SENATE DOCKET, NO. 1507        FILED ON: 1/17/2019

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 685

The Commonwealth of Massachusetts

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PRESENTED BY:

Cindy F. Friedman

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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 relative to accountable care.

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PETITION OF:

SENATE DOCKET, NO. 1507        FILED ON: 1/17/2019

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 685

The Commonwealth of Massachusetts

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

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An Act relative to accountable care.

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 is hereby amended by adding the following section:-

Section 78. (a) 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 no later than July 1, 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.

(b) The division shall make the ACOs’ annual reports under this section publicly available on the MassHealth website.