Amendment #28 to H3400

Managed Care Organizations

[Sponsors] Representative Stanley of West Newbury moves to amend the bill by inserting after section xx the following sections:

“SECTION 1. Chapter 118E of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by adding the following new section:

Section 62. ¬ The Executive Office of Health and Human Services shall discontinue membership in the MassHealth fee-for-service program and primary care clinician plan, and for plan years beginning on or after January 1, 2011, shall begin to enroll all members meeting eligibility requirements, as established pursuant to applicable federal and state law and regulation, into a Medicaid managed care organization that has contracted with the commonwealth to deliver such managed care services, in accordance with the enrollment and assignment process for other eligible categories and at the appropriate levels of premium.

SECTION 2.  Notwithstanding any general or special law to the contrary, the Executive Office of Health and Human Services shall begin a two-year program designed to minimize enrollment in the fee for service payment to all providers of medical care or services for which medical assistance and medical benefits are available under Chapter 118E.  In accordance with the recommendations of the Special Commission on Payment Reform created pursuant to Section 44 of Chapter 305 of the Acts of 2008 and any subsequent commission on payment reform, any medical assistance provided under Chapter 118E shall be reimbursed by a global capitation payment or other payment that demonstrates lower payments for more coordinated and efficient care. The Secretary shall provide an annual report to the house and senate committee on ways and means and the joint committee on health care financing on or before December 31st outlining in detail the changes that have been made to date and the savings that have resulted.”