Error puts 16,000 in dark about benefits
MassHealth mailing on eligibility delayed
A mailing glitch by a state agency last month left 16,000 residents without proper notice that they might be losing their healthcare coverage or information on how to appeal a denial of coverage.
The notices were mailed last week, about a month after they should have been sent. In the meantime, some residents may have lacked health insurance, potentially leaving them at risk for enormous out-of-pocket medical bills.
MassHealth, the state Medicaid provider, yesterday acknowledged the notices were sent late and said it would cover medical bills for any resident that was left without coverage as a result.
"We strive for perfection," said Philip Poley, chief operating officer of MassHealth. "If we hear that we weren't perfect, we look for the source of the problem. It's our responsibility to notify members in a timely fashion regarding their eligibility."
The error, discovered by healthcare advocates, illustrates some of the bureaucratic complications involved in extending healthcare coverage to all Massachusetts residents as a result of the state's healthcare reform law.
The Commonwealth Health Insurance Connector Authority administers Commonwealth Care, a program that provides free and subsidized health policies to low-income residents. The connector, in turn, farms out the process of determining who is eligible for the program - and the associated mailings - to MassHealth.
The 16,000 residents affected by the mailing problem included about 1,000 whose coverage was being canceled because they failed to pay monthly insurance premiums; 6,200 who were eligible to enroll in health plans offered by their employers; and 8,700 who should have received health coverage from other sources, such as college health plans for students.
"These people should have received an initial notice telling them why they were ineligible for Commonwealth Care and a follow-up notice in a matter of days telling them how to appeal the decisions," said Dick Powers, a spokesman for the connector.
Residents whose coverage was terminated will now be given 30 days to appeal the decision, said Poley, and those whose coverage ends June 30 are encouraged to submit their appeals as soon as possible.
"We are deeply concerned about the potential havoc that this bureaucratic error will have on thousands of Massachusetts citizens," said Barbara Anthony, executive director of Health Law Advocates, a Boston advocacy group. "The term of one's healthcare coverage is a very serious matter and it should have been handled much more efficiently and with great sensitivity by the state authorities."
Brian Rosman, research director of Health Care for All, an advocacy group that has supported the creation of a universal health coverage policy, said, "We hope the state finds a way to provide retroactive coverage so people do not interrupt their medical care when they've been terminated through no fault of their own."
Rosman said the delayed mailing shows the need for local nonprofits and health advocacy groups to continue to receive funding for activities related to healthcare reform. The House, in its version of the state budget, set the annual funding at $3.5 million for the fiscal year that begins July 1. But the Senate recommends eliminating the funding. The differences could be resolved in a conference committee between the two houses of the Legislature.
Jeffrey Krasner can be reached at krasner@globe.com. 