05.16.2016

Urging reconsideration of health safety net eligibility changes

MHA sent a letter to EOHHS Secretary Marylou Sudders on May 6, requesting reconsideration of scheduled eligibility changes to the state’s Health Safety Net program, and, in particular, the new presumptive determination policy.

MHA explained that the Health Safety Net presumptive determination policy will result in uninsured individuals who would otherwise be eligible for MassHealth to instead be enrolled temporarily in the Health Safety Net. The policy also doesn’t address retroactive situations, such as when a low-income patient seeks financial assistance after they receive care, either because they were unable to complete an application at the time of care or later determine they cannot afford their out-of-pocket expenses.

“While we appreciate that EOHHS may have intended to develop this policy in response to the many concerns raised about the reduction of retroactive coverage, it does not materially address those concerns and in turn produces a host of new concerns related to program integrity and hospital operations,” wrote MHA Executive Vice President Tim Gens. “In the interest of sustaining a viable safety net for low-income patients, we respectfully request the eligibility regulations be revised to remove this policy and that Health Safety Net coverage be restored to prior levels.”

The eligibility changes are currently scheduled to take effect June 1, 2016.