Appendix K Emergency Preparedness Response and COVID-19 Addenda

  • On January 11, 2022, the Centers for Medicare and Medicaid Services (CMS) approved Massachusetts' 1915(c) Appendix K Emergency Preparedness Response and COVID-19 Addendum, granting the Commonwealth additional flexibilities for the operation of Home and Community Based Services (HCBS) waivers.
  • On July 8, 2021, the Centers for Medicare and Medicaid Services (CMS) approved Massachusetts' 1915(c) Appendix K Emergency Preparedness Response and COVID-19 Addendum, granting the Commonwealth additional flexibilities for the operation of Home and Community Based Services (HCBS) waivers.
  • On March 25, 2021, CMS approved Massachusetts’ fourth 1915(c) Appendix K Emergency Preparedness Response and COVID-19 Addendum, which grants additional flexibilities for the operation of Home and Community Based Services (HCBS) waivers.
  • On March 10, 2021, the CMS approved Massachusetts’ request for extension of its 1915(c) Appendix K Emergency Preparedness Response and COVID-19 Addendum, under which the state is granted flexibilities for the operation of Home and Community Based Services (HCBS) waivers, until six months after the end of the federal public health emergency (PHE) for COVID-19.
  • On June 17, 2020, the CMS approved Massachusetts' second 1915(c) Appendix K Emergency Preparedness Response and COVID-19 Addendum, granting the Commonwealth additional flexibilities for the operation of Home and Community Based Services (HCBS) waivers. 
  • On April 29, 2020, the Centers for Medicare and Medicaid Services (CMS) approved Massachusetts' 1915(c) Appendix K Emergency Preparedness Response and COVID-19 Addendum, granting the Commonwealth additional flexibilities for the operation of Home and Community Based Services (HCBS) waivers. 

Disaster Relief State Plan Amendments

  • On March 9, 2022, CMS approved Massachusetts Disaster Relief State Plan Amendment to provide a temporary rate increase for adult day health and habilitation services.
  • On February 11, 2022 CMS approved Massachusetts’ Disaster Relief State Plan Amendment to add a temporary rate increase of 10% to behavioral health services including ABA services, Children's Behavioral Health Initiative (CBHI) services, early intervention rates, psychologist rates and substance abuse disorder (SUD) clinic rates effective April 1, 2020 through July 31, 2020.
  • On November 10, 2021 CMS approved Massachusetts’ Disaster Relief State Plan Amendment to allow the use of FY2019 time study results when calculating FY2020 final cost reimbursement rates for the Department of Children and Families (DCF) and the Department of Mental Health (DMH) rehabilitation services.
  • On October 14, 2021 CMS approved Massachusetts’ Disaster Relief State Plan Amendment to make supplemental payments to Pediatric Chronic Disease and Rehabilitation Inpatient Hospitals (CDRH).
  • On June 2, 2021 CMS approved Massachusetts’ Disaster Relief State Plan Amendment to reimburse certain specifically listed clinical laboratory services, including COVID-19 specimen collection and testing, with updated fee schedules.
  • On April 27, 2021 CMS approved Massachusetts’ Disaster Relief State Plan Amendment to add temporary rate increases for Adult Day Health and Day Habilitation providers during the emergency period.
  • On April 8, 2021 CMS approved Massachusetts’ Disaster Relief State Plan Amendment to eliminate co-pays for a number of eligible populations and services.
  • On March 25, 2021 CMS approved Massachusetts’ Disaster Relief State Plan Amendment to add temporary rate increases for Adult Day health and Day Habilitation providers during the public health emergency.
  • On February 12, 2021 CMS approved Massachusetts’ Disaster Relief State Plan Amendment to update payment methodologies for certain Hospitals, Community Health Centers, and Physicians, and authorize coverage for mobile testing services done by EMTs during the COVID-19 Emergency period.
  • On January 19, 2021 CMS approved Massachusetts’ Disaster Relief State Plan Amendment to pay a one-time supplemental payment to Chronic Disease and Rehabilitation Inpatient Hospitals.
  • On December 18, 2020, CMS approved Massachusetts’ CHIP Disaster Relief State Plan Amendment to implement flexibilities including those related to related to continuous coverage for certain CHIP members, self-attestation for certain eligibility factors, hospital presumptive eligibility periods and cost sharing.
  • On December 10, 2020, CMS approved Massachusetts’ Disaster Relief State Plan Amendment to update payment methodologies for acute inpatient and psychiatric inpatient hospital services during the PHE.
  • On October 27, 2020, CMS approved Massachusetts’ Disaster Relief State Plan Amendment to update payment methodologies for certain Long-Term Services and Support providers during the COVID-19 Emergency Period as well as expand the provider types that can order, certify and recertify member's home health care plans.
  • On August 18, 2020, CMS approved Massachusetts’ Disaster Relief State Plan Amendment related to hospital presumptive eligibility (HPE) and cost-sharing requests. The SPA allows flexibilities for HPE for certain individuals 65 and older and allows the state to eliminate copays on acute inpatient hospital stays for all members.
  • On July 20, 2020, CMS approved Massachusetts’ Disaster Relief State Plan Amendment related to drug benefits. The SPA allows for adjustment to the professional dispensing fee when medications are delivered to members and makes certain exceptions to the state's preferred drug list if drug shortages occur. 
  • On July 15, 2020, CMS approved Massachusetts’ Disaster Relief State Plan Amendment to temporarily increase behavioral health rates for Applied Behavioral Analysis, certain Children and Behavioral Health Initiative, Early Intervention, Psychologist, and Substance Use Disorder Clinic services.​​

