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Massachusetts health care — wonky, with a healthy dose of reality

MassHealth/Medicaid

A Primer on the MA Medicaid Waiver

Beth Waldman, who left in January as Director of the MA Office of Medicaid and is now with Bailit Health Purchasing, did an overview of the MA Medicaid 1115 Waiver for folks in California late last month. For folks looking to understand the basics of the MA waiver, it's a fine introduction, as well as a way to understand its relevance to California. Click here to view. Read more »

New MassHealth Advocacy Guide Now Available

Weighing in at 248 pages, we think we've found beach reading for the summer! A new edition of the MassHealth Advocacy Guide -- published by the MA Law Reform Institute -- is now available. It is current as of September 2006 and includes valuable information about changes in the 2006 health reform law including: Expansion of children's coverage, restoration of optional adult benefits and creation of a new subsidized insurance program called Commonwealth Care. In addition to updated tables showing benefits covered by MassHealth, and income eligibility levels, there are new tables showing... Read more »

First Look at Patrick’s First Budget

The Governor and his capable Secretary of Administration and Finance, Leslie Kirwan, impressed many political observers by producing a budget that addresses a $1.3 billion budget gap, while largely fulfilling his campaign commitments to local aid relief, education and public safety. Patrick also made great strides over his predecessors by including in his budget explanations of each line item, as well as many spreadsheets detailing the spending history in various funding areas. The Governor, Secretary Kirwan and the agency heads also followed through on the Governor’s commitment to... Read more »

March Madness -- Fasten Seat Belts

Busy, busy month ahead with some huge decisions looming – not least of which is the Connector Board Meeting on 3/20 where they are supposed to decide on standards for “minimally creditable coverage” and affordability parameters to determine who gets penalized for non-coverage under the Individual Mandate. Fasten your seat belts – this ride may get bumpy. Patient Safety Awareness Week: March 4-10, 2007 The National Patient Safety Foundation designates this week to raise awareness about safety. HCFA is taking part with a legislative briefing. If you want to raise awareness or organize an event... Read more »

Insurers Press Administration on Medicaid Documentation

MAHP, the Massachusetts Association of Health Plans, has written to EOHHS Secretary Bigby on the Medicaid citizenship documentation issue (see this blog entry for background). You can read the letter here. The letter commends MassHealth for taking positive steps to protect coverage for citizens caught in the new paperwork requirement. MassHealth has extended the time deadlines and is using computer matches where possible. The letter makes some important recommendations: "We therefore encourage the state to undertake the following steps: continue and expand the data match process; assist... Read more »

MassHealth to reinstate coverage to 739 members

MassHealth staff told us Friday that they would be reinstating coverage to 739 members who had recently received termination notices due to missing paperwork. This is terrific news and reflects the strong commitment by the Governor, EOHHS and MassHealth to maximizing coverage. Background: Back last July, a new federal law took effect (part of the DRA - Deficit Reduction Act) that asked U.S. citizens to submit proof of their citizenship status and identity in order to receive Medicaid benefits. The law, while ostensibly dealing with immigration, puts the burden solely on U.S. citizens, who... Read more »

Milestone: MassHealth Dental Begins Contract with Third Party Administrator

For years now, advocates have been pressing state officials to contract out the running of the MassHealth Dental Program to a Third Party Administrator (TPA). The reasons include the longstanding antipathy of dentists to the administration of the program, and the ability of a TPA to run the program in a way that will improve functioning and participation. Yesterday -- February 1 -- it happened. The MassHealth Dental TPA began as planned on February 1, 2007. Doral Dental USA, one of the nation's largest multistate-administrators of government dental benefits, now serving more than 7... Read more »

A Physician's View on MassHealth

Dr. Joe Heymann from Amesbury is a great physician and a great physician leader, former President of the Mass. Medical Society in the mid-1990s. He takes issue with our positive posting on Beth Waldman, not so much against Beth, but against MassHealth rules and regs that work against patients. We're printing his post in full here to give his views a full airing. Legit complaints and concerns. Hope the Patrick Administration will take notice: While I don’t know Ms. Waldman personally, and have met her only once at the Massachusetts Medical Society, I have heard that she was a hard-working... Read more »

Thank You, Beth Waldman

To most folks in Massachusetts, MassHealth is a large and anonymous bureaucracy. To many folks in the health care advocacy community, it's the most important program state government runs, and it also has a superb record in listening to consumer advocates and responding to our concerns. An important reason for this attitude is Beth Waldman who has served as Director of the Office of Medicaid since September 2003. She has served in Medicaid since May 1994. For the past three and one half years, she's been a critically important person for this program. Beth is leaving her position on 1/12/... Read more »

More Details on SCHIP Relief

More details emerging re: Congressional Action over the weekend to provide stop-gap funding for states facing SCHIP (State Children's Health Insurance Program) shortfalls. 14 states face SCHIP shortfalls in this fiscal year totally just over $1B. MA is on the list facing a shortfall of $144M. The Congressional action enables redistribution of $271.6M in unused SCHIP funds in FY04 and 05. The money goes first to those states facing funding shortfalls most immediately. That's a total of only six states, including MA -- also GA, IL, MD, NJ, RI. Massachusetts is a big winner among these... Read more »

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