MedicaidCoverageMedium impact
Managed Care Entity Bulletin 131: SCO Medicaid Only Transition to MassHealth Fee-for-Service (FFS)
MassHealth·MA·Managed Care
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
Starting January 1, 2026, Senior Care Options (SCO) plans will only accept dually eligible members (those with both Medicare and Medicaid). Medicaid-only SCO members will be automatically disenrolled and transitioned to MassHealth fee-for-service.
Action Required
By August 1, 2025: Billing team must identify all SCO Medicaid-only patients and prepare for their transition to MassHealth fee-for-service by January 1, 2026. Update patient eligibility verification processes to confirm dual eligibility status for SCO members. Contact affected patients about upcoming coverage changes and verify new MassHealth fee-for-service authorization requirements.