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Winter 2024 MassHealth Training Forum Provider Updates

Updates on Member Eligibility Redetermination, Ordering, Referring and Prescribing Resumption of Claim Denials, Provider Online Service Center (POSC) Primary and Subordinate User Access, and other important provider related updates, MassHealth Transportation PT-1, Long-Term Services and Supports (LTSS) Provider communications, MassHealth Doula Provider Program, e-signatures, Children’s Behavioral Health Initiative CANS tool, provider education, and provider bulletins.… Continue Reading Winter 2024 MassHealth Training Forum Provider Updates

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Winter 2024 MA Health Care Learning Series

MassHealth Continuous Eligibility (CE), End of Year Tax Filing, MAhealthconnector.org system updates, Health Connector Special Enrollment Period (SEP) rules, Health Connector consumer resources, APTCs, free tax assistance, tax resources, Inflation Reduction Action, pilot ConnectorCare expansion and Simple Sign-Up processes. Meeting Presentation Materials Download PDF  Download Q&A  

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Winter 2024 Health Safety Net Updates

Overview on some Health Safety Net (HSN) eligibility requirements and updates rartial deductible reporting, Fiscal Year closing 2021, Special Circumstance application, updated portal agreements, FY23 outpatient claim adjustments, populations exempt from collection action, 2023 HSN Procedure Code lists, and HSN resources. Meeting Presentation Material Download PDF  

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Understanding Immigration Requirements and Application Completion for Health Insurance Coverage in Massachusetts: Part 1

Learn about the immigration requirements for those applying for health care coverage using the Massachusetts Application for Health and Dental Coverage and Help Paying Costs or ACA-3 application. Review coverage options and eligibility criteria, key immigration terms, and best practices. Meeting Presentation Materials Download PDF Download Transcript  

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Fall 2023 What’s New in the Medicare World in 2024?

SHINE will provide new Medicare and insurance options for 2024, Medicare enrollment periods, Medigap, Medicare Advantage plans, Medicare Plan Finder, LINET program, pharmacy outreach program, Medicare resources, prescription drug benefits resulting from the Inflation Reduction Act, Medicare Savings Plan and Extra Help, and news relevant to the 65+ population with MassHealth. Meeting Presentation Material Download… Continue Reading Fall 2023 What’s New in the Medicare World in 2024?

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Fall 2023 MassHealth Training Forum Provider Updates

Updates on Member Eligibility Redetermination, Ordering Referring and Prescribing Resumption of Claim Denials, a review of the MassHealth Coordinating Aligned, Relationship-centered, Enhanced Support (CARES) for Kids Program, resumption of PCC and primary care ACO referral requirements, Long-Term Services and Supports provider communications, primary user policy, Payment and Care Delivery (PCDI) updates, Robotic Processing Automation (RPA)… Continue Reading Fall 2023 MassHealth Training Forum Provider Updates

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Fall 2023 Health Connector Open Enrollment

The Health Connector team will provide an update on Open Enrollment for plan year 2024, Health Connector redeterminations and renewals, Advance Premium Tax Credits (APTC), dental plans, shopping tools, ConnectorCare expansion, newly available Health Insurance plans, shopping considerations for your community as well as payment and enrollment reminders. Meeting Presentation Material Download PDF

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Summer 2023 Collecting Race, Ethnicity, Language, Disability, Sexual Orientation, and Gender Identity Data (RELD and SOGI Data)

MassHealth and the Health Connector are dedicated to improving data collection including demographic data. Data collection helps MassHealth, and the Health Connector make informed policy and operational decisions to provide equitable access to health coverage for members and tailor services to meet members’ needs. Topics include reasons for collecting RELD and SOGI data, definitions of… Continue Reading Summer 2023 Collecting Race, Ethnicity, Language, Disability, Sexual Orientation, and Gender Identity Data (RELD and SOGI Data)

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Summer 2023 Protecting Beneficiaries from Becoming Victims of Healthcare Errors, Fraud and Abuse

Comprehensive overview of the MA Senior Medicare Patrol (SMP) Program mission. Additionally, members will gain a better appreciation for the role they can have in activating consumers to become better engaged in their healthcare by keeping a personal healthcare journal, “My Health Care Tracker,” and documenting all medical encounters. Through case scenarios members will understand… Continue Reading Summer 2023 Protecting Beneficiaries from Becoming Victims of Healthcare Errors, Fraud and Abuse

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Summer 2023 MassHealth Training Forum Provider Updates

Updates on Member Eligibility Redetermination, Ordering Referring and Prescribing Resumption of Claim Denials, a review of the updated Prior Approval policy, New Automated ORP Revalidation process, data collection forms, Long-Term Services and Supports Provider communications, COVID-19 policy updates, and MassHealth provider bulletins Meeting Presentation Material Download PDF

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Summer 2023 MassHealth Premium Assistance Program

Overview of the MassHealth Premium Assistance program. We will discuss the application process, standards for qualification, and the enrollment process if Premium Assistance has confirmed that a member has access to qualifying employer sponsored insurance. We will also discuss the HIRD initiative and how it is used to assist MassHealth in identifying members who may… Continue Reading Summer 2023 MassHealth Premium Assistance Program

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Summer 2023 MA Health Care Learning Series

MassHealth and the Health Connector updates related to the MassHealth Renewals process, Health Connector Redeterminations and Renewals and system updates for the online application at MAhealthconnector.org. Topics include Request for Information (RFI), MassHealth Initial Disability Reviews (IDR), MassHealth Continuous Disability Reviews (CDR), Race, Ethnicity, and Language questions, Sexual Orientation and Gender Identity (SOGI) questions, RAC… Continue Reading Summer 2023 MA Health Care Learning Series

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Summer 2023 Health Safety Net Updates

Updates on new inpatient bad debt claim requirements, an update on certain inpatient claims pricing at $0.00, reimbursable telehealth services, INET portal agreements, information related to Health Safety Net interim payments and claim reconciliations, and FY21 closure date. Meeting Presentation Material Download PDF  

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Spring 2023 MassHealth Updates

MassHealth Updates include information and updates to MassHealth’s 2023-2024 Redetermination, MassHealth’s ACA-3 and SACA-2 applications, CAC Recertification, MassHealth flexibilities, 2023 Income Standards and Federal Poverty Guide, and more. Meeting Presentation Material Download PDF  

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Spring 2023 MA Health Care Learning Series

MassHealth and the Health Connector updates related to the MassHealth Renewals process, Health Connector Special Enrollment Period for those losing access to MassHealth coverage and best practices for helping people maintain access to care. Topics include member scenarios, Health Connector communications, MassHealth redeterminations, and Health Connector premium hardship waivers. Meeting Presentation Material Download PDF  

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