HOUSE DOCKET, NO. 3615        FILED ON: 1/18/2019

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1175

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Elizabeth A. Malia

_________________

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 relative to accountable care organizations.

_______________

PETITION OF:

 

Name:

District/Address:

Date Added:

Elizabeth A. Malia

11th Suffolk

1/15/2019

Denise C. Garlick

13th Norfolk

1/31/2019

David Henry Argosky LeBoeuf

17th Worcester

2/1/2019

Rebecca L. Rausch

Norfolk, Bristol and Middlesex

1/30/2019

José F. Tosado

9th Hampden

1/31/2019


HOUSE DOCKET, NO. 3615        FILED ON: 1/18/2019

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1175

By Ms. Malia of Boston, a petition (accompanied by bill, House, No. 1175) of Elizabeth A. Malia and others for legislation to require annual reports by certain accountable care organizations.  Health Care Financing.

 

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 2217 OF 2017-2018.]

 

The Commonwealth of Massachusetts

 

_______________

In the One Hundred and Ninety-First General Court
(2019-2020)

_______________

 

An Act relative to accountable care organizations.

 

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. Chapter 118E of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after section 77 the following new section:-

Section 78. The Division shall require all accountable care organizations (“ACOs”) certified under section 15 of Chapter 6D that contract directly with the Division or its managed care entities to report annually in a public document the following information:

(1)Baseline expenditures for pre-ACO participation for the following categories: behavioral health services, primary care, acute care costs, emergency services, pharmacy, and other specialties that MassHealth deems appropriate, categorized in a standardized manner as established by the Division, by the following levels of care: inpatient, diversionary, and outpatient.

(2)ACO spending, total and as a percentage of total MassHealth expenditures, on eligible members for the following categories: behavioral health services, primary care, acute care costs, emergency services, pharmacy, and other specialties that MassHealth deems appropriate, categorized in a standardized manner as established by the Division, by the following levels of care: inpatient, diversionary, and outpatient.

(3)The percentage of members eligible for Community Partner coordination services provided by the ACO, primary care providers, and Community Partners for the total ACO membership.

(4)For each ACO, membership enrollment for each Community Partner.

(5)Any additional data that MassHealth deems appropriate.