Author: Julie Jones

Pharmacy Copays

Hello, Can anyone clarify the rules around the pharmacy copays?  If a patient has only MassHealth, we have had no issues having their copay waived for inability to pay.  But when a patient has Medicare and MassHealth, the pharmacy is saying that they do not have to follow this rule since the person has Medicare […]

MassHealth Letter

Hello again, We’ve started receiving quite a few MassHealth letters that state the individual does not qualify for MassHealth (or any other program) due to “The person cannot be found 130 CMR 503.002 (G)(2)”.  Does anyone know what this means?  Are they looking for proof of residency or something else?  These are all homeless individuals […]

PSIs

Hi all, We’ve always sent in Permission to Share Information (PSI) forms to MassHealth with my name (as the manager) and the organization’s information.  This has allowed any of our staff to call in and be given the rights provided by the PSI.  Over the last week or so I’ve had three different staff call in about various […]

Family Case

Hi all, Can anyone help with advice for this mom?  Mother is in the process of separating from the father (he did move out).  Mother does not work and is on a Connector Care plan.  Father is self-employed and also on a Connector Care plan.  They have two children who were both born premature and […]