Rules for Health Safety Net established

Final regulations for the Health Safety Net Trust Fund (HSN) were released on September 21 by the Division of Health Care Finance and Policy (DHCFP) and go into effect on October 1st.

HSN replaces the Uncompensated Care Pool. The HSN will continue to reimburse hospitals and community health centers for care provided to underinsured and uninsured patients, but the rules about what and who is covered have changed.

Deductibles:

For individuals under 200% of the federal poverty level (FPL), there will be no deductible for HSN services. For those between 201-400% FPL, deductible rates remain at current levels. As a result of several hearings on proposed regulations, a $35 per month charge for Safety Net services that advocates opposed was not included.

Eligibility:

The HSN will only reimburse providers for services used by patients who cannot access health insurance.

Services provided to individuals who are eligible for but not enrolled in MassHealth or Commonwealth Care will not be covered. This change will be phased in. The state will begin sending information about this change to the first group of 'eligible but not enrolled' users of the HSN soon.

Services provided to individuals who are offered employer-sponsored insurance, but do not enroll in it, may continue to use the HSN until April 2008. In April, the HSN will be restricted to those employees whose employer-sponsored insurance is deemed unaffordable.

• Click here for information on the affordability tool.

Co-pays:

Patients between 101% - 200% FPL will have co-pays similar to those of Commonwealth Care for services received at hospitals. There will be no co-pays for adults using community health centers or for children, regardless of service site.

• Click here for a list of Commonwealth Care co-pays (PDF).

Covered services:

The HSN reimburses only for services provided under MassHealth Standard.

• Click here for a list of MassHealth-covered services.

More information:

• Final regulations at the official Health Safety Net website.
• What Health Care for All has to say.
• EOHHS press release (PDF) about this change.
• Alice Dembner's September 22 article in the Boston Globe.