HOUSE DOCKET, NO. 2748        FILED ON: 1/19/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1189

The Commonwealth of Massachusetts

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PRESENTED BY:

Patricia A. Duffy

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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 updating high-cost hospitals and Health Policy Commission system accountability.

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PETITION OF:

HOUSE DOCKET, NO. 2748        FILED ON: 1/19/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1189

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Third General Court
(2023-2024)

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An Act updating high-cost hospitals and Health Policy Commission system accountability.

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 10 of chapter 6D of the General Laws as so appearing in the 2022 Official Edition, is hereby amended by striking clause (6) of subsection (f) and inserting in place thereof the following 2 clauses:-

(6) The payer mix of the population served by the entity and the demographics of the population served including but not limited to the underlying risk of the population.

(7) any other factors the commission considers relevant.

SECTION 2. Subsection (q) of said section 10 of said chapter 6D of the General Laws, as so appearing in the 2022 Official Edition, is hereby amended by striking the figure “$500,000” and inserting in place thereof the following words:-

A sum commensurate with the amount that the spending for the entity’s members or patients exceeded the benchmark as established under section 9A in the relevant year or years.

SECTION 3. Section 18 of chapter 12C of the General Laws, as so appearing in the 2022 Official Edition, is hereby amended by striking the words “health status adjusted”.

SECTION 4. Chapter 12C of the General Laws is hereby further amended by inserting after section 18 the following section:-

Section 18A. The center shall additionally perform an analysis of data it receives under this chapter to identify hospitals whose contribution to spending growth is considered excessive and who threaten the ability of the state to meet the healthcare cost growth benchmark established by the health policy commission under section 10 of chapter 6D. The center shall additionally perform analysis to identify hospitals whose relative prices are in the top quartile and whose relative price values within a payer’s network have increased. The center shall confidentially provide a list of said hospitals identified under this section to the health policy commission such that the authority may pursue further action under section 10 of chapter 6D.