6 Managed Care Organizations Selected for Health Care Coverage

Secretary of Health and Human Services (HHS) John Polanowicz  announced last week that six managed care organizations have been selected to provide comprehensive health care coverage for low-income adults who will qualify for the new MassHealth CarePlus program as part of the Affordable Care Act (ACA) starting in 2014.

The ACA allows states to expand Medicaid coverage to low-income adults making less than 133 percent of the federal poverty level – about $15,000 a year for an individual. CarePlus is MassHealth’s new benefit plan for this population. HHS expects about 325,000 individuals to be enrolled in MassHealth as part of the ACA’s Medicaid expansion; the majority of which will be enrolled in MassHealth CarePlus.

“President Obama’s Affordable Care Act has many important benefits for Massachusetts, including an expansion of Medicaid coverage to more low income residents through our new CarePlus program,” said Secretary Polanowicz. “This program will help us expand our already nation-leading coverage, with more comprehensive, streamlined care, and additional federal funding to support this population.”

Six MCOs were selected through a competitive process to serve MassHealth CarePlus members, including: Boston Medical Center HealthNet Plan, CeltiCare Health Plan of Massachusetts, Fallon Community Health Plan, Health New England, Neighborhood Health Plan, and Network Health. These MCOs will now work with HHS to prepare for the January 1, 2014 start date for CarePlus enrollment.

MassHealth will automatically enroll existing eligible members in CarePlus, and members will have the opportunity to select among the CarePlus MCOs, when they receive their new enrollment guides in December.

“Each of these managed care organizations has a strong record of serving members through MassHealth or Commonwealth Care, and we excited to work with them through the ACA to provide enhanced coverage to more members,” said Acting MassHealth Director Kristin Thorn.

Under the ACA, many low-income employees who were not previously eligible for subsidized coverage will also become eligible for MassHealth CarePlus without penalties for employers.

MassHealth is Massachusetts’ Medicaid program serving low-income people. The state-run program receives significant federal financial support, and the ACA enables a higher federal matching rate to provide coverage for Medicaid expansion. The ACA has also provided funds to improve program integrity at MassHealth, to prevent fraud and abuse of the system before it happens.

Using tools available through the ACA, the Patrick Administration is significantly streamlining state health insurance coverage within MassHealth and the Health Connector. Learn more about how the ACA is good for Massachusetts: http://www.mass.gov/eohhs/feature-story/top-10-reasons-why-the-affordable-care-act-is-good.html

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