Beginning May 31, 2017, MassHealth will no longer be doing Prior Authorization (PA) of Long-Term Services and Supports (LTSS) for the majority of MassHealth members needing LTSS. MassHealth has instead contracted with a " Third-Party Administrator" (TPA) to authorize or deny requests for Long-Term Services and Supports (LTSS) by consumers and the Fee for Service System (FSS). Prior Authorization is now being provided by Optum Government Solutions, Inc., a subsidiary of United Healthcare, a national for-profit insurance company. MassHealth is contracting with a Third-Party Administrator, in part, because of fraud committed by home health providers in amounts in excess of the tens of thousands of dollars. DPC is very supportive of increased efforts do away with fraud, but remains wary of consolidating prior authorization authority into a national for-profit corporation.

All people with disabilities who rely on LTSS oppose fraud; it is against our own interest. Rather than money going to provide services for people, the money is taken out of the system hurting everybody. DPC appreciates assurances by MassHealth that Optum will have to use MassHealth guidelines, in making prior authorization decisions, but in too many ways the TPA remains a black box.

In coming weeks, DPC will update you with more information about Optum. In the meantime, you can find out more about the Third-Party Administrator here or you can also call the MassHealth helpline.

Optum: Beyond the TPA    

In addition to being responsible for prior authorization of LTSS, Optum will also be overseeing the new Electronic Visit Verification (EVV) in Massachusetts. EVV is the new electronic verification system that will be monitoring hours worked by PCAs. Think of it as a high tech remote punch clock, but in this case, the punch clock verifies the location of both the consumer and the PCA using Global Positioning Satellite (GPS). The PCA and consumer will need to check in at the beginning and end of each shift.  

DPC is meeting with consumers around the state to better understand your concerns and develop recommendations to MassHealth. At present, DPC is troubled that a one-size-fits-all approach will hurt consumers and PCAs.

MassHealth is also holding hearings (see schedule below) that we encourage you to attend. MassHealth has other plans for the TPA that have not been announced yet. We will continue to monitor these changes and inform you as they take place.

Let us know what you think of the TPA and EVV.  

John Winske

jwinske@dpcma.org

Justices of the Supreme Judicial Court invite applications for appointment to the Board of Directors of the Mental Health Legal Advisors Committee ( MHLAC) for terms ending in June 2021. MHLAC provides legal and policy advocacy to people with mental health concerns throughout the Commonwealth, with a focus on issues related to clients' ability to remain independent and to avoid abuse in community and institutional settings. Attorneys with experience in the delivery of legal services to indigent persons with mental health concerns, familiarity with clinical milieu, or background in mental health law and civil rights advocacy, are encouraged to apply. 

Committee members attend quarterly meetings in Boston and serve on Board subcommittees. One page resumes, with cover letters, should be submitted by mail or, preferably, email to: Mona R. Hochberg ( Mona.Hochberg@sjc.state.ma.us) at Supreme Judicial Court, John Adams Courthouse, One Pemberton Square, Boston, MA, 02108 by May 31.  If you have questions about the application process or the position, please contact Mona or Phillip Kassel, Executive Director, MHLAC ( pkassel@mhlac.org). 

When: Friday, June 2, 2017

Time: 10:00 am - 2:00 pm

Where: Easter Seals Technology Center, NPC Building Community Room,
89 South St. Boston, MA 02111

Cost: Free
Exhibitors will be on hand to show their latest devices in the area of low
vision and blindness. Here is a list of some of the companies and agencies
that will be participating.

* The Carroll Center Store 

  www.carroll.org

* New England Low Vision and Blindness -
www.nelowvision.com

* AdaptiVision

* Perkins Talking Book Library -
www.perkins.org/library

* BaumUSA, Inc 

 www.baumusa.com

* National Braille Press 

www.nbp.org

* MA Commission for the Blind
www.mass.gov/eohhs/gov/departments/mcb

* Sonzia.Inc 

www.sonzia.com

Please request accommodations by May 20.
For more information, please contact 

Catherine Bly 617-226-2634
cbly@eastersealsma.org

RSVP: Appreciated - ALL ARE WELCOME!

MassMATCH is funded by the Administration for Community Living at the U.S. Department of Health and Human Services and 

Managed by the Massachusetts Rehabilitation Commission. MassMATCH Assistive Technology Regional Center-Boston 

Operated by Easter Seals MA provides device demonstrations and loans of the latest equipment to the public.

When:  Wednesday, June 7, 2016, 5:00 P.M. - 7:00 P.M.

Where:  Transportation Building, Board Room (2nd Floor)

10 Park Plaza. Boston

Judge King will host his semi-annual public meeting on Accessibility at the T and the T's progress towards compliance with the MBTA/BCIL Settlement Agreement (focused on bus and subway service).  

Please note our new meeting time-5-7PM.

For more information, including how to request an accommodation, click here .

Also, I will be sending out a formal update on all of our on-going Accessibility Initiatives a week before the meeting. Stay tuned!

Hope to see you there,

 

When:  Monday,  June 12, 2017,  5:30 P.M. - 8:00 P.M.

Where:  Blue Cross Blue Shield of Massachusetts, 101 Huntington Avenue, Prudential Complex, Boston

Join us for our annual meeting, dinner and a training on using Facebook, Twitter and Social Media for Advocacy.

If you or someone you know is interested in applying to serve of the Board of Directors of the DPC please send a resume and a one page statement of why you want to serve and your skills to AKalogeropoulos@dpcma.org.  

To register contact Amy at AKalogeropoulos@dpcma.org.  

Also please inform us of any reasonable accommodation or dietary needs no later than Tuesday, May 30th.