Providing continuity of care for medicaid and chip-eligible youth following incarceration - masshealth is committed to driving positive changes in health care quality for demonstration beneficiaries…

Providing continuity of care for medicaid and chip-eligible youth following incarceration - masshealth is committed to driving positive changes in health care quality for demonstration beneficiaries thereby reducing disparities and improving health equity. As described in more detail below, masshealth will develop a robust monitoring and reporting process to assess implementation progress, service access and utilization, and individual outcomes. These activities will be critical to ensuring that implementation partners are held accountable for driving positive change in service access and quality, as well as reducing health disparities. Masshealth will continuously engage implementation partners and individuals with lived experience to inform the monitoring strategy, as well as strategies to address health disparities. This application for $5 million is to support massachusetts with the requirements of section 5121 of the 2023 CAA and to launch a successful reentry demonstration, as approved on april 19TH, 2024 by CMS in the masshealth 1115 waiver demonstration. Masshealth is applying to the CMS grant opportunity: section 206 of the consolidated appropriations act, 2024: state planning grants to promote continuity of care for medicaid and chip beneficiaries following incarceration to fund a procured third-party administrator to support correctional facilities in billing claims for pre-release services. Historically, correctional facility healthcare providers have not been eligible for medicaid payment for the services they deliver inside correctional facilities. Masshealth expects providers to begin billing masshealth for services delivered through the reentry demonstration. To reduce the administrative burden and provide as much support as possible so the correctional providers can focus on care delivery, masshealth will procure a third-party administrator (TPA) to process claims for services on behalf of the correctional facility providers. This TPA will be a key part of supporting our RE-entry demonstration program, by supporting facilities with required billing and reporting, allowing care providers to spend more time on care delivery, and providing accurate data on service delivery to support masshealth and facility's monitoring and evaluation efforts related to the RE-entry demonstration.