Budget Amendment ID: FY2012-S3-42

OTH 42

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

Messrs. Hart and Finegold moved that the proposed new text be amended section 1 Chapter 118 G insert the following:

Notwithstanding any general or special law to the contrary, each health plan carrier shall be required to report and explain to the Division of Insurance what actions they have taken to remedy the disparity identified in the Attorney General's March 16, 2010 Examination of Health Care Costs and Driver Trends in Health Care Cost Trends and Cost Drivers which concluded that acute care hospitals defined in section 1 Chapter 118 G are paid considerably less than other hospital providers.  Further, a contract or agreement between a health plan carrier and a disproportionate share health care provider, including a hospital or its affiliated physician group practice, entered or renewed on or after September 1, 2011, shall not contain rates that are less than the carrier’s statewide average rate in the previous year beginning July 2010 through June 2011.