Slide 1: One Care: Implementation Council Meeting
Executive Office of Health and Human Services
MassHealth Demonstration to 
Integrate Care for Dual Eligibles
May 14, 2024 10:00 AM – 12:00 PM
Virtual Meeting via Zoom
 
Note: this slide contains the following footnote. “CONFIDENTIAL; FOR POLICY DEVELOPMENT PURPOSES ONLY”
Slide 2: Flexible Benefits (Section 1 – Definition of Terms)
Section 1 of the One Care Three-way Contract outlines Definition of Terms used through out the contract

Flexible Benefits Definition
•	In Section 1.60 of the Three-way Contract Flexible Benefits is defined as:

•	Items or services other than – or beyond the amount, duration, and scope, of – Covered Services (defined in Section 1 and listed in Appendix B, Exhibits 1, 2, 3, and 4). The Contractor may use the capitated payment to fund such items as specified in an Enrollee’s Individualized Care Plan and appropriate to address an Enrollee’s needs.

Person-centered Care and Planning Definition
•	In Section 1.96 of the Three-way Contract Flexible Benefits is included in the Person-centered care and Planning Definition as follows:

•	The provision of Covered Services, Flexible Benefits, and coordination to an Enrollee to meet the Enrollee’s needs and goals. Placed at the center of care and planning, the Enrollee and their needs, preferences, and goals provide direction and purpose for what and how medical, behavioral health, LTSS, and Flexible Benefits are provided, including to address social determinants of health and health equity. This is achieved by integrating available resources of the MassHealth and Medicare programs as defined in contracts with participating health plans.

Note: this slide and all slides going forward contain the following footnote. “Confidential – for policy development purposes only”
Slide 3: Flexible Benefits – Individualized Care Plan (ICP) Section 2.6.3
Additional language has been added to the Individualized Care Plan Section 2.6.3 of the One Care Three-way contract to note that the ICP must:

Individualized Care Plan Section 2.6.3.2.6
•	Identify Flexible Benefits that may promote independent living or recovery, positively impact outcomes, or address access or other barriers to achieving goals in the ICP.

Individualized Care Plan Section 2.6.3.2.7
•	Flexible Benefits may be identified and requested in the ICP by the Enrollee, a provider, or any member of the Enrollee’s ICT as part of Person-Centered Planning. Consistent with Section 2.9.5, The Contractor is encouraged to authorize Service Requests for Flexible Benefits in the ICP that add value, including by promoting independent living or recovery, positively impacting outcomes, or addressing barriers to achieving goals in the Enrollee’s care plan.
Slide 4: MassHealth is seeking individuals to serve on the One Care Implementation Council
Application Deadline is Wednesday, May 15, 2024 at 5:00pm

Applications can be found on Commbuys and the One Care Implementation Council web pages

•	Notice of Opportunity to Participate in the Implementation Council for One Care

•	COMMBUYS