Massachusetts Health & Hospital Association 
INSIDE THE ISSUE
> RFA Harms Telehealth
> Crafting Best Waiver Possible
> Strengthening Postpartum Care
> MOLST-to-POLST Intake Form
MONDAY REPORT
State Moves Ahead with Medicaid Contract that Pulls Back on Telehealth
The acute care hospital 2027 RFA – the main contract between the MassHealth program and hospitals, detailing payment rates and regulations – was released last week and, against the strong objections of hospitals and patient advocates, permits MassHealth to end hospital reimbursement for telehealth medical services provided through hospitals. MassHealth states it will not reduce payment for hospital-based behavioral health telehealth services.
While the state says the move will save it $15 million annually, MHA and other advocates note that substantially reducing payment for healthcare that is provided through telehealth means such services will become financially unsustainable, leading to their potential reduction or elimination. Without telehealth, access for MassHealth patients – especially those with chronic conditions or who live in rural areas – will be harmed. Patients who rely on telehealth because they face transportation challenges or scheduling conflicts due to work or school will find it harder to access that care, the hospital community has argued.
Disinvesting in hospital-based telehealth for medical services will also disrupt the continuum of care that strengthens referrals and access to primary care – which is currently the subject of legislation in conference committee aimed at requiring that more resources are funneled to preventative care.
The 2027 RFA – or, formally, the Request for Applications – also introduces a post-hospitalization outpatient review process that will require the state and hospitals to devote time and resources to claims that already have been paid. Such “Monday morning quarterbacking” goes against the state’s declared intention to streamline the regulatory process in an effort to reduce overall costs and address affordability, MHA argues.
“Less access, less funding, and more administrative processes do not assist the collective effort to sustain an innovative and affordable healthcare system for patients in the commonwealth,” said Dan McHale, MHA’s senior vice president of healthcare finance and policy. “The RFA, in addition to the access issues and red tape it imposes, also provides no inflation updates to rates for the third year in a row. This will further compound the more than a billion dollars in hospital payment reductions and financial exposure resulting from coverage losses and drastic, changing federal policy. We must keep that harsh reality in mind in each and every healthcare action going forward – including in the very contract upon which hospitals’ core Medicaid funding is built.”
The New Medicaid Waiver: Best Hope for Massachusetts Healthcare
The Massachusetts Executive Office of Health and Human Services (EOHHS) has posted for public comment its draft of the MassHealth Section 1115 Demonstration waiver.
The waiver, which will eventually be submitted to the Centers for Medicare and Medicaid Services (CMS) for approval, details how Massachusetts will finance and operate its Medicaid program, MassHealth, for the five-year period between January 1, 2028, and December 31, 2032. It represents an important opportunity to soften the blow of upcoming financial losses due to the implementation of the One Big Beautiful Bill Act and other federal policy changes.
EOHHS released the proposal on Monday, September 14 and interested parties have until Monday, October 19 to submit comments on it before a final version is sent to CMS in November. Throughout 2027, EOHHS will negotiate with CMS before the final agreement goes into effect in 2028.
Among other things, the proposed waiver seeks authority for voluntary hospital global budgets for Medicaid services and a new hospital incentive program, and it continues the Accountable Care Organization program with increased expectations on efficiency and performance. The waiver does not propose to increase safety net provider payments.
Given the tremendous pressures being brought to bear on Massachusetts hospitals and health systems, and therefore on the state’s economy, in the coming year it will be important to create the most ambitious waiver possible, MHA and its members have shared with the state. MHA will continue to meet with its membership on the issue and will be in close communication with EOHHS, the Healey-Driscoll administration, and the federal Congressional delegation, which has been strategizing on how best to cope with some of the healthcare cuts contained in the One Big Beautiful Bill Act.
“The governor and state officials understand that the waiver is our best opportunity to seek federal support for critical improvements to our healthcare system and to ensure that Massachusetts receives the resources it needs to maintain patient care under increasingly challenging circumstances,” said MHA’s incoming Interim President & CEO Mike Sroczynski. “Our provider organizations are counting on the final waiver to be ambitious and aggressive, and while the current iteration released on Monday does not yet meet that mark, we are hopeful that the state, working with hospitals, will be able to craft an agreement that positions us well for the next five years when the federal cuts are expected to have the greatest effect.”
Healey Administration Takes Action on Maternal Health
The Healey-Driscoll administration announced last week that it is seeking $2 million through a supplemental appropriation bill to expand the Department of Public Health’s Welcome Family home visiting program that allows a maternal and child health nurse to visit a family’s home after the birth of a child.
The voluntary program, funded through a federal grant, currently serves 3,000 out of the state’s 68,000 annual births. The $2 million will allow visits to any family that request them across Massachusetts, according to the state.
According to a media release from the governor’s office, in 2025, Welcome Family offered 1,620 postpartum depression screenings. Of those, 208 screened positive, and every person who screened positive received a referral to services.
Healey made the announcement last Tuesday at Beth Israel Deaconess Medical Center in Boston. She also said the supplemental bill would include $250,000 for the Department of Mental Health’s Massachusetts Child Psychiatry Access Program for Moms that helps prevent and treat mental health and substance use issues during pregnancy and postpartum. As part of the maternal health package, DPH will also comb through its regulations to strengthen language that currently only refers to postpartum depression as opposed to a wider range of mental health conditions.
“Postpartum depression, anxiety, and other maternal mental health conditions are real medical conditions, and no mother should feel ashamed to ask for help or feel like she has to navigate this journey alone,” Healey said. “We’re working to expand postpartum care, identify concerns earlier, and connect families to the mental health support they need, because taking care of moms means taking care of the whole family.”
“Our hospitals and health systems are grateful for the Healey-Driscoll administration’s continued focus on postpartum support, which builds on years of collaborative work between policymakers and healthcare providers to connect parents with the resources they deserve,” said Leigh Simons, MHA’s vice president of policy & regulatory affairs.
An Important Step in MOLST-to-POLST Implementation
Massachusetts is transitioning from the paper-based MOLST form to the Massachusetts ePOLST Registry in April 2027. Portable Orders for Life-Sustaining Treatment or POLST is a medical order that documents a patient’s treatment preferences in an emergency where they may be unable to communicate for themselves. The significant difference between POLST and the current MOLST is that POLST orders are organized around a patient’s goals of care and stored electronically. The state and provider community have spent several years preparing for the transition.
Now, the state has made available a critical step that healthcare organizations must follow to begin the onboarding process to the ePOLST Registry. Organizations are being asked to complete the ePOLST Registry Intake form even if they are unsure whether they will use the standalone registry or will integrate the registry within their facility’s Electronic Health Record (EHR). For more information about registry access, click here. Only one form per organization should be submitted. Upon submission, the primary contact indicated on the form will receive a detailed e-mail with next steps and additional information. Please complete the form by Friday, October 2, 2026. Contact MassPOLST@mass.gov with any questions.