Beginning later this week, MassHealth will begin a simplified redetermination process for some members in nursing facilities. This new method will affect over 11,000 MassHealth members that will no longer need to proactively send paperwork to MassHealth. Instead, they will only need to return forms if something has changed in their situation that would affect their eligibility for coverage.
Every year thousands of Medicaid recipients lose their health insurance due to eligibility redeterminations. HCFA HelpLine counselors often hear from people that can’t access the health care that they need, not because they’re categorically ineligible for coverage, but because the state needs some information from them. Often these gaps in coverage happen during the annual redetermination process.
Medicaid members and providers have often complained about the burden of paperwork required by the program. MassHealth, Massachusetts’ Medicaid program, is working to make it better through a grant from the Robert Wood Johnson Foundation aimed at improving their annual redetermination process.
In a letter explaining the change (pdf), MassHealth COO Philip Poley writes that “This new administrative annual renewal process is only the initial step in our efforts to streamline eligibility review processes for members. We also hope and plan to expand this and other types of streamlined eligibility review processes to additional members….
We applaud this effort and look forward to seeing it expanded to all MassHealth, Commonwealth Care, and other health care coverage populations soon.