The General Laws are hereby amended by inserting after chapter 111, Section 25D, the following section:
- Section 25E
In order to be eligible to bill MassHealth for certified home health services pursuant to Section 1891 of the Social Security Act, 42 U.S.C.A. § 1395bbb, any new applicant seeking to provide home health services must submit to a Certificate of Need (CON) review established by the Massachusetts Department of Public Health and assessed by an independent board appointed by the Governor, General Court, the Secretary of Health and Human Services, the Center for Health Information and Analysis, and the Home Care Alliance of Massachusetts.
To obtain a CON, an application must be filed with said independent board in which the applicant demonstrates the need for or prove the cost efficiency of a new agency. The applicant must present to the department and board both evidence of unmet need and how the proposed agency would fit into the comprehensive health care delivery system of the service area. This application requirement shall not apply to home health agencies providing Medicare-certified services and/or that are certified by the Centers for Medicare and Medicaid Services as of July 1, 2014.
Any applicant shall also specify the following:
a) service area, including municipality and county names.
b) an ongoing quality assurance program that includes compliance with all applicable federal and state quality of care standards, and provide a copy of its program protocols when it requests first-time approval.
c) written assurance that its costs are not excessive in relation to those of other agencies that operate in the same and nearby service areas.
d) documentation that it can comply with the capital reserve and other solvency requirements specified by the Centers for Medicare and Medicaid Services (CMS) for a Medicare-certified home health agency pursuant to Section 1891 of the Social Security Act, 42 U.S.C.A. § 1395bbb.
e) other requirements as determined by the Board.
An appropriate fee structure shall be determined by the department and the Board.
This bill shall take effect one year after its enactment.
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