1135 Waivers

  • On December 23, 2020, CMS approved Massachusetts' fourth 1135 waiver request, allowing for clinic services to be provided in the clinic practitioner’s home and the state’s COVID-19 isolation and recovery sites. PDF | Word
  • On October 29, 2020, CMS approved one item from Massachusetts' third 1135 waiver request, and one item from its fifth 1135 waiver request, allowing for flexibilities in private duty nursing services and waiving the signature requirements of HCBS person-centered service plans. PDF
  • On September 29, 2020, Massachusetts submitted a fifth 1135 waiver request to request that non-physicians be allowed to sign off on the plan of care for private duty nursing. PDF | Word
  • On July 9, 2020, Massachusetts submitted a fourth 1135 waiver request to request a waiver to permit the state to make payments for clinic services delivered via telehealth or in other non-clinic locations. PDF | Word
  • On June 16, 2020, CMS approved ​one item from Massachusetts' third 
    1135 Waiver request, allowing the state to modify the deadline for conducting annual Targeted Case Management monitoring visit and follow-up. The waiver can be found at https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99401
  • On May 8, 2020, CMS approved one item from Massachusetts' third 
    1135 request, allowing MassHealth to provide Home and Community-Based Services (HCBS) in alternative care settings, including: hotels, shelters, and residential schools. The waiver can be found at ​ https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/98331
  • On April 23, 2020, Massachusetts submitted a third 1135 waiver request to CMS, requesting additional flexibilities for the health care system. PDF | Word
  • ​On April 7, 2020, Massachusetts submitted a second 1135 waiver request to CMS, requesting additional flexibilities for the health care system. PDF | Word
  • On March 26, 2020, the Centers for Medicare and Medicaid Services (CMS) approved Massachusetts’ 1135 Waiver, granting the Commonwealth additional flexibilities for the health care system, including MassHealth, and removing barriers that interfere with needed services. Massachusetts’ 1135 Waiver can be found here: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54066
  • On March 20, 2020, Massachusetts submitted its 1135 Waiver request to CMS PDF | Word 

1115 Waivers

  • On December 30, 2020, CMS approved Massachusetts’ 1115 Waiver request ​to provide MassHealth additional flexibilities to best respond to the COVID-19 public health emergency. 
    • Emergency 1115 Approval Letter: PDF | Word 
    • Emergency 1115 Evaluation Approval Letter: PDF | Word 
    • Emergency 1115 Evaluation Design: PDF | Word
  • On April 24, 2020, Massachusetts submitted an 1115 Waiver request ​to provide MassHealth additional flexibilities to best respond to the COVID-19 public health emergency PDF | Word

MAGI Verification Plan

  • On September 15, 2020 following consultation with CMS, Massachusetts updated its MAGI-based verification plan addendum​, which outlines certain the policies and procedures during the COVID-19 national emergency. 
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