Amendment #524 to H3400

New Rate Method for chronic disease pediatric hospitals

[Sponsors] Representative Moran of Boston moves that the bill be amended in Section 2, in line item 4100-0060, by adding at the end thereof the following new language:

“provided further, that the Division of Health Care Finance and Policy and the Executive Office of Health and Human Services shall establish a new rate methodology to cover the cost of care provided by any facility licensed by the department of public health as a chronic disease hospital providing services solely to children and adolescents as follows: (1) the rate of reimbursement for any such facility shall be developed collaboratively through an agreement among the office of Medicaid, the Division of Health Care Finance and Policy and any such facility; (2) the reimbursement rate for any such facility shall incorporate the following components: (a) utilization of the reimbursement methodology used by the division and the Executive Office of Health and Human Services to determine payments for Medicaid disproportionate share pediatric hospitals in effect in 2007 utilizing the most recently filed 403 cost report with the division and the payments received from Medicaid eligible patients for the base period; (b) a per-diem rate for inpatient and a payment on account factor for outpatient shall be established which reimburses the full unrecovered cost, including capital; and (c) the rates shall be inflated over the base period by the applicable Medicare market basket inflation factors; and (3) notwithstanding any general or special law to the contrary, in no event shall the rates of payment be lower than the rates in effect for such facility in the prior fiscal year;”.