Category: MassHealth

Limitation to the Coverage Determination due to PHE

Although the PHE continues, the Mass Health public notice indicates that the coverage extension will be allowed for most clients, not all. I’ve already had three clients who received a notice from Mass Health indicating they need to reapply for coverage because they are turning 65 and need to submit a SACA.

PCA Webinar for Advocates -May 4, 2022 10 am

PCA Training for Advocates:  May 4, 10:00-11:30am We hope that you’ll come to (and spread the word about) our Personal Care Attendant (PCA) Training for Advocates! This training will cover the basics of MassHealth’s PCA program, which is unique in its structure and operation; and how to help consumers appeal decisions regarding their PCA hours with the Board of Hearings, one of the most common types of MassHealth […]

Out of state ER bill

I have a client who had a medical emergency in Maine last year. She has gone back and forth between MassHealth and the hospital in Maine. MassHealth states that unless the hospital is enrolled as a MassHealth provider, they won’t pay the claim. The hospital states that they “will not” enroll as a MassHealth provider […]

Monthly Report Data Collection

Hi fellow Navigators, My name is Buliah Mae, Lead Navigator for the Hilltown Community Health Centers.  Our three-person team is  currently considering new ways to track our monthly report data and are interested in how other health centers do this. What are the pros and cons? Is the program web based? Is the program customized […]


Hi All…   I think I’m out of the loop on this one…    I saw a bulletin for case managers about covid flexibilites to move patients to rehab with a hospital presumptive app.   Is there an application out there?  Do we have to contract?   Thanks..