One Care Initiative Launches Ombudsman Program

The Massachusetts One Care Initiative, which aims to better coordinate care and services for dually eligible individuals ages 21-64, officially launched the One Care Ombudsman program (OCO). Home health agencies involved in One Care should be aware of this new resource.

According to a notice sent by the state, the OCO:

  • Is an independent program operated by the Disability Policy Consortium (contracted by EOHHS) and its partners, Health Care For All (HCFA) and Consumer Quality Initiatives (CQI);
  • Addresses concerns and helps resolve conflicts regarding members’ enrollment in One Care or access to covered benefits and services so they can receive the benefits and exercise the rights they are entitled to in One Care; and
  • Works with members and their representatives, as well as MassHealth and the three One Care plans, to find resolutions to members’ concerns or complaints.

The OCO does not duplicate or replace other resources that are already available to help people with One Care (such as the SHINE program, the One Care plans’ member services, and MassHealth Customer Service). The OCO is an additional resource to support members who need or request independent problem-resolution assistance beyond what is available now. The OCO provides three main types of services: Continue reading “One Care Initiative Launches Ombudsman Program”