HOUSE DOCKET, NO. 3454        FILED ON: 1/16/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1015

The Commonwealth of Massachusetts

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PRESENTED BY:

Michael J. Moran

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act ensuring community hospital acceleration, revitalization and transformation.

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PETITION OF:

HOUSE DOCKET, NO. 3454        FILED ON: 1/16/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1015

The Commonwealth of Massachusetts

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In the One Hundred and Eighty-Ninth General Court
(2015-2016)

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An Act ensuring community hospital acceleration, revitalization and transformation.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. (a) Notwithstanding any special or general law to the contrary, the health policy commission shall establish a one-time surcharge assessment on all surcharge payers.  The surcharge amount shall equal the product of: (i) the surcharge percentage; and (ii) $100,000,000. The commission shall calculate the surcharge percentage by dividing the surcharge payor’s total surplus as of 12/31/2014 by the total surplus of all surcharge payors. The commission shall determine the surcharge percentage for the assessment by June 30, 2015. In the determination of the surcharge percentage, the commission shall use the best data available as determined by the commission.   The commission may waive the assessment for certain surcharge payors, if the commission reasonably determines the payor lacks access to resources available to pay the assessment.

(b) Surcharge payors shall pay the full amount of the surcharge amount as follows:

(1) a single payment to be made no later than December 31, 2015; or

(2) in 4 equal annual installments to be paid on or before December 31 of each year beginning on December 31, 2015.

(c) The assessment shall be distributed to the Distressed Hospital Trust Fund, established in section 2GGGG of chapter 29 of the General Laws, as such assessments are collected.  The funds received from this assessment shall be distributed through a competitive grant process developed by the commission to qualified acute hospitals.  To be eligible to receive a grant, a qualified acute hospital shall only include (1) any acute hospital that is not a teaching hospital; and (2)(i) any hospital whose relative prices are below the statewide median relative price, as determined by the center for health information and analysis, or (ii) whose public payer mix is equal to or greater than 51 per cent.  Not more than 10 per cent of the amounts from this assessment in any 1 year shall be used by the commission of the combined cost of program administration, technical assistance to grantees or program evaluation.

(d) The commission shall specify by regulation appropriate mechanisms that provide for determination of a surcharge payor’s liability, including requirements for data to be submitted by surcharge payors.

(e) A surcharge payor’s liability to the fund shall in the case of a transfer of ownership be assumed by the successor in interest to the surcharge payor.

(f) The commission shall establish by regulation an appropriate mechanism for enforcing a surcharge payor’s liability to the fund if a surcharge payor does not make a scheduled payment to the fund; provided, however, that the commission may, for the purpose of administrative simplicity, establish threshold liability amounts below which enforcement may be modified or waived. Such enforcement mechanism may include assessment of interest on the unpaid liability at a rate not to exceed an annual percentage rate of 18 per cent and late fees or penalties at a rate not to exceed 5 per cent per month. Such enforcement mechanism may also include notification to the office of Medicaid requiring an offset of payments on the claims of the surcharge payor, any entity under common ownership or any successor in interest to the surcharge payor, from the office of Medicaid in the amount of payment owed to the fund, including any interest and penalties, and to transfer the withheld funds into said fund. If the office of Medicaid offsets claims payments as ordered by the commission, the office of Medicaid shall be considered not to be in breach of contract or any other obligation for payment of non-contracted services, and a surcharge payor whose payment is offset under an order of the commission shall serve all Title XIX recipients under the contract then in effect with the executive office of health and human services. In no event shall the commission direct the office of Medicaid to offset claims unless the surcharge payor has maintained an outstanding liability to the fund for a period longer than 45 days and has received proper notice that the commission intends to initiate enforcement actions under regulations promulgated by the commission.

(g) If a surcharge payor fails to file any data, statistics or schedules or other information required under this chapter or by any regulation promulgated by the commission, the commission shall provide written notice to the surcharge payor. If a surcharge payor fails to provide required information within 14 days after the receipt of written notice, or falsifies the same, such payor shall be subject to a civil penalty of not more than $5,000 for each day on which the violation occurs or continues, which penalty may be assessed in an action brought on behalf of the commonwealth in any court of competent jurisdiction. The attorney general shall bring any appropriate action, including injunctive relief, necessary for the enforcement of this chapter.

(h) Surcharge payors shall not seek an increase in premiums to pay for this assessment.