Budget Amendment ID: FY2012-S3-419
EHS 419
H.E.L.P PROGRAM
Mr. Hart moved that the proposed new text be amended in section 2, in item 4590-0250, by inserting after the words “department of elementary and secondary education” the following:-
“; provided further, that not less than $60,000 shall be expended to the H.E.L.P. program so-called, for black males health”
Budget Amendment ID: FY2012-S3-421
EHS 421
Teaching Community Health Centers
Ms. Chandler and Messrs. Moore and Finegold moved that the proposed new text be amended by inserting, after Section ___, the following new section:-
"SECTION ___. Notwithstanding any general or special law or regulation to the contrary, the secretary of the executive office of health and human services shall amend the medicaid waiver for the waiver years 2012, 2013, and 2014 to include a pilot project amendment to fund teaching community health centers with a residency program in primary care or family medicine. The health centers for the project shall maintain accreditation, through the demonstration waiver years, as either an independent teaching community health center or as a teaching community health center accredited through an affiliation with a Commonwealth funded medical school or licensed as part of a teaching hospital. Each qualified teaching community health center will be given a grant of $1.5m for the 1115 demonstration waiver years of 2012, 2013, and 2014.”
Budget Amendment ID: FY2012-S3-422
EHS 422
Specialized Dental Services for Those with Disabilities
Ms. Chandler moved that the proposed new text be amended by inserting, after Section ___, the following new SECTION:-
"SECTION ___. There may be no less than 3 dental chairs for persons w disabilities at the proposed mental health facility situated in Worcester.”
Budget Amendment ID: FY2012-S3-423
EHS 423
YMCA Matching Grants
Mr. McGee moved that the proposed new text be amended in section 2, in item 4590-1507, by inserting the following words:- “provided further that the Alliance of Massachusetts YMCA shall distribute funds to all YMCA’s that received grants from this item in fiscal year 2011……………………….$1,300,000”
Budget Amendment ID: FY2012-S3-424
EHS 424
WIC
Messrs. McGee and Montigny and Ms. Chang-Diaz and Messrs. Downing and Tolman and Ms. Fargo and Mr. Eldridge moved that the proposed new text be amended in section 2, in item 4513-1002, by striking out the figure “$9,766,617” and inserting in place thereof the figure “$12,428,884."
Budget Amendment ID: FY2012-S3-425-R1
Redraft EHS 425
Young Parents Program
Messrs. McGee, Finegold and Montigny and Ms. Fargo and Mr. DiDomenico and Ms. Donoghue moved that the proposed new text be amended in section 2, in item 4401-1000, <w:p><w:r><w:t xml:space="preserve">in the first line by striking the words "and limited to" and by adding after “the Young Parents program” the following: “provided further, that the young parents program shall receive no less than the amount expended in the previous fiscal year," and in said item, by striking out the figures “$4,279,933” and inserting in place thereof the figures: “$6,689,934”
Budget Amendment ID: FY2012-S3-427
EHS 427
Smoking Prevention and Cessation
Ms. Fargo and Messrs. Moore, Montigny and Kennedy and Ms. Candaras, Ms. Chandler and Ms. Jehlen and Mr. McGee moved that the proposed new text be amended in section 2, in item 4590-0300, by striking out the figure "$4,150,703" and inserting in place thereof the following figure:- "$4,485,983".
Budget Amendment ID: FY2012-S3-428
EHS 428
DPH Critical Operations and Essential Services
Ms. Fargo, Ms. Jehlen, Ms. Chang-Diaz and Ms. Chandler moved that the proposed new text be amended in section 2, in item 4510-0100, by striking out the figure "$15,975,017" and inserting in place thereof the following figure:- "$17,364,149".
Budget Amendment ID: FY2012-S3-429
EHS 429
School Nurse Programs
Ms. Fargo and Mr. DiDomenico and Ms. Donoghue and Messrs. Finegold, Knapik and Welch and Ms. Chang-Diaz and Messrs. Timilty, Eldridge, Michael O. Moore and McGee moved that the proposed new text be amended in section 2, in item 4590-0250, by striking the words “and (d)” in line 7 and inserting the following:- “(d) assisting with district reporting of student dismissal rates to the office of school and district accountability; (e) addressing the needs of children under the age of 18 with Type 1 or Type 2 diabetes in underserved areas; and (f)”, and further amending said item by inserting after the words “that funds” in line 14 the following:- “shall be expended for school nurse programs in an amount not less than that expended in fiscal year 2011", and further amending said item by striking out the figure, “$10,536,723” and inserting the figure, “$11,924,925”.
Budget Amendment ID: FY2012-S3-430
EHS 430
Youth Violence Prevention Grants
Ms. Fargo and Mr. DiDomenico and Ms. Chang-Diaz and Messrs. Welch, Finegold, Eldridge and Montigny moved that the proposed new text be amended in section 2, in item 4590-1506, by striking the figure "$1,000,000" and inserting in place thereof the following figure:- "$1,500,000".
