Budget Amendment ID: FY2012-S3-478

EHS 478

MassHealth Home Care

Mr. Tolman moved that the proposed new text be amended by adding at the end thereof by adding the following new section:-

SECTION XX.  For the purpose of improving patient transitions across care settings, MassHealth shall establish a new rate of home health care payment pursuant to 114.3 CMR 50.04 for patients with chronic medical conditions who are at risk for re-hospitalization, as determined by a certified home health agency, pursuant to Title XVIII and Title XIX of the Social Security Act, upon initial evaluation and in consultation with the pertinent hospital discharge planner and patient’s primary care physician, when discharged from hospital care to said home health care agency.

Home health agencies will only be reimbursed for such payment provided that the patient avoids returning to the hospital for the same condition for which the patient was originally hospitalized for thirty (30) days under the direct care and supervision of said agency.

The MassHealth Care Transition Rate shall be determined by the Secretary of Health and Human Services and based on a nurse-led team model with published evidence of readmission reduction.”