Health Care -- General

Enter the word(s) you are searching for; use quotes for exact phrase
Displaying 51 - 100 of 181
View by Library Type
Sort by

MAGI Resources

Various
Since 2014, MAGI or Modified Adjusted Gross Income has been the  income methodology used by MassHealth for most people under age 65, and also used by the Connector to determine eligibility for ConnectorCare and Premium Tax Credits. Attached is a set of FAQs about MAGI from the Center on…

Free or Discounted Broadband & Cell Phone Resources

MassHealth
This is a resource produced by MassHealth with help from the Dept. of Telecommunications that lays out in table form  resources available from many different Broadband and Telephone carriers for discounted or free service or devices including many temporary special offers related to…

Health Connector Updates- MA Health Care Training Forum Materials

Health Connector
Attached is a powerpoint presentation that the Health Connector presented at the July 2020 MA Health Care Training Forum (MTF) meeting regarding Health Connector updates. It describes the most recent COVID-19 related changes, the Health Connector's transition to a new customer…

July 23 MTF Announcement: 1. MassHealth Buy In & 2. Telephonic authorizations

MassHealth
This is an MTF announcement dated July 23, 2020 about two policy updates: 1. Correcting a system error affecting the Jan 1, 2020 expansion of the Medicare Savings Program (Senior Buy-In/Buy-In Programs). and 2. a June 29, 2020 change in policy authorizing applicants and members to complete a…

Filing a Pro Se Appeal from the MassHealth Board of Hearings

MLRI
Attached is a sample complaint appealing from a decision of the MassHealth Board of Hearings and an outline of key steps in filing an appeal with links to information on the Court's websites.  The Court website has information on filing an appeal from the decision of a state agency like…

Superior Court Decision Granting Hardship Waiver in Medicaid Estate Recovery Case

Judge Christine Roach
This was a Medicaid Estate Recovery case in which EOHHS was pursuing a reimbursement claim against the estate of a single parent who died at home leaving her disabled adult son living in the home along with the sister who had moved in after their mother's death. The family home was the only…

Assister Updates from MassHealth & Health Connector

MassHealth and Health Connector
MassHealth and the Health Connector issue regular updates via email to Certified Application Counselors and Navigators as Assister Updates that we will be posting from time to time. However, please check our Table of COVID-19 changes because some of these polices from Mar-May have changed over…

New Health Connector Mailing Address

Health Connector
On May 19, 2020 The Health Connector changed its mailing address. The new mailing address is Health Connector Processing Center, P.O. Box 4404, Taunton, MA 02780.  The MassHealth-Health Connector Mail/Fax Cover Sheet has been updated to reflect the new mailing…

Applying for Health Coverage: How does unemployment income count?

Vicky Pulos
This guide describes where to enter unemployment income on the combined application form used to apply for both MassHealth and help paying for private insurance from the Health Connector. It includes pictures of what some of  the key screens of the online health application look like…

MassHealth Training Forum April 2020 Materials

MassHealth & Health Connector
This website contains materials from the April 2020 MassHealth Training Forum --Powerpoint presentations covering the major COVID-19 related changes over the last 2 months including slides from MassHealth addressing the MassHealth termination moratorium; verifying eligibility by self-attestions,…

How MassHealth & the Health Connector Treat New Payments under the CARES ACT

MLRI
This MLRI Table shows how MassHealth and the Health Connector count new payments authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act: a one-time tax rebate from the IRS in the amount of $1200 per eligible adult and $500 per qualifying child under 17, extended Unemployment…

MassHealth Continuous Coverage during COVID 19 Emergency

MLRI
On March 18, the Families First Coronavirus Response Act was enacted. It prohibited states from ending coverage for Medicaid beneficiaries enrolled on March 18, 2020 or later and continuing until the end of the COVID-19 emergency. CMS has issued two sets of FAQs for the states with more…

Summaries & Analyses of Coronavirus Response Acts

NHelp, NILC, NELP, Justice in Aging
Attached is a document with links to summaries of the Coronavirus Response Act focusing on health (National Health Law Project), immigrants (National Immigration Law Center), employment/unemployment (National Employment Law Center), and older adults (Jusitice in Aging). 

MassHealth Coverage Protected During COVID-19 Emergency

EOHHS
Important News from MassHealth: Moratorium on Eligibility Terminations During Emergency:  MassHealth announced important new protections for MassHealth members who were enrolled in MassHealth benefits on March 18, 2020 or later. Many thanks to everyone at the Office of Medicaid for their…

Health Care Proxies in Massachusetts

Go to the Trial Court Law Library website to access information about health care proxies, including a sample form.

