SENATE DOCKET, NO. 789        FILED ON: 1/15/2015

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 616

The Commonwealth of Massachusetts

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PRESENTED BY:

Mark C. Montigny

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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 to benefit the Health Safety Net Trust Fund.

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PETITION OF:

SENATE DOCKET, NO. 789        FILED ON: 1/15/2015

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 616

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 531 OF 2013-2014.]

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 to benefit the Health Safety Net Trust Fund.

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.   The Center for Health Information and Analysis shall amend the Health Safety Net Payments and Funding regulations (114.6 CMR 14.00) in order to increase the revenue available for provider payments and to reduce the Health Safety Net fund’s shortfall amount.  Such amendment shall:

a) Establish a new Large Physician Organizations Assessment that creates a $20,000,000 annual liability for independent physician organizations with more than 500 physician members.  A physician organization - whether a parent physician group or a local practice group as defined by the Center for Health Information and Analysis - shall be considered independent, however organized, so long as such practice is owned and controlled by one or more of the practitioners so associated.   Such independent physician organizations shall be exempt from liability for this new assessment if their percentage of gross billed charges for services reimbursed by the state Office of Medicaid is equal to or greater than 15% of their total gross billed charges for that fiscal year.

b) Ensure that such Large Physician Organizations who contribute to the Health Safety Net under subsection (a) are reimbursed for uncompensated care in a manner consistent with payments made to hospitals and community health centers under 114.6 CMR 14.00, the Massachusetts Section 1115 Demonstration Waiver governing safety net care, or any other federally required limit on payments under 42 U.S.C.1396a(a)(13) or 42 CFR 447.