Amendment #715 to H.3400

Amendment #715 to H3400

Commonwealth Care Bridge

[Sponsors] Representatives Cabral of New Bedford, Rushing of Boston, Straus of Mattapoisett, Sanchez of Boston, Swan of Springfield, Sciortino of Medford, Malia of Boston, Toomey of Cambridge, Turner of Dennis, Fox of Boston, Balser of Newton, O’Day of West Boylston, Smizik of Brookline, Khan of Newton, Canavan of Brockton, Sannacandro of Ashland, Provost of Somerville, Forry of Boston, Coakley-Rivera of Springfield and Brady of Brockton move to amend the bill in Section 2E by striking out item 1595-5819 and inserting in place thereof the following:

“1595-5819"

For an operating transfer to the Commonwealth Care Trust Fund, established under section 2OOO of chapter 29 of the General Laws; provided, that up to $15,000,000 shall be transferred from the Commonwealth Care Trust Fund to the Health Safety Net Trust Fund, established under section 36 of chapter 118G of the General Laws, to cover only those costs of the health safety net incurred between July 1, 2011 and December 31, 2011; provided further, that up to an additional $15,000,000 shall be transferred from the Commonwealth Care Trust Fund to the Health Safety Net Trust Fund upon receipt of a certification from the Secretary of the Executive Office of Health and Human Services to the Secretary of the Executive Office for Administration and Finance and the House and Senate Committees on Ways and Means that the Division of Health Care Finance and Policy has successfully implemented a claims adjudication system for both inpatient and outpatient claims in accordance with provisions of Chapter 58 of the acts of 2006; provided further, that the Secretary of the Executive Office of Health and Human Services shall also report on all measures undertaken to recover invalid payments made to health care safety net providers in prior fiscal years; provided further, that the hospital fiscal year 2012 payment amount to each hospital shall be funded by the Health Safety Net Trust Fund; provided further, that payments may be made either as safety net care payments under the commonwealth’s section 1115 waiver, or as an adjustment to Title XIX service rate payments, or a combination thereof; provided further, that the executive office of health and human services and the health safety net office may use other federally permissible funding mechanisms available for public service hospitals, as defined in 114.1 CMR 36.02, to reimburse up to $70,000,000 of uncompensated care at the hospitals using sources distinct from the funding made available to the Health Safety Net Trust Fund; provided further, that the secretary of administration and finance, in consultation with the secretary of health and human services and the executive director of the commonwealth health insurance connector authority, shall on a quarterly basis evaluate the revenue needs of the health safety net program funded by the Health Safety Net Trust Fund and the Commonwealth Care subsidized health insurance program funded by the Commonwealth Care Trust Fund, and if necessary, transfer monies between these funds for the purpose of ensuring that sufficient revenues are available to support projected program expenditures; provided further, that the secretary of administration and finance shall report any transfers made between the Health Safety Net Trust Fund and the Commonwealth Care Trust Fund to the house and senate committees on ways and means and the joint committee on healthcare financing within 30 days of the proposed transfer; and provided further, that up to $2,500,000 shall be applied for the purpose of providing small business health insurance wellness subsidies pursuant to section 7A of Chapter 176Q of the General Laws.............................. $752,011,822”; and

in said section 2E by striking out item 1595-5820; and

by inserting after section 107 the following section:-

SECTION 107A. (a) Notwithstanding any general or special law to the contrary and except as provided in subsection (b), an eligible individual pursuant to section 3 of chapter 118H of the General Laws shall not include a person who is not eligible to receive federally-funded benefits under sections 401, 402 or 403 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. No. 104-193, as amended, for fiscal year 2012.

(b) Notwithstanding any general or special law to the contrary, the secretary of administration and finance, the secretary of health and human services and the executive director of the commonwealth health insurance connector authority may, in their discretion and subject only to the terms and conditions in this subsection, establish or designate a health insurance plan in which a person who is not eligible to receive federally-funded benefits under said sections 401, 402 or 403 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public Law 104-193, as amended, but who is an eligible individual pursuant to said section 3 of said chapter 118H may enroll for the period including July 1, 2011 to June 30, 2012, inclusive. The plan may be contracted for selectively from the health plans that contracted in fiscal year 2011 to provide insurance coverage to commonwealth care or MassHealth enrollees. Total state costs of providing coverage to all such persons, net of enrollee contributions and any federal financial participation, shall not exceed $50,000,000 for fiscal year 2012. To the extent that additional federal financial participation becomes available for paying the costs of such coverage, the secretary of administration and finance may direct the comptroller to make such amounts available from the General Fund for the purpose of paying for the costs of such coverage. If the secretary of administration and finance, the secretary of health and human services and the executive director of the commonwealth health insurance connector authority determine that the projected costs of enrolling eligible individuals in such coverage in fiscal year 2012 will exceed net state costs of $50,000,000, they may limit enrollment in such coverage. If the secretary of administration and finance, the secretary of health and human services and the executive director of the commonwealth health insurance connector authority are unable to establish or designate a health insurance plan under this section, the secretary of administration and finance may direct the comptroller to transfer up to $50,000,000 from the Commonwealth Care Trust Fund to the Health Safety Net Trust Fund for the cost of health safety net claims for these individuals.