March 2002	Most adult dental services eliminated; dentures still covered.
July 2002	Creation of MassHealth Drug List; list of higher cost drugs by drug class that requires prior authorization - ongoing additions to the list. MassHealth outreach efferts reduced or eliminated.
October 2002	Reduced time to return eligibility renewal form from 60 days to 30 days; return envelopes no longer enclosed; no reminder letter.
November 2002	Children's Medical Security Plan caps enrollment and starts a waiting list.
January 2003	Elimination of 5 optional services for adults: dentures, eyeglasses, orthotics, prosthetics, and chiropractic services. Drug co-payment raised from $0.50 to $2.00. Restricted eligibility for nursing facility care: reduction of spousal maintenance allowance from federal maximum to minimum.
February 2003	Prescription Advantage closes enrollment and increases cost- sharing.
March 2003	Increased premium charges for Family Assistance and CommonHealth members with income over 150% of the FPL. Elimination of emergency detoxification services for uninsured.
April 2003	Elimination of coverage for 36,000 long-term unemployed adults in MassHealth Basic. Elimination of post detoxification level-B services for adults. Elimination of coverage for acute hospital stays over 20 days for adults.
June 2003	Drug prior authorization required for certain psychiatric drugs for the first time.
July 2003	Healthy Start income limit reduced from 225% FPL to 200% FPL for pregnant women. 10,000 adult "aliens with special status" downgraded from full state-funded MassHealth to emergency Medicaid (MassHealth Limited). Emergency rules expand definition of "estate" subject to recovery after death of MassHealth recipient age 55 or over or MassHealth nursing home resident of any age. (Effective date delayed until July 1, 2004.) Prosthetic and orthotic services for adults restored.
August 2003	Prescription Advantage reopens enrollment. Bedhold payment for non-medical leave of absence from nursing facility eliminated.
September 2003	Restricted financial eligibility for nursing facility care where spouse remains at home: "income first" rule. Income eligibility for HIV+ individuals reduced from 200% FPL to 133% FPL. Medical Security plan charges premiums for Direct Coverage of $20/$30 per week for individual/family coverage for people collecting unemployment insurance; and lowers contribution toward private (COBRA) insurance.
October 2003	MassHealth Essential creates coverage for up to 36,000 long-term unemployed adults under 65.
November 2003	Premiums charges applied to 17,000 households under 65 with income between 100 - 150% FPL. Childrens Medical Security Plan charges premiums to families with income between 150 - 200% FPL and quadruples premium for families with income between 200% and 400% FPL.
January 2004	New coverage for women with breast or cervical cancer. More than 9,000 children on the Children's Medical Security Plan waitlist. No open enrollment for seniors age 66 or older in Prescription Advantage.
February 2004	Pharmacy copayments for generic drugs lowered to $1, for brand name raised to $3, subject to $200 annual cap. Copayments of $3 for non-emergency use of ER and $3 for an acute inpatient hospital stay, subject to a $36 annual cap. Further service copays planned. Medical Security Plan premiums for direct coverage are eliminated after enrollment in MSP direct coverage fell by nearly 50% since September when premiums were first required.
March 2004	Legislation delays effective date of estate recovery changes until July 1, 2004.