MassHealth Publications in Response to COVID-19

Office of Medicaid/EOHHS
From an email sent out by the Office of Medicaid/ EOHHS: In coordination with agencies across the Executive Office of Health and Human Services, MassHealth/ EOHHS have released provider bulletins and additional guidance in response to 2019 novel Coronavirus Disease (COVID-19). These policies…

Bulletin to Commercial Health Insurers

Office of Consumer Affairs - Division of Insurance
The Division of Insurance ("Division") issues this Bulletin to provide information to Commercial Health Insurers, Blue Cross and Blue Shield of Massachusetts, Inc., and Health Maintenance Organizations ("Carriers") about the Division's expectations regarding Carriers' appropriate coverage…

MassHealth BOH reverses Dentaquest Denial

Scott Bernard
Favorable BOH decision reversing Dentaquest denial of prior authorization for deep gum and root cleaning. Dentaquest is the third party administrator of the MassHealth dental program. The decision concerns periodontal care for an adult.  Note that on the last page the hearing officer writes:…

2020 Upper Income Levels for MassHealth & Other Health Programs

MLRI and EOHHS
Attached are updated income tables for 2020 showing the upper income limits in MassHealth and Other Health programs. One table is the MassHealth Desk Guide showing the annual and monthly amounts that correspond to different percentages of the federal poverty level used by MassHealth; the 5%…

MassHealth Premium Assistance

MassHealth
Attached is a powerpoint presentation that MassHealth's Premium Assistance Unit presented at the Jan 2020 MassHealth Training Forums. Also attached is a MassHealth memo (still current in Feb 2020) describing & giving examples of how the amount of premium assistance is calculated.

MassHealth & Temporary Census Earnings

Vicky Pulos
Temporary census work is currently available but MassHealth members may have concerns that the added income will jeopardize their continued eligibility for MassHealth.  This Q & A for providers & advocates describes how MassHealth treats temporary census earnings for individuals…

Six changes affecting MassHealth on Jan 1, 2020

Vicky Pulos
Six changes affecting MassHealth on Jan 1, 2020: Primary Care Providers Joining New ACOs Jan 1 MassHealth notified 37,000 members whose primary care provider joined a new ACO that they would be assigned to that ACO on Jan. 1, 2020. The list of providers changing plans is…

A Quick and Easy Method of Screening for Medicaid Eligibility under the Pickle Amendment

Gordon Bonnyman
The Pickle Amendment, named after its congressional sponsor and enacted in 1977, requires that an individual is to be deemed a Supplemental Security Income (SSI) recipient (which in most states means automatic Medicaid eligibility) if the individual1 was simultaneously entitled to receive both…

October 2019 Health Update: Open Enrollment & More

Vicky Pulos

Open Enrollment 2020 & ConnectorCare

Vicky Pulos
Open enrollment for 2020 coverage is from Nov. 1, 2019 to Jan. 23, 2020. People enrolled in ConnectorCare in 2019, should check to see if they will be enrolled in the right plan for them in 2020 or whether they need to take action to update information in their account and/or select a different…

A New Opportunity for Seniors and People with Disabilities Enrolled in MassHealth Home & Community Based Waivers & PACE To Maintain Eligibility After an Increase in Income

MLRI
Memo on a new policy on "post-eligibility treatment of income" for people already enrolled in a HCBS who experience an increase in income. Update: October 1, 2019 MassHealth Eligibility Operations Memo, Post-Eligibility Treatment of Income (PETI) for Home- and Community-Based…

August 2019 State Health Update:

vicky pulos
Attached is an update of several health items in the FY 20 state budget, improvements in the state medical child support law,  improvements in the MassHealth/Connector online system, and several positive changes in MassHealth eligibility policies. 

Medicaid revises policy on home health aides & DME in response to advocacy letter

Office of Medicaid; MLRI, HLA, DLC & GBLS
In August 2018 legal advocates wrote to the Medicaid director identifying several ways that current MassHealth regulations and policies on home health aide services and durable medical equipment (DME) are out of compliance with federal Medicaid regulations and harming our clients. We outlined the…

EPSDT & MassHealth

Vicky Pulos
Medicaid's "Early and Periodic Screening, Diagnosis and Treatment" (EPSDT) benefit for children is a powerful tool advocates can use to help children and youth under age 21 enrolled in MassHealth Standard or CommonHealth get the health benefits they need. This memo provides citations…

2019 Upper Income Levels for MassHealth & Other Health Programs

MLRI and EOHHS
Attached are updated income tables for 2019 showing the upper income limits in MassHealth and Other Health programs. One Table is the MassHealth Desk Guide showing the annual and monthly amounts that correspond to different percentages of the federal poverty level used by MassHealth; the 5% of FPL…

Information Regarding the 2019 Federal Government Shutdown & Impact on Benefits Programs

MLRI
Massachusetts Law Reform Institute (MLRI) has compiled information on the federal government shutdown and specifically what is happening to low income residents who receive or are applying for food assistance, health care, cash assistance benefits, unemployment insurance or housing. This…

PCA Time for Task and PCA Operating Standards

Office of Medicaid
Pursuant to a Jan 2019 record request, we obtained a copy of two subregulatory documents developed by MassHealth regarding Personal Care Attendant (PCA) services. Neither document is new, but both are currently in use at least as of Jan 2019. One is the Time for Task Guidelines, dated 11-16-11,…

Open Enrollment 2019

MLRI & others
Open enrollment in Mass. this year is Nov. 1, 2018 to Jan. 23, 2019. This is the time of year when people can buy individual (non-group) insurance on their own or change their non-group coverage for 2019. For people who were eligible for ConnectorCare but missed enrollment deadlines for 2018…

