Health Announce: Jan. 7, 2025

01/07/25

Happy New Year!

What’s in a name? That which we call a rose / By any other name would smell
as sweet;
Shakespeare, Romeo and Julie, Act II Scene II

A good name is rather to be chosen than riches…
King Solomon, Proverbs 22:1

Last September, Governor Healey signed legislation renaming Massachusetts Rehabilitation Commission (MRC) to MassAbility. And currently An Act renaming the Executive Office of Elder Affairs to the Executive Office of Aging and Independence (S3006) awaits signature on the Governor’s desk. The renaming of these state agencies reflects a move to a more inclusive model for providing services and delivering care, one that focuses on strengths, autonomy, and independence.

Language shapes people and their perceptions. In advocacy work, we strive to use terms that center each individual’s dignity and their experience and that promote inclusivity and empowerment. We also choose language to effectively advocate and persuade different audiences. Words matter – and they constantly change to reflect new paradigms and understandings. Just like our advocacy work.

Topics for this week’s Health Announce:

Changes to Children’s Medical Security Plan copay and premium policy.
SJC adopts new rules to protect low-income people in small claims court.
Also on the debt front – big news from the Feds on medical debt!
MassHealth Accountable Care Organization (ACO) network changes effective Jan 1, 2025.
If you haven’t already: Mark your calendars!

Be well,

Jennifer Hotchkiss Kaplan

Senior Health Law Attorney

Massachusetts Law Reform Institute

1. Changes to Children’s Medical Security Plan copay and premium policy.

As of January 1, 2025, all Children’s Medical Security Plan (CMSP) members no longer have copays. Though the Executive Office of Health and Human Services (EOHHS) previously disclosed this plan, it released Eligibility Operations Memo 24-10 and All Provider Bulletin 398 in December formally announcing the change.

Additionally, CMSP members with income up to 300% of the Federal Poverty Level (FPL) will no longer have premiums. Outstanding past-due CMSP premium balances for this group were adjusted to $0 as of January 1, 2025. CMSP members with incomes greater than 300% FPL will still be charged premiums and continue to be subject to premium billing rules.

Updates to the regulations, 130 CMR 522.004(E) regarding copays and 130 CMR 506.011 regarding premiums, will occur at a later date.

2. SJC adopts new rules to protect low-income people in small claims court.

In mid-December, the Massachusetts Supreme Judicial Court (SJC) approved new rules effective February 3, 2025, aimed at protecting low-income people from agreeing to use legally protected income to pay creditors. Certain income and assets, such as social security and disability payments, are exempt from collection under state or federal law. However, creditors were getting around these exemptions by inducing low-income debtors to agree to a payment schedule, later issued as payment orders, that relied on exempt income to settle the debt.

The new regulations make clear that in all circumstances – whether the court determines the payment schedule or the parties agree to a schedule themselves that they ask the court to enter as a payment order – the court must always hold a payment hearing before issuing the payment order. Whether or not the hearing is contested, the court should review the debtor’s Statement of Finances and Income form and “expressly find the [debtor] able to pay without relying on exempt income or assets.” Letter to SJC Rules Committee at 3 (Oct. 10, 2024). If the debtor is unable to do so, the court should not enter the payment order.

🎉Shout out to Northeast Legal Aid! 🎉 Their 2017 lawsuit, Delisle v. Clerk-Magistrate of the Lowell Division of the District Court, SJ-2017-0320, prompted this SJC action to amend the rules.

3. Also on the debt front – big news from the Feds on medical debt!

This morning, Vice President Harris announced a final rule by the Consumer Financial Protection Bureau removing medical debt from all credit reports. Over 15 million people will be impacted by this new rule. Though the three largest credit reporting agencies announced voluntary changes last year to exclude from individuals’ credit reports certain types of medical debt, such as paid medical debts or unpaid medical debts less than a year old, these changes left out over 15 million people with $49 billion in outstanding medical bills appearing on their credit reports. Removal of medical debt from credit reports will make it easier for individuals to get approved for home mortgages and car loans. This action comes on top of the elimination of over $1 billion in medical debt for more than 700,000 people by states and localities using American Rescue Plan (aka ARPA) funds.

Though not up yet, the first place the final rule should show up is at this website where rules submitted for publication are posted before the issue of the federal register in which it will be officially published.

4. MassHealth Accountable Care Organization (ACO) network changes effective January 1, 2025.

All Provider Bulletin 396 lays out ACO changes effective as of January 1, 2025. There are four kinds of changes: Seven ACOs added hospitals to their networks; Mass General Brigham (MGB) dropped Lowell General Hospital from its network; WellSense Alliance dropped Framingham and Quincy from its service area; and 19 primary care practices changed to a different MassHealth managed care/ACO plan.

What these changes mean for members:

1. According to MassHealth (MH), WellSense Alliance members in Framingham and Quincy who were enrolled prior to January 1 can remain in their same plan with the same primary care providers (PCPs) after January 1 or change plans if they choose. Presumably no MH members from those two towns will be able to newly enroll in WellSense Alliance after January 1, 2025.

2. According to the October Massachusetts Health Care Training Forum (MTF) session, about 11,000 members have PCPs switching to a different plan in 2025. In November, those members received notice that they will be assigned to follow their PCP to the new plan effective January 1 unless they choose a different plan before then. If they are unhappy with the auto-assignment, they will be able to choose a different plan during a 90-day plan selection period, but a new plan will mean finding a new PCP.

3. In addition to plans adding hospitals to their networks, one plan, MGB, is dropping a hospital. MGB is dropping Lowell General Hospital from its network, but adding other hospitals including Lawrence General Hospital. MGB members who want to change to a plan that includes Lowell General Hospital in its network can call MassHealth to change plans.

Members experiencing network changes can get more information about their plan options and how to change plans from the MassHealth Enrollment Guide for 2025, posted in English and 5 other languages, from the MassHealth Choices website, by calling MassHealth Customer Service (800-841-2900), or by calling a certified application counselor or Navigator.

5. If you haven’t already: Mark your calendars!

Here are upcoming events to note in your calendars:

Wednesday, January 8: #GetCovered at the Health Connector Webinar, 12 pm – Register here.

Thursday, January 23: Walk to the Hill for Civil Legal Aid

Tuesday, February 4, 2025: MLRI’s Health Care Access Program through MCLE