Amendment #449 to H3400

Rate Convergence & DOI Reporting for Carriers on DSH rates of payment

[Sponsors] Representatives Kane of Holyoke, Finn of West Springfield, Ashe of Longmeadow and Swan of Springfield  moves to amend the bill by inserting, after section XX, the following section:

Chapter 176O is hereby amended by inserting after section 5 the following section:-

Section 5A. (a) A contract or agreement between a carrier and a health care provider, including a hospital or physician group practice, effective October 1, 2011, shall adhere to the following:

(1) A carrier with contracts for payment between the carrier and a disproportionate share hospital, as defined in section 1 of Chapter 118 G, and its affiliated physician group practices, shall not contain rates that are less than the carrier’s statewide average rate, as defined by the previous year of October 1 to September 30 plus an annual adjustment for the projected change of the Consumer Price Index for Medical Care Services for the New England region.

2) Each carrier shall be required to report and explain to the Division of Insurance what actions they have taken to remedy the relative rate disparity identified in the Attorney General's March 16, 2010 Examination of Health Care Cost Trends and Cost Drivers which concluded that said disproportionate share hospitals are paid considerably less than other acute hospital providers.