23,000 MassHealth Households Reselected for Renewals in June & July 2023
MassHealth July 6, 2023 Assister Update about changes affecting almost 30,000 people
We are forwarding an announcement from MassHealth to enrollment assisters about changes affecting almost 30,000 people in a way that is good but likely to be confusing for those affected. More to come as we learn more.
Group 1: 23,000 people initially selected for renewal between April -June who have not yet successfully renewed will get another chance.
Background: In June 2021 Sec Becerra wrote to state Medicaid agencies "deeply concerned” with early reports coming in from some states of high rates of “people losing coverage for avoidable reasons that State Medicaid offices have the power to prevent or mitigate” and encouraged states to take advantage of time-limited waiver options to increase the likelihood of successfully renewals based on data-matching (so-called ex parte renewals). MassHealth had asked for and gotten authority to rely on third parties for updated addresses,but had not taken advantage of the waiver options to expand ex parte renewals. See Table of approved waiver options here. Meanwhile, MassHealth was finding that since April 1, its rate of ex parte renewals, which it told us has been about 50% of all cases selected for renewal, was turning out to be much lower. This would mean more paperwork and more procedural denials for people who may be eligible unless the agency took further action.
What happened?
MassHealth has enhanced its auto-renewal process. It doesn’t say how, but two changes they told us about earlier include 1. expanding the reasonable compatibility threshold from 20% to 30%: this means if a renewing member attests to income still under 133% FPL and a data match shows income is higher but by 30% or less, the attestation is verified, and 2. If a renewing member reports zero income or very low income and the IRS match shows no return was filed, the attestation of zero income is verified. We will let you know when we learn more about other enhancements.
What happens next?
According to the notice 23,000 households who had been sent blue envelopes and not yet successfully renewed will be re-selected in June and July. Once re-selected MassHealth will try again to see if individuals in these households can be auto-renewed under the enhanced process. If so, they will get a white envelope confirming their eligibility. If not, they will get another blue envelope and another opportunity to renew.
Group 2: 5,000 people subject to an asset test in the MA-21 system who were terminated after April 1 have been reinstated and sent a new renewal form.
What happened?
According to the notice, 5,000 people in the MA-21 system (this is the system for people eligible as 65 or older or needing long term care) who had been protected and selected for renewal were terminated for non-response without an adequate termination notice. This happened because of a defect in the system that has now been corrected. They have now been reinstated and sent a blue envelope to renew. That’s all the information we have to date.
Earlier, MassHealth had identified “inadvertent” terminations occurring after April 1 for people who had turned 65 but were still “protected” in the HIX system who would once again be “protected” for 90 days during the unwinding. At the same time, we’ve been reporting to senior Medicaid officials other cases of no-notice terminations, terminations after April 1 based on renewals initiated before April 1, and other erroneous terminations during the unwinding. We don’t yet know whether the system fix and reinstatements relate to one or more of these known issues or something new.
MLRI Flyer on Erroneous Termination based on Timing Alone
MLRI has prepared the attached flyer to help advocates identify terminations that are erroneous under the timing rules in effect during the unwinding period from April 1, 2023-March 31, 2024. It includes tips for individual advocacy to help clients get reinstated, and citations to the applicable state and federal authorities. We hope to find out soon whether there are now up to 5,000 fewer people who will need this one-on-one assistance based on the July 6 announcement.
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| Protections+from+loss+of+MassHealth+during+the+unwinding+Timing+(4).pdf (1.84 MB) | 1.84 MB |