Amendment #179 to H4100

Transfer MassHealth to Managed Care Organization

Representatives Jones of North Reading, Peterson of Grafton, Hill of Ipswich, Poirier of North Attleborough, deMacedo of Plymouth, Adams of Andover, Barrows of Mansfield, Bastien of Gardner, Beaton of Shrewsbury, Boldyga of Southwick, D'Emilia of Bridgewater, Diehl of Whitman, Durant of Spencer, Fattman of Sutton, Ferguson of Holden, Frost of Auburn, Gifford of Wareham, Harrington of Groton, Howitt of Seekonk, Humason of Westfield, Hunt of Sandwich, Kuros of Uxbridge, Levy of Marlborough, Lombardo of Billerica, Lyons of Andover, O'Connell of Taunton, Orrall of Lakeville, Ross of Attleboro, Smola of Palmer, Vieira of Falmouth, Webster of Pembroke, Winslow of Norfolk and Wong of Saugus move to amend the bill by inserting, after section xx, the following section:—

“SECTION XX.  Chapter 118E of the General Laws, as appearing in the 2010 Official Edition, is hereby amended by adding the following section:-

Section 63. The executive office of health and human services shall discontinue membership in the MassHealth fee-for-service program and primary care clinician plan, and shall begin enrolling all members meeting eligibility requirements as established pursuant to applicable federal and state law and regulation, and for whom the discontinuation would result in cost savings for the MassHealth program, 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 processes for other eligible categories and at the appropriate levels of premium. The office shall submit a report to the joint committee on health care financing and the clerks of the house and the senate by June 30, 2012 detailing which members it has newly enrolled in a Medicaid managed care organization, which members it has maintained in the MassHealth fee-for-service program and primary care clinician plan, and an actuarial justification for those members who have not been transferred to a Medicaid managed care organization.”.