Mailing error left 16,000 Commonwealth Care beneficiaries unaware of coverage cancellation, how to appeal decisions

Jun 26 2008

Massachusetts state officials on Monday said a mailing glitch last month left 16,000 residents without proper notice that they could lose their health coverage under Commonwealth Care and information about how to appeal the decision, the Boston Globe reports.

The notices were mailed last week, about a month later than they should have been sent, according to the Globe. MassHealth, the state's Medicaid program, said it would cover out-of-pocket medical expenses incurred by beneficiaries who lost coverage as a result of the late notices. Commonwealth Care offers coverage to state residents whose incomes make them ineligible for MassHealth but who are unable to purchase private insurance. The Massachusetts Health Insurance Connector Authority administers Commonwealth Care, but MassHealth determines who is eligible for the program.

Of the 16,000 residents affected by the glitch, 1,000 had their coverage canceled because they did not contribute monthly premiums; 6,200 were eligible to enroll in health plans offered by employers; and 8,700 should have received health coverage from other sources. Dick Powers, a spokesperson for the Massachusetts Health Insurance Connector Authority, said, "These people should have received an initial notice telling them why they were ineligible for Commonwealth Care and a follow-up notice in a matter of days telling them how to appeal the decisions."

Residents whose coverage was terminated have 30 days to appeal the decision, and those whose coverage ends on June 30 are encouraged to submit their appeals as soon as possible, MassHealth CEO Philip Poley said.

"We are deeply concerned about the potential havoc that this bureaucratic error will have on thousands of Massachusetts citizens," Barbara Anthony, executive director of Health Law Advocates, said. Brian Rosman, research director of advocacy group Health Care for All, said, "We hope the state finds a way to provide retroactive coverage so people do not interrupt their medical care when they've been terminated through no fault of their own" (Krasner, Boston Globe, 6/24).