MassHealth has introduced new guidance for managing medication administration in cases where both a Home Health Agency (HHA) and a Personal Care Attendant (PCA) are part of a member's care team. Under Massachusetts law, only one entity can be designated to assist with or administer medications. These new guidelines are designed to reduce overlap and ensure clarity in care responsibilities.

Key updates include:

• 60-Day Authorization Periods: A temporary 60-day window will now be used to allow Personal Care Management (PCM) agencies, MassHealth members, and HHAs to assess the member’s preferences and determine the most appropriate authorization path.
• Single Point of Responsibility: The MassHealth member or their designated surrogate will decide whether medication assistance should be included within their PCA service authorization, when clinically appropriate.
• Exception Protocols Defined: MassHealth has clarified specific exceptions for cases involving IV medications, methadone, J/G tubes for pediatric patients, and members under Rogers Orders or other court directives.

Agencies are encouraged to review the updated process carefully and ensure internal practices align with these changes. Importantly, HHAs will now have a formal opportunity to provide input into the PCM’s assessment of whether medication assistance through PCA services is suitable for a specific patient.

The Home Care Alliance is actively engaged in ongoing discussions with MassHealth and will provide additional updates and resources to support member agencies as implementation continues.