THE FEDERAL GOVERNMENT allows states to recoup Medicaid costs after the deaths of patients who use the program. Estate recovery allows homes to be seized and sold to pay off expended Medicaid dollars, a move advocates decry as penalizing low-income families, and making Medicaid into a loan program.
Some states take the federal rules a step further. “MassHealth has some of the strongest and most draconian state recovery rules in the country,”Somerville Rep. Christine Barber said on a new “Health or Consequences” episode of The Codcast with John McDonough of the Harvard Chan School of Public Health and Dr. Paul Hattis, who recently retired from Tufts University School of Medicine.
According to the federal government, states have the option to recover payments for all Medicaid services except Medicare cost-sharing paid on behalf of Medicare Savings Program beneficiaries.
Barber said most people don’t typically think of health care and Medicaid as a loan families have to pay back, and “that’s exactly what’s happening here.”
The ongoing coronavirus pandemic has exacerbated circumstances, with family members who own and live in homes formerly occupied by Medicaid recipients struggling to contest the state claims due to ongoing court closures and backups.
“It’s been hard to find a lawyer, go to court, go through paperwork to address state recovery issues,” Barber said. She filed a bill with Northampton Sen. Jo Comerford to extend the amount of time a person has to respond to claims. The bill has been the subject of discussions with the Baker administration and has already had a hearing. Barber is hoping changes could be made “in the next couple of weeks.”
It is well known that there is often a difference in opinion on Beacon Hill between the Governor and legislature on health care issues, but the pandemic has provided new opportunity for camaraderie. McDonough asked about how legislators reconcile differences in opinion on their policies, but Barber emphasized the teamwork brought about during coronavirus, particularly on telehealth. Barber praised the Baker administration’s expansion of telehealth coverage in March. “It’s something incredibly helpful in the pandemic. I’ve used telehealth. Constituents think it’s helpful, especially for mental health,” she said. Patients with transportation issues can finally see a doctor, she said, while having their appointments covered.
All commercial insurers and the Group Insurance Commission, which provides health insurance for 460,000 state employees and their families, must cover all medically necessary telehealth services in the same way and pay the same rates as in-person services.
Legislation to extend telehealth rules to continue insurance coverage for two years at the same rate as in-person visits is pending on Beacon Hill.