demonstration, with an opportunity to comment by Sept 9, 2023 including proposals to: 

• • Provide 12-months continuous eligibility for all adults (continuous eligibility for children is already required as of Jan 1, 2024),
  • provide certain MassHealth services for 90 days prior to release from incarceration,
  • reinstate 3-months retroactive coverage for the remaining adults not eligible for it under the current waiver,
  • create a medical respite benefit for people who are homeless, and
  • improve implementation of state statutory expansions of the Medicare Savings Program

Attached are  comments that MLRI wrote, co-wrote with the Center on Health Law and Policy Innovation (CHLPI)  on pre-release services with 30 signers, and HCFA's sign on letter endorsed by 37 signers.  The comments support all the amendments but make recommendations to clarify or strengthen several of the proposals including:

• involving more stakeholder from the community and with experience of the carceral system in planning pre-release services,
• expanding the scope of medical respite,
• implementing 3-months retroactive coverage without waiting for the waiver authority to be removed, and
• addressing the scheduled sunset of Medicare Savings Program benefits for CommonHealth members in 2026 unless the agency obtains an approved amendment that satisfies federal requirements before then.

After reviewing the comments, MassHealth will submit its proposed amendments to CMS which will also offer a comment opportunity. Expectations are that it may be 12 months before CMS takes action on the amendments.