New Health Insurance Confidentiality Protections

Health Care for All
This is a link to HCFA's page on  new state law called the Protecting Access to Confidential Health Care (PATCH) Act that took effect July 1, 2018. This law fixes a crucial barrier to accessing health care by ensuring that if you are covered under another person's health plan in…

Superior Court DJ on Inadequate MassHealth Notices

Hon. Douglas Wilkins
This is a declaratory judgment decision in two companion cases filed in Suffolk Superior Court, Maas v. Sudders and Hirvi v. Sudders, by 2 private attornies & members of the MA Chapter of the Natl. Assoc. of Elder Lawyers (NAELA). Each case was filed as an affirmative action seeking to…

Massachusetts Family Law & the ACA

MLRI
What Massachusetts Family Law Practitioners Should Know about the ACA Family law cases routinely involve decisions regarding custody, health care coverage, tax dependency exemptions, whether to file joint tax returns and what tax filing status might be most beneficial to the…

2018 Spousal Impoverishment Standards

CMS
Updated standard for calculations when one spouse is in nursing home applying for MassHealth and one spouse is at home. 

Continuity of Care in MassHealth Managed Care after March 1, 2018

Office of Medicaid and Others
March 1, 2018 over 1 million members will be moving to new kinds of health plans. This affects individual under age 65 with MassHealth as their only coverage. Individuals should have received notice of the change from MassHealth and their new plans. There are protections in place to try to avoid…

2018 ConnectorCare enrollment options after Jan 23

Health Care for All
People purchasing individual coverage including ConnectorCare can only do so during "open enrollment" or if they have experienced a "qualifying event." Open enrollment for 2018 ended in MA on Jan 23, 2018.  However, it is not too late for people to obtain ConnectorCare…

MassHealth Managed Care Changes for 1 million March 1, 2018

Vicky Pulos
Attached is an updated powerpoint describing MassHealth managed care changes in the works for several years now that will affect over 1 million members starting March 1, 2018. The materials provide an overview of what's going on including descriptions of several problem scenarios, possible…

MassHealth Income Guidelines effective March 1, 2018

MLRI. MassHealth
The MLRI Health Income Chart includes the 5% MAGI allowance, plus the $20 income disregard for MassHealth Senior calculations The MassHealth Desk Guide does not include combined figures.

MassHealth Income Guidelines 2017 & 2018

MLRI, MassHealth
Attached are four tables.  The MLRI MassHealth Income Table for March 1 2017.  This table factors in the 5% MAGI income deduction to the various poverty levels.  Effective in MassHealth Mar 1, 2017 to Feb 28, 2018. Updated for Connector Open Enrollment beginning Nov 1,…

MLRI Letter to HWM on H2 proposal to drop 140,000 from MassHealth

Vicky Pulos
In January, 2018 the Governor's budget bill (H2) once again proposed dropping 140,000 nondisabled adults with income over 100% FPL but under 138% FPL from MassHealth leaving them with only potential ConnectorCare coverage. This letter to the Chair of the House Ways and Means Committee describes…

How Will a MassHealth Premium of 3% of Income Affect Children?

Vicky Pulos
MassHealth is proposing updating its premium and copayment charges by Jan. 2019.  This paper looks at what MassHealth's proposal to base premiums on 3% of family income for families with income over 150% of poverty will mean for children with income between 150-300% of poverty. 

CHIP Flyer

CHAC
Federal funding for the Children's Health Insurance Program expired on September 30, 2017.  Massachusetts and other states are continuing to operate their programs using unexpended prior funding, but this is rapidly running out.  Funding in Massachusetts could be exhausted sometime in…

Update on MA legislation: Senate HEALTH bill

MLRI
On Nov. 7, the State Senate passed a broad-ranging health bill, a House bill is expected in early 2018.  

MassHealth Restructuring Web Page

MassHealth
Bookmark this page for materials on changes in the MassHealth delivery and payment system. It currently includes copies  of the Model contracts with new Accountable Care Organizations that will be providing services starting March 1, 2018 and includes a powerpoint presentation on new behavioral…

MassHealth Managed Care Notices Mailed Nov 13-Dec 22 2017

MassHealth & MLRI
Starting on Nov 13, and continuing through Dec 22, 2017 MassHealth is notifying 1.2 million members enrolled in managed care of new options starting March 1, 2018 including new Accountable Care Organizations. This is the Delivery System Reform Innovation approved in the November 2016 amendment to…

2018 Open Enrollment in Massachusetts

Vicky Pulos, MLRI
Attached is a flyer with basic information about  open enrollment for 2018.  This applies to people who are enrolled in or applying for ConnectorCare or other non-group health insurance. The flyer includes links to key information on the Health Connector website and elsewhere. Also…

ConnectorCare Premiums for 2018

Connector
Attached are the premium charges by plan and by region for ConnectorCare in 2018.  Starting Nov 1, 2017 current enrollees can change plans, and new applicants can sign up for coverage starting Jan. 1, 2018.  ConnectorCare is offering only one "affordable" plan choice and current…