ASSET TEST

DMA has postponed the implementation of asset testing for the remainder of this fiscal year (through June 30th). They may still decide to implement asset testing during the next fiscal year, but their plans are unclear. I will keep you posted as I learn more.

Premiums

DMA has issued the first batch of termination notices to newly-charged households who have failed to pay premiums. The notice does indicate why the member is being dropped, but does not advise members that they may seek a hardship waiver, or what they need to do to be reinstated.

PT, OT, Speech Prior-Approval

Prior to February 1, 2004 prior authorization was required for more than 20 PT or 20 OT visits within a 12-month period. Speech/language therapy did not require prior authorization. Originally planned for February 1, 2004, a new prior authorization policy, has been delayed and is scheduled to go into effect on April 15, 2004. Under the new policy, PT and OT will require prior authorizationis required for more than 8 PT visits, 8 OT visits or 15 speech/language therapy visits.

-Adapted from materials from Kim Simonian, MPH, Health Access and Community Partnerships, Partners HealthCare Community Benefit Programs.