Implementation of health care law proceeds

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Mitt Romney (file photo)
Governor Mitt Romney announced on Monday that his administration has hit the first milestone in the implementation of the new health insurance law by submitting to the federal government for approval a comprehensive plan detailing how it will substantially reduce the number of uninsured in the Commonwealth. Romney also announced the formation of the MassHealth Fraud Prevention unit to insure the integrity of the $7 billion per year program, funded by $1.5 million in the health care reform bill. Until now, MassHealth had several programs in different parts of the agency addressing the issue of fraud. Approval by the federal Centers for Medicare and Medicaid Services (CMS) is required to maintain the availability of $385 million of federal Medicaid funding during each of the next two fiscal years. Last year, CMS advised Massachusetts to submit its plan by January 15, noting that a minimum of 120 days would be needed to review the proposal without jeopardizing the continuous availability of the $385 million after July 1. The state missed that deadline as health care reform was not passed by the Legislature until April. “Despite the legislative delays, it is our hope that our partners in the federal government will expedite their review and approve the Commonwealth’s plan by July 1,” said Romney. “We will be aggressive in our efforts to secure the maximum level of federal funding and stand ready to provide any and all additional information that may be required.” Romney said a rapid response team comprised of Health and Human Services and MassHealth staff has been assembled to assist the CMS review process. Health and Human Services Secretary Tim Murphy said: “Implementation will be just as challenging as getting the legislation passed, but it is a challenge we relish. We look forward to working closely with the federal government and other stakeholders to make health care insurance available to every resident of Massachusetts.” According to the plan filed today, the recently approved health insurance law accomplishes the following key goals sought by the federal government: Subsidizes the purchase of private insurance for low-income individuals to reduce the number of uninsured; Directs more federal and state dollars to individuals and less to institutions; and Improves the fiscal integrity of the MassHealth program. Key milestones in the timeline submitted as part of the plan include the operationalization of the Connector Authority between May and October, the offering and enrollment of lower-income residents into premium assistance programs by October, the offering of private, non-subsidized products by January, and statewide open enrollment between March and May 2007 in anticipation of the individual insurance requirement that starts July 1, 2007. Meanwhile, the Legislature and the Executive branch are redoubling efforts to ensure program integrity in MassHealth. MassHealth is also planning a comprehensive effort to re-credential its providers. The effort, suggested by national program integrity experts consulted by MassHealth, will begin with an immediate targeted review of high-risk providers. “We’ve created this unit to build and document a coordinated process of detecting, identifying and referring suspected fraud and abuse within both the provider and member communities,” said Massachusetts Medicaid Director Beth Waldman. “Centralization will allow MassHealth to direct resources strategically and provide an efficient way to inform providers and members that we take fraud very seriously.” “We believe re-enrolling our providers will pay dividends and reduce risk to the program,” said Murphy. “And we are confident that the creation of the Fraud Prevention Unit will enhance our efforts to build an efficient and sound system for fraud and abuse identification and referral in MassHealth.” Massachusetts’ full submission to CMS is available at www.mass.gov/eohhs .
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Social Service Organizations Highlight Challenges, Successes at Poverty Talk

By Brittany PolitoiBerkshires Staff

Dr. Jennifer Michaels of the Brien Center demonstrates how to use Narcan. Easy access to the drug has cut overdose deaths in the county by nearly half. 

PITTSFIELD, Mass. — Recent actions at the federal level are making it harder for people to climb out of poverty.

Brad Gordon, executive director of Upside413, said he felt like he was doing a disservice by not recognizing national challenges and how they draw a direct line from choices being made by the Trump administration and the challenges the United States is facing. 

"They more generally impact people's ability to work their way out of poverty, and that's really, that's really the overarching dynamic," he said. 

"Poverty is incredibly corrosive, and it impacts all the topics that we'll talk about today." 

His comments came during a conversation on poverty hosted by Berkshire Community Action Council. Eight local service agency leaders detailed how they are supporting people during the current housing and affordability crisis, and the Berkshire state delegation spoke to their own efforts.

The event held on March 27 at the Berkshire Athenaeum included a working lunch and encouraged public feedback. 

"All of this information that we're going to gather today from both you and the panelists is going to drive our next three-year strategic plan," explained Deborah Leonczyk, BCAC's executive director. 

The conversation ranged from health care and housing production to financial literacy and child care.  Participating agencies included Upside 413, The Brien Center, The Food Bank of Western Massachusetts, MassHire Berkshire Career Center, Berkshire Regional Transit Authority, Greylock Federal Credit Union, Massachusetts College of Liberal Arts, and Child Care of the Berkshires. 

The federal choices Gordon spoke about included allocating $140 billion for the U.S. Immigration and Customs Enforcement, investing $38 billion to convert warehouses into detention centers, cutting $1 trillion from Medicaid over 10 years, a proposed 50 percent increase in the defense budget, and cutting federal funding for supportive housing programs. 

Gordon pointed to past comments about how the region can't build its way out of the housing crisis because of money. He withdrew that statement, explaining, "You know what? That's bullshit, actually."

"I'm going to be honest with you, that is absolute bullshit. I have just observed over the last year or so how we're spending our money and the amount of money that we're spending on the federal side, and I'm no longer saying in good conscience that we can't build our way out of this," he said. 

Upside 413 provided a "Housing Demand in Western Massachusetts" report that was done in collaboration with the University of Massachusetts at Amherst's Donahue Institute of Economic and Public Policy Research. It states that around 23,400 units are needed to meet current housing demand in Western Mass; 1,900 in Berkshire County in 2025. 

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