Doctors and advocates tell committee post‑acute care coverage rules confuse patients and slow placements

A physician who treats people with spinal cord injury and other complex conditions told the Joint Committee on Health Care Financing that current MassHealth processes for notifying enrollees about post‑acute coverage decisions are opaque and contribute to placement delays.

Why this matters: Witnesses said unclear procedures for coverage determinations can leave patients stuck in acute hospitals while awaiting post‑acute placements, increasing cost and reducing timely access to rehabilitative services.

Dr. Chloe Slocum, a rehabilitation physician at Spaulding sites in Cambridge and Charlestown, told the committee that post‑acute settings — long‑term care hospitals, inpatient rehabilitation facilities and skilled nursing facilities — play a key role in helping patients regain function and return home. She testified in support of House Bill 14 12 and Senate Bill 903, which aim to improve MassHealth communication with enrollees and coordination during determination processes.

Dr. Slocum said regulatory language currently emphasizes payment processes and provider obligations, not clear explanations for patients and families about clinical decisions. She told lawmakers the bills would reduce the bottleneck of patients awaiting placement and help address inequities in access to post‑acute care.

The committee asked clarifying questions about operational details and noted the testimony as part of a wider set of bills addressing access across the continuum of care. No vote was taken; witnesses urged the committee to advance the bills with clear requirements for enrollee notice and coordination.