Bill > S844

This bill aims to improve continuity of care for MassHealth (Massachusetts' Medicaid program) members with chronic conditions by modifying prior authorization requirements for community-based long-term care services. The bill defines "community long-term care services" to include various support services like Adult Day Health, Adult Foster Care, Home Health Aide, and Personal Care Attendant Services, and defines "chronic condition" as a persistent health condition expected to last more than one year. Under the new provisions, when MassHealth requires prior authorization for long-term services addressing a chronic condition, the authorization will be valid for up to five years, providing more stability and reducing administrative burden for patients. The bill also stipulates that service plans can be modified at the request of the member or primary care provider if there are changes in the patient's condition or service needs. Additionally, the bill allows Area Agencies on Aging (ASAPs) to conduct service authorizations for community long-term care services, with these authorizations serving as prior authorizations, and requires ASAPs to promote prompt service delivery. These changes are designed to streamline care, reduce paperwork, and ensure more consistent support for individuals with ongoing health challenges.

Health and Social Services

https://malegislature.gov/Bills/194/S844