Consolidated Amendment "H" to H4100
Health and Human Services and Elder Affairs
Consolidated Amendment “H”
Health and Human Services and Elder Affairs
Fiscal Note: $24,849,293
Amendment 583 has been re-categorized from Health and Human Services to Legislation, Non-Budget.
Amendments 248 and 535 have been re-categorized from Public Health.
Amendment 642 has been re-categorized from Revenue.
Amendments 376, 609 and 740 have been re-categorized from Social Services.
Amendments from the Health and Human Services: 29, 31, 32, 37, 40, 41, 45, 47, 69, 98, 153, 178, 179, 189, 232, 248, 256, 291, 300, 301, 308, 323, 337, 359, 364, 376, 379, 417, 421, 437, 467, 475, 497, 525, 534, 535, 545, 571, 574, 597, 609, 632, 642, 665, 670, 692, 695, 705, 727, 729, 730, 732, 740, 780, 784, 811, 843, 849, 859, and 860.
Amendments from Elder Affairs: 33, 42, 56, 101, 400, 519, 532, 602, 633, 698, 773, 781, and 789.
Mr. Dempsey of Haverhill and others move to amend H.4100 in section 2, in item 1108-5200, by striking out the figures “$1,133,002,702” and inserting in place thereof the figures “$1,228,002,702”.
And further amend the bill in section 2, in item 4000-0050 by striking out the
figures “$167,192” and inserting in place thereof the figures “$235,485”.
And further amend the bill in section 2, by striking out item 4000-0300 and
inserting in place thereof the following item:
4000-0300For the operation of the executive office of health and human services, including the operation of the managed care oversight board; provided, that the executive office shall provide technical and administrative assistance to agencies under the purview of the secretariat receiving federal funds; provided further, that the executive office and its agencies, when contracting for services on the islands of Martha’s Vineyard and Nantucket, shall take into consideration the increased costs associated with the provision of goods, services and housing on said islands; provided further, that the executive office shall monitor the expenditures and completion timetables for systems development projects and enhancements undertaken by all agencies under the purview of the secretariat, and shall ensure that all measures are taken to make such systems compatible with one another for enhanced interagency interaction; provided further, that the executive office shall continue to develop and implement the common client identifier; provided further, that the executive office shall ensure that any collaborative assessments for children receiving services from multiple agencies within the secretariat shall be performed within existing resources; provided further, that funds appropriated in this item shall be expended for administrative and contracted services related to the implementation and operation of programs authorized by chapter 118E of the General Laws; provided further, that in consultation with the division of health care finance and policy, no rate increase shall be provided to existing Medicaid provider rates without taking all measures possible under Title XIX of the Social Security Act to ensure that rates of payment to providers do not exceed the rates that are necessary to meet only those costs which must be incurred by efficiently and economically operated providers in order to provide services of adequate quality; provided further, that expenditures for the purposes of each item appropriated for programs authorized by chapter 118E of the General Laws shall be accounted for in the Massachusetts management accounting and reporting system not more than 10 days after the expenditures have been made by the Medicaid management information system; provided further, that no expenditures shall be made that are not federally reimbursable, including those related to Titles XIX or XXI of the Social Security Act or the MassHealth demonstration waiver approved under section 1115(a) of said Social Security Act or the community first section 1115 demonstration waiver, whether made by the executive office or another commonwealth entity, except as specifically authorized herein, or unless made for cost containment efforts, the purposes and amounts of which have been submitted to the executive office of administration and finance and the house and senate committees on ways and means 30 days prior to making such expenditures; provided further, that in calculating rates of payment for children enrolled in MassHealth receiving inpatient services at acute care pediatric hospitals as defined in section 1 of chapter 118G of the General Laws, the executive office shall make a supplemental payment, if necessary, sufficient to assure that inpatient SPAD and outlier payments for discharges with a case mix acuity equal to or greater than 5 shall be at least equal to 85 per cent of the expenses incurred in providing services to those children; provided further, that the executive office of health and human services may continue to recover provider overpayments made in the current and prior fiscal years through the Medicaid management information system, and that these recoveries shall be considered current fiscal year expenditure refunds; provided further, that funds shall be provided in an amount not less than the total appropriated in item 1599-2009 in section 2 of chapter 182 of the acts of 2008; provided further, that the executive office may collect directly from a liable third party any amounts paid to contracted providers under chapter 118E of the General Laws for which the executive office later discovers another third party is liable if no other course of recoupment is possible; provided further, that no funds shall be expended for the purpose of funding interpretive services directly or indirectly related to a settlement or resolution agreement with the office of civil rights or any other office, group or entity; provided further, the executive office shall not set further limitations for acute care hospital inpatient and outpatient case-mix appeals than those in effect as of February 1, 2012; provided further, that interpretive services currently provided shall not give rise to enforceable legal rights for any party or to an enforceable entitlement to interpretive services; provided further, that the executive office shall maintain the fiscal year 2012 overall reimbursement rate for the commonwealth’s only medical respite program for the homeless; provided further, that notwithstanding any general or special law to the contrary, the executive office shall require the commissioner of mental health to approve any prior authorization or other restriction on medication used to treat mental illness in accordance with written policies, procedures and regulations of the department of mental health; provided further, that funds may be expended for the operation of the office of health equity within the executive office of health and human services; provided further, that not later than January 18, 2013 the executive office of health and human services shall submit a report to the house and senate committees on ways and means detailing the methodology used to project caseload and utilization in fiscal year 2012 and fiscal year 2013; provided further, that funds shall be expended to support the functions of the office of performance management in carrying out the executive order known as "Improving the Performance of State Government by Implementing a Comprehensive Strategic Planning and Performance Management Framework in the Executive Departments"; provided further, that any projection of deficiency in item 4000-0430, 4000-0500, 4000-0600, 4000-0700, 4000-0870, 4000-0875, 4000-0880, 4000-0890, 4000-0895, 4000-0950, 4000-0990, 4000-1400 or 4000-1405 shall be reported to the house and senate committees on ways and means not less than 90 days before the projected exhaustion of funding; and provided further, that any unexpended balance in these accounts shall revert to the General Fund on June 30, 2013………………………………………………………………$87,222,963
And further amend the bill in section 2, in item 4000-0600 by striking out, in line 15, the words “up to” and inserting in place thereof the word “of”.
