MassHealth/ Medicaid

In Massachusetts, Medicaid and the Children’s Health Insurance Program (CHIP) are combined into one program called MassHealth. Medicaid is a shared state and federal program to provide health insurance for poor and disabled residents. CHIP is medical coverage source for individuals under age 19 whose parents earn too much income to qualify for Medicaid, but not enough to pay for private coverage. MHA monitors prospective and recently implemented changes to MassHealth, provides information about how specific aspects of the plan affect care providers, and advocates for fair and equitable implementation of the program. 
MassHealth has released several bulletins regarding the coverage and coding of Medication for Addiction Treatment (MAT) in order to increase access to treatment.
The State Senate begins debate tomorrow on the Senate Ways & Means proposed state budget for FY2020 and the 1,100-plus amendments to it that have been filed.
The Massachusetts House of Representatives today begins debate on the proposed FY2020 state budget, and the nearly 1,400 amendments to it that have been filed.
MHA will be working with legislative champions in the House to strengthen the FY2020 budget directive in a manner that will ensure the administration fulfills the $15 million transfer to the Health Safety Net.
The Health Policy Commission in coming months is scheduled to decide on whether the state’s healthcare cost growth benchmark – currently set at 3.1% – should remain at that level.
The 2018 Cost Trends Report from the Health Policy Commission released last month showed the persistent growth in prescription drug spending over the state’s healthcare cost growth benchmark.
The state’s bold experiment with its dual eligible programs is getting some revisions, while raising some concerns among hospitals and physicians.
In a letter to CMS last week, MHA urged the federal agency to reconsider rules regarding how Medicaid Managed Care Organizations (MCOs) direct payments to providers.
As 2019 begins, here are a few key developments that should occur.
The 1.6% total healthcare spending growth rate in Massachusetts was well below the national rate.
Care is fluid and ever-changing and should not be determined by a rigid number arrived at through popular vote. Vote NO on 1.
The 2019 acute care hospital Request for Application was released last week and will take effect November 1.
The state has released Massachusetts hospital financial performance data for all of 2017 and the picture is not at all rosy.
The Massachusetts Legislature approved a $41.88 billion FY2019 state budget last Wednesday and sent it to Governor Baker.
In a 37-0 vote last Thursday, the Massachusetts Senate passed “An Act for Prevention and Access to Appropriate Care and Treatment of Addiction.”
Last week, the Centers for Medicare and Medicaid Services responded to the state’s 1115 Medicaid Waiver request that had been filed last September.
Debate begins today on the Massachusetts House Ways & Means Committee’s state budget proposal for FY 2019.
With increased federal activity relating to immigration, healthcare facilities have been grappling with questions related to patients and staff whose legal status in the U.S. may be in jeopardy.
The Massachusetts House Ways & Means Committee released its proposed FY19 state budget last Wednesday, and a preliminary review of it shows that the budget writers were responsive to some key hospital priorities.
MassHealth continues to tweak its sweeping Accountable Care Organization (ACO) program that went live in March.

Resources

Click on the links below for easy access to important information related to state healthcare issues and advocacy.
Visit the Commonwealth of Massachusetts websites below to find information on legislative hearings and other meetings of interest to the healthcare community.
To guide your navigation of the legislative process and assist your advocacy efforts, please visit the following state websites:
MHA has also developed the following documents for your information and benefit:
  • Directory of Government Officials
  • 2016-2017/2017-2018 State Legislative Package