Budget Amendment ID: FY2012-S3-431
EHS 431
State Laboratory and Disease Control
Ms. Fargo moved that the proposed new text be amended in section 2, in item 4516-1000, by striking out the figure "$13,243,542" and inserting in place thereof the following figure:- "$13,293,542".
Budget Amendment ID: FY2012-S3-432-R1
Redraft EHS 432
Health Care Quality and Patient Protection
Ms. Fargo and Ms. Chandler moved that the proposed new text be amended in section 2, in item 4510-0710, by striking the figure "$6,493,455" and inserting in place thereof the following figure:- "$6,774,419".
Budget Amendment ID: FY2012-S3-433
EHS 433
Lyme Disease Study Commission
Ms. Fargo and Messrs. Michael O. Moore, Wolf and Rodrigues and Ms. Candaras moved that the proposed new text be amended by inserting, after Section 152, the following new Section:-
"SECTION 153. Notwithstanding any general or special law or regulation to the contrary, a special commission hereafter referred to as the commission, is hereby established for the purpose of investigating and studying the incidence and impacts in the commonwealth of Lyme disease and other tick-borne diseases, including but not limited to anaplasmosis, babesiosis, bartonellosis, and ehrlichiosis.
Said study shall include, but not be limited to, a cost-benefit analysis of: (i) conducting a Lyme disease public health clinical screening study in high risk regions; (ii) developing education materials and training resources for detecting signs and symptoms of tick-borne illnesses in school-aged populations, to be used by clinical providers and school health personnel (iii) statewide surveillance and testing for tick-borne diseases in both Ixodes scapularis (black-legged deer tick) and Amblyomma americanum (Lone Star) ticks, and (iv) educating the medical community about research on all aspects of Lyme, both acute and chronic. The commission shall also investigate the availability of grants and federal funds for the study of Lyme disease and other tick-borne diseases to determine if future action is feasible and warranted to support Lyme and tick-borne diseases research in the Commonwealth. (v) The Commission shall review mandatory reporting procedures to promote improved compliance both for CDC-positive and clinically diagnosed cases of Lyme disease and associated tick-borne co-infections.
Said commission shall consist of: 3 members of the Senate, 1 of whom shall be appointed by the Senate Minority Leader; 3 members of the House of Representatives, 1 of whom shall be appointed by the House Minority Leader; the Commissioner of the Department of Public Health or a designee; the Commissioner of the Division of Health Care Finance and Policy or a designee, 3 members of local boards of health from different Lyme endemic areas of the state; the Director of the State Laboratory Institute or a designee; the State Epidemiologist or a designee; and 4 members to be appointed by the Governor, 1 of whom shall be a physician specialized in infectious disease, 1 of whom shall be a professional member of the International Lyme and Associated Diseases Society, and 2 members who shall be considered experts in the treatment or research of Lyme disease. Additionally, there shall be 4 public members, 2 of whom shall be patients or family members of patients; and 2 shall be members of Lyme and other tick-borne diseases organizations representing diverse regions across the state. One patient shall be appointed by the Senate, one patient by the House of Representatives and the 2 members of Lyme & other tick-borne diseases organizations shall be appointed by the Governor.
Said commission shall report to the Senate and House of Representatives the results of its investigation and study, together with drafts of legislation, if any, necessary to carry its recommendations into effect, by filing the same with the clerks of the Senate and House of Representatives, who shall forward the same to the Joint Committee on Public Health and the House and Senate Committees on Ways and Means by April 1, 2012."
Budget Amendment ID: FY2012-S3-434
EHS 434
Health Promotion and Disease Prevention
Ms. Fargo and Mr. DiDomenico and Ms. Chang-Diaz and Ms. Chandler moved that the proposed new text be amended in section 2, in item 4513-1111, by inserting after the word "Society;" in line 6 the following:- "hepatitis C prevention and management; colorectal cancer prevention;",
and further amending said item by striking out the figure "$3,383,981" and inserting in place thereof the following figure:- "$5,949,484".
Budget Amendment ID: FY2012-S3-435
EHS 435
Poison Control and Prevention Center
Ms. Fargo and Ms. Clark and Mr. McGee moved that the proposed new text be amended in section 2, in item 4513-1000, by inserting after the word "agencies;" in line 4 the following:- “provided, that funds shall be expended to the Regional Center for Poison Control and Prevention in an amount no less than the amount expended for fiscal year 2011;"
Budget Amendment ID: FY2012-S3-436
EHS 436
MassHealth Pharmacy Copayment
Ms. Fargo and Messrs. Rodrigues and Finegold and Ms. Chandler and Mr. Joyce moved that the proposed new text be amended by inserting, after Section 152, the following new Section:-
"SECTION 153. Section 25 of chapter 118E of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by striking out paragraph 4 of subsection (5) and inserting in place thereof the following paragraph:-
Notwithstanding the first paragraph of this section, the division may require medicaid recipients to pay enrollment fees, premiums, deductibles, coinsurance, copayments or similar cost-sharing charges as participants in managed care plans implemented by the division, so long as any waivers of Title XIX provisions regarding recipient cost-sharing are obtained from the secretary in conjunction with any other federal approvals and waivers necessary to implement these managed care plans. In the absence of managed care plans, the division shall require, to the extent permitted by federal law, that recipients, if eligible for such benefits, be liable for a copayment of up to $5 toward the purchase of each pharmaceutical product, including prescription drugs and over-the-counter drugs, provided that copayments for pharmaceutical products greater than $3 are mandatory and must be paid in full; and to require copayment of $5 for the use of emergency room services in acute care hospitals for the treatment of nonemergency conditions. The division may also require, to the extent permitted by federal law, that recipients be liable for a copayment of up to $5 for all other covered services with the exception of mental health and substance abuse services. The division shall establish a per-member out-of-pocket cap for all copayments."