And further amend the bill in section2, in item 4000-0640, by adding the following after the word “policy” the following:-
; provided further, that effective July 1, 2012 for the fiscal year ending June 30, 2013, the division of health care finance and policy shall establish nursing facility MassHealth rates that fully recognize the Medicaid share of the nursing home assessment established by section 25 of chapter 118G of the General Laws, and fund continuation of the Fiscal Year 2012 Add-On provision in section 6.06(13) of the division of health care finance and policy’s 114.2 CMR 6.00: Standard Payments to Nursing Facilities, enacted on September 1, 2011; provided further, that not less than $2,800,000 shall be expended as incentive payments to nursing facilities meeting the criteria determined under the MassHealth Nursing Facility Pay-for-Performance Program and that have established and participated in a cooperative effort in each qualifying nursing facility between representatives of employees and management that is focused on implementing that criteria and improving the quality of services available to MassHealth members; and provided further that the MassHealth agency shall adopt regulations and procedures necessary to carry out section
And further amend the bill in said item by striking out the figure “$288,500,000” and inserting in place thereof the figure “$318,500,000”.
And further amend the bill in section 2, in line item 4000-0700, by striking out the figure “$1,939,680,126” and inserting in place thereof the figure “$1,954,480,126”
And further amend the bill in section 2, in line item 4000-1602, by striking out the figures “$500,000” and inserting in place thereof the figure “$1,000,000”
And further amend the bill in section 2, in line item 4401-1000, by striking the figure “$3,000,000” and inserting in place thereof the figure “$4,000,000” and by striking the figure “$7,109,035” and inserting in place thereof “$8,109,035”
And further amend the bill in section 2, in line item 9110-1500, by striking out the figure “$47,289,340” and inserting in place thereof the figure “$47,789,340”.
And further amend the bill in section 2, in line item 9110-1660, by striking out the figures “$1,610,617” and inserting in place thereof the figure “$1,717,616”.
And further amend the bill in section 2, in line item 9110-1700, by striking out the figure “$136,000” and inserting in place thereof the figure “$186,000”.
And further amend the bill in section 2, in line item 9110-9002, by inserting after the words “established by the secretary of elder affairs” the following words “; provided further, that not less than $100,000 shall be spent for the Needham Senior Center located in the town of Needham.
And further amend the bill in said line item by striking out the figure “$8,060,177” and inserting in place thereof the figure “$8,534,177”.
And further amend the bill in section 2E, in line item 1595-5819, by striking out the figure “$795,022,286” and inserting the figure “$741,278,955”.
And further amend the bill by adding the following sections:
SECTION XX. Chapter 118E of the General Laws, as appearing in the 2010 Official Edition, is hereby amended by inserting after section 62 the following new section:-
Section 63. Auto-Assignment for Medicaid Beneficiaries.
Beginning October 1, 2012, and until such time as the Managed Care Advisory Committee, established pursuant to Section 178 of Chapter 131 of the Acts of 2010 has filed its report with the legislature, the division shall make provisions to enroll those MassHealth beneficiaries who did not affirmatively select a managed care option into a Medicaid managed care organization that has contracted with the Commonwealth to deliver managed care services to eligible MassHealth beneficiaries, provided that the division shall give the Primary Care Clinician plan no greater preference than any single MCO in such assignment process and shall divide said assigned members equally among the Primary Care Clinician Plan and individual Medicaid managed care organizations on a rotating basis.
