ACO/BeHealthy Partnership Reminder

Posted on May 9, 2018

As a reminder, the continuity of care period began March 1. For members and providers who need additional time to complete the transition process, Health New England is working with you to ensure uninterrupted care and continued coverage for members through May 31. For behavioral health, continuity of care remains at 90 days (May 31). Some important reminders:

• Providers may still see their patients within this transition period.
• Out-of-network providers should be contacting the patient’s new plan, identified in EVS, for authorization and payment arrangements.
• Providers should inform patients they are not in the network and should not make subsequent appointments unless they have made long-term arrangements with Health New England.
• Health New England will still honor prior authorizations for services and prescriptions from previous plans during this transition.
• MassHealth members who are newly enrolled into the BeHealthy Partnership plan as of March 1 have until July 1, 2018, to change their health plan for any reason.
• As of April 9, 2018, MassHealth is allowing members who are out-of-area to request a service area exception. MassHealth will make their determination within 30 days of the request and will evaluate if the member meets the following criteria:
  • If the member has established a relationship with a PCP that does not cover the area where the member resides
  • Member is homeless and a specific Accountable Care Partnership Plan can better accommodate the member’s support needs
  • The Accountable Care Partnership Plan significantly supports language, communication and cultural needs; specialized health care needs; or other accessibility needs

Categories: Be Healthy/Masshealth Plan, HNE/Industry News and Information