Amendment #348 to H3400

rate methodology for Critical Access Hospitals

[Sponsors] Representative Pignatelli of Lenox, Gobi of Spencer, Madden of Nantucket and Speranzo of Pittsfield move to amend the bill by adding the following section:

SECTION XX. Notwithstanding any general or special law to the contrary, the executive office of health and human service shall reimburse, and shall require state sponsored or state managed plans providing health care benefits, including all MassHealth programs and any paying health care benefits by or through the group insurance commission established under Section 3 of Chapter 32A of the General Laws to reimburse, any licensed hospital facility operating in the commonwealth that has been designated as a critical access hospital pursuant to U.S.C. 1395i-4, in an amount equal to at least one hundred and one percent (101%) of the allowable state sponsored or state managed plan cost, as determined by utilizing the Medicare cost based reimbursement methodology, for both inpatient and outpatient services provided to eligible patients of such facility; and provided further,

the commonwealth health insurance connector authority shall require all carriers with which it contracts to provided the commonwealth care health insurance program to reimburse any licensed hospital facility operating in the commonwealth that has been designated as a critical access hospital pursuant to 42 U.S.C. 1395i-4 in an amount equal to at least one hundred and one percent (101%)of the allowable commonwealth care programs cost, as determined by utilizing the Medicare cost based reimbursement methodology, for both inpatient and outpatient services provided to eligible patients of such facility.