Section XX: Notwithstanding any general or special law to the contrary, the executive office of health and human services shall conduct a procurement to select an entity or entities to conduct an analysis of the children with complex care needs in the MassHealth program. The goal of the procurement shall be to identify a suitable vendor to partner with the Executive Office to identify all children with complex care needs in the MassHealth program, understand the services, service providers and medical resources utilized and current costs of serving these children; and to analyze the suitability of their current primary or majority care settings relative to the goals of the Commonwealth’s Patient-Centered Medical Home Initiative and the goal of providing the highest quality care most efficiently by managing care and utilization of services. The analysis conducted pursuant to the procurement shall group the patients by primary diagnosis, including mental health diagnoses, or other clinical profile characteristics and assess the current medical home capabilities of primary care providers for the relevant patients in each category, by geographic region. The office shall not award any money or other compensation with the contract. The request for proposals shall be released by October 1, 2012 and the vendor shall be selected by November 30, 2012.
The chosen entity or entities shall produce a report of its findings to the executive office of health and human services, the division of insurance, the joint committee on health care finance, the house and senate committees on ways and means and the house and senate clerks, for public availability, no later than August 31, 2013. Such report shall include the following: (a) recommendations for how children with complex care needs could be served in keeping with the goals of the Commonwealth’s Patient Centered Medical Home Initiative; (b) recommendations for appropriate quality benchmarks for their care or recommendations regarding the development of such metrics; (c) an analysis of potential federal and external funding sources; and (d) an analysis of care models and financial arrangements used for children with complex care needs in other states.
SECTION XX. Notwithstanding any general or special law to the contrary, the executive office of health and human services shall conduct an investigation of all federal and state assistance programs to determine which have eligibility requirements within the requirements of MassHealth and which could feasibly share data with the MassHealth program for purposes of renewing eligible children and their eligible parents in MassHealth through the express-lane eligibility option created under the Children’s Health Insurance Program Reauthorization Act of 2009 (PL 111-3). The office shall submit a report on the results of that investigation to the house and senate committees on ways and means, the joint committee on health care financing, the joint committee on children and families and persons with disabilities and the house and senate clerks not later than April 1, 2013.
SECTION XX. Notwithstanding any general or special law to the contrary, there shall be a special commission for the purpose of studying and making recommendations concerning services for unaccompanied homeless youth age 22 and under, with the goal of ensuring a comprehensive and effective response to the unique needs of this population. The focus of the commission’s work shall include, but not be limited to, an analysis of the barriers to serving unaccompanied youth who are gay, lesbian, bisexual, and transgender; an analysis of the barriers to serving unaccompanied youth under 18 years of age; an assessment of the impact of mandated reporting requirements on unaccompanied youths’ access to services; the state’s ability to identify and connect with unaccompanied youth; and recommendations to reduce identified barriers to serving this population, including, but not limited to, extending the time for certain categories of mandated reporters to file reports and establishing special licensure provisions to allow service providers to serve homeless youth under 18 years of age. The commission, in formulating its recommendations, shall take account of best practices and policies in other states and jurisdictions.
The commission shall include, the secretary of health and human services, the commissioner of the department of children and families, the commissioner of the department of elementary and secondary education, the commissioner of the department of public health, the commissioner of the department of mental health, the commissioner of MassHealth, the commissioner of the department of transitional assistance, the undersecretary of housing and community development, 2 members of the senate, appointed by the senate president, 2 members of the house of representatives, appointed by the speaker of the house, 3 youth who have experienced homelessness, appointed by the office of the child advocate, and a representative from each of the following organizations: Massachusetts Coalition for the Homeless, Task Force on Youth aging Out, Massachusetts Appleseed Center for Law and Education, MassEquality, Massachusetts Housing and Shelter Alliance, Massachusetts Transgender Political Coalition, the Boston Alliance of Gay, Lesbian Bisexual and Transgender Youth, and three persons to be named by the Governor.
The commission shall submit a report to the Governor, the speaker of the house of representatives and the president of the senate, the joint committee on children, families and persons with disabilities and the office of the child advocate no later than March 31, 2013, setting forth the commission’s findings, together with any recommendations for regulatory or legislative action with a timeline for implementation, cost estimates and finance mechanisms. Thereafter, the commission shall submit a report annually by December 31st of each year to the Governor, the speaker of the house of representative and the president of the senate, the joint committee on children, families and persons with disabilities, the clerks of the house of representatives and the senate and the office of the child advocate, detailing the extent of homelessness among unaccompanied youth within the commonwealth and the progress made toward implementing the commission’s recommendations along with other efforts to address the needs of this population.
SECTION XX. Notwithstanding any general or special law to the contrary, the department of revenue, in conjunction with the executive office of health and human services, shall investigate and report on the feasibility and costs of implementing a sales tax exemption for any medical equipment deemed medically necessary and prescribed by a physician. The department of revenue shall report its findings and recommendations, together with drafts of legislation necessary to carry those recommendations into effect, by filing the same with the clerks of the house of representatives and senate, the joint committee on revenue and the house and senate committees on ways and means not later than December 31, 2012.