HOUSE DOCKET, NO. 2986        FILED ON: 1/16/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 820

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Nick Collins

_________________

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 reforming the healthcare expenditure benchmark.

_______________

PETITION OF:

 

Name:

District/Address:

Date Added:

Nick Collins

4th Suffolk

1/16/2015


HOUSE DOCKET, NO. 2986        FILED ON: 1/16/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 820

By Mr. Collins of Boston, a petition (accompanied by bill, House, No. 820) of Nick Collins relative to health care expenditure benchmarks.  Financial Services.

 

The Commonwealth of Massachusetts

 

_______________

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

_______________

 

An Act reforming the healthcare expenditure benchmark.

 

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.  Section 18 of Chapter 12C of the general laws is hereby amended by adding the following after the first sentence:-

For providers and provider organizations, excessive spending shall be determined based on the increase in the provider or provider organization’s total health care expenditures in excess of:  (a) the cost growth benchmark divided by (b) the provider or the provider organization’s relative price.

SECTION 2. Chapter 176O of the general laws is hereby amended by adding a new Section 28 as follows: 

Section 28. (a)  Notwithstanding any other general or special law to the contrary, no carrier shall grant a provider or provider organization an annual increase in rates that exceeds the cost growth benchmark established in section 9 of chapter 6D divided by the provider or provider organization’s relative price as reported by the center for health information and analysis. The commissioner shall adopt regulations to carry out this section.

(b)  The division shall by regulation require carriers limit the growth of payments to high cost providers, as determined by the center for health information and analysis pursuant to section 18 of chapter 12C, to rates at or below the rate of increase of the cost growth benchmark divided by that provider’s or the provider organization’s average relative price for all health care networks.