Budget Amendment ID: FY2012-S3-437
EHS 437
Volunteer Ambulance Service
Mr. Downing moved that the proposed new text be amended by inserting, after Section ___ the following 2 Sections: -
“SECTION ___. Chapter 111c of the General Laws is hereby amended by striking out section 25, as inserted by chapter 188 of the acts of 2010, and inserting in place thereof the following section:-
Section 25. (a) When a class I, II or V ambulance transports a patient receiving care at the paramedic level of advanced life support the ambulance shall be staffed in accordance with regulations promulgated by the department, with a minimum of 2 emergency medical technicians, only 1 of whom shall be certified at the EMT-Paramedic level; provided, however, that the service staffing a class I, II or V ambulance may staff the ambulance with more than 1 emergency medical technician certified at the EMT-Paramedic level.
(b) When a class I, II or V ambulance operated by a volunteer ambulance service provider transports a patient receiving care at the non-paramedic level of basic life support, the ambulance shall be staffed in accordance with regulations promulgated by the department, with at least 1 emergency medical technician who is certified at minimum at the EMT-Basic level, and 1 EMS first responder; provided, however, that the service staffing a class I, II or V ambulance may staff the ambulance with more than 1 emergency medical technician.
SECTION ___. The department of public health shall promulgate such rules and regulations as are necessary to implement the provisions of this section.”
Budget Amendment ID: FY2012-S3-439
EHS 439
Glavin Regional Center
Mr. Michael O. Moore moved that the proposed new text be amended in section 2, in item 5930-1000, by adding at the end thereof the following:- “; provided further, that an independent non-governmental entity selected by the office of the inspector general shall complete a study of the reductions and closings of the Glavin Regional Center, including intensive individual supports, for the purpose of closing that state institution; provided further, that no steps shall be taken to close said institution through layoffs or attrition until the study is completed; provided further, that the study shall examine the costs and benefits of maintaining the institution and shall identify alternative methods of providing the services currently provided by that institution; provided further, that the study shall identify the number and names of all private nonprofit vendors who contract with the department to provide direct care in the community, the amount of state and federal resources paid to those vendors in fiscal years 2009, 2010 and 2011 and the amount of clients served by these private nonprofit vendors in each of those fiscal years; provided further, that nothing in this item shall preclude an individual from exercising his rights to transfer to a community based residential placement either state or vendor operated; provided further, that the entity shall report its findings in and its recommendations to the secretary, as well as the house and senate committees on ways and means not later than December 1, 2011; provided further, the general court shall have approved by law any such reductions or closings of the Glavin Regional Center; provided further, that the study shall examine the costs and benefits of maintaining the institution and shall identify alternative methods of providing the services currently provided by that institution.”
Budget Amendment ID: FY2012-S3-441
EHS 441
MARKET MINISTRIES
Mr. Montigny moved that the proposed new text be amended in section 2, in item 7004-0101, by adding at the end thereof the following:- “provided further, that not less than $200,000 shall be expended for Market Ministries emergency homeless shelter in New Bedford”
Budget Amendment ID: FY2012-S3-443-R1
Redraft EHS 443
DOMESTIC VIOLENCE AT RISK HOUSEHOLDS
Mr. Tarr moved that the proposed new text be amended in section 2, in item 4513-1130, by inserting at the end thereof the following:-
“and provided further, that funds shall be expended on counseling services and education, through media outreach, to at-risk households on the negative repercussions of domestic violence on families and children, with a focus on the role of fathers”
Budget Amendment ID: FY2012-S3-444-R1
Redraft EHS 444
RESTRICTIONS ON CASH BENEFITS AND EBT CARDS
Messrs. Tarr, Hedlund, Knapik, Richard T. Moore and Timilty moved that the proposed new text be amended by striking out Section 22 and inserting in place thereof the following section:-
"SECTION 22. Chapter 18 of the General Laws is hereby amended by inserting after section 5H the following 2 sections:-
Section 5I. An individual or store owner shall not accept direct cash assistance funds held on electronic benefit transfer cards for the purchase of alcoholic beverages, lottery tickets or tobacco products. An individual or store owner who knowingly accepts electronