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Public Health in Massachusetts

The Center for Health Law and Policy Innovation of Harvard Law School has a special focus on infectious disease and access to health care services that promote public health in Massachusetts.

CHLPI publishes a variety of factsheets and other resources to help health care providers, community-based organizations, and the general public navigate coverage for infectious disease prevention, care, and treatment.

Coronavirus (COVID-19) Updates

The following updates highlight certain steps taken by Massachusetts officials to respond to COVID-19. The updates are not exhaustive and the policy landscape is evolving rapidly. For more information, please review specific department websites.

  • On March 10th, Governor Baker declared a state of emergency to respond to COVID-19. 
  • The Department of Public Health has issued guidance
  • The  Division of Insurance has issued guidance outlining expectations regarding appropriate coverage of testing and treatment for COVID-19. Included among the expectations are that carriers: 
    • forgo cost-sharing for various COVID-19-related services;
    • promote tele-health options;
    • relax prior authorization requirements so that members can get medically necessary care if they are at risk of contracting the coronavirus; and
    • relax out-of-network requirements when access to urgent testing or treatment is unavailable from in-network providers.
  • MassHealth has released guidance for providers and managed care entities. The guidance includes various measures to support access to services including:  
    • guidance for managed care entities that aligns with the Division of Insurance bulletin above;
    • expanded coverage, through Hospital-Determined Presumptive Eligibility, for individuals with a diagnosis or presumptive diagnosis of COVID-19; and 
    • effective March 14, MassHealth is allowing early refills and 90-day supplies of prescription medications. 
  • On March 15, Governor Baker issued an order regarding telehealth, which includes the following statement:  “To protect the Public’s health and to mitigate exposure to and the spread of COVID-19, the Group Insurance Commission (“GIC”), all Commercial Health Insurers, Blue Cross and Blue Shield of Massachusetts, Inc, and Health Maintenance Organizations (Carriers) regulated by the Division of Insurance (“Division”), are herby required to allow all in-network providers to deliver clinically appropriate, medically necessary covered services to members via telehealth.”  
  • The MA Department of Insurance issued a bulletin following up on the Governor’s order, requiring health insurance carriers to permit all in-network providers to deliver covered services via telehealth for the duration of the Emergency Order.  
  • MassHealth will protect coverage for all individuals who have Medicaid coverage as of March 18, 2020 and for all individuals approved for coverage during the COVID-19 outbreak national emergency and for one month after the emergency period ends. Coverage will only end if an individual requests termination of eligibility or if they are no longer a resident of the state. Members will not lose coverage or have a decrease in benefits for any other reason. Additional helpful information is available in this FAQ published by MassHealth.
  • The Massachusetts Law Reform Institute is maintaining a table summarizing key COVID-19 related changes affecting applicants and members in MassHealth, Health Safety Net, and the Health Connector. 
  • The Department of Public Health maintains a report of cases, updated by 4pm daily. 
    • Under an Order by Governor Baker, health care providers must make every reasonable effort to collect complete demographic information, including full name, date of birth, sex, race and ethnicity, address, and telephone number on patients with confirmed or suspected COVID-19, and must include such information collected when ordering a laboratory test for the disease. Laboratories conducting tests for COVID-19 must report demographic information in accordance with requirements for reporting other infectious diseases to the Department. 
  • The Department of Public Health has posted guidance on the process for requesting Personal Protective Equipment (PPE) from the Massachusetts Emergency Management Agency. 
  • MassHealth has published a guide for health care providers on identifying patients who need food assistance and connecting them to resources in the community. The guide is available in English and Spanish. MassHealth has also published a related resource for patients. The resource is available in English and Spanish.
  • Information on health care settings and MA’s reopening is available here. “Beginning June 8, 2020, health care providers may incrementally resume in-person elective, non-urgent procedures and services, including routine office visits, dental visits, and vision care, subject to ongoing compliance with public health and safety standards. All other in-person medical, behavioral health, dental and vision services may resume, except for elective cosmetic procedures and in-person day programs, which will be a part of Phase 3.”
  • The Health Insurance Connector Authority has extended the Special Enrollment Period for uninsured Massachusetts residents to purchase health insurance to July 23.

Supreme Court Lifts Injunction, Permits New Public Charge Rules to Take Effect

As of January 27, 2020, the United States Supreme Court lifted the injunction on new public charge regulations.

Importantly, the regulation does not apply to most immigrants. We recommend visiting protectingimmigrantfamilies.org for more information.

Resources

Keeping Health Information Private: the PATCH Act

For people who are covered under someone else’s health insurance plan, a Massachusetts law called the PATCH Act (for Protecting Access To Confidential Healthcare) may help keep information about health services they receive private. The resource below provides more information about the PATCH Act and how it works, as well as a sample script that can be used for contacting health insurance companies.

At a Glance Guides

These tools provide an overview of coverage for key services in Massachusetts in order to give health care providers quick access to basic coverage information and help inform discussions with patients.

Insurance Reimbursement for Preventive Health Care Services in Massachusetts

Many health insurance plans must cover the entire cost of certain preventive health care services and cannot impose a financial contribution (e.g., a co-payment or other “out-of-pocket” payment) on patients. These factsheets provide an overview of coverage for specific preventive services.

  • Hepatitis A and Hepatitis B (forthcoming)

FAQ: Prior Authorization for Hepatitis C Virus Treatment

This resource answers common questions about prior authorization requirements for hepatitis C virus treatment in the Massachusetts Medicaid program and dispels myths that create barriers to care.

Other

CHLPI is also active in other public health and health care initiatives in Massachusetts, including:

  • EndHepCMA, a collaborative effort among stakeholders to achieve the elimination of hepatitis C in Massachusetts
  • Food is Medicine Massachusetts, a coalition organized to implement the recommendations of the Food is Medicine State Plan, improve cross-sector communication among Food is Medicine partners, and advocate for federal and state policies that support Food is Medicine interventions
  • MA Trans Health Coalition, a network of over 40 organizations committed to expanding access to comprehensive and non-discriminatory gender-affirming health care in the Bay State

911 Good Samaritan Resources

These resources explain how the Massachusetts 911 Good Samaritan law can protect people from drug-related charges if they seek help for themselves or someone else who is overdosing. Available in poster and pocket card formats, and in English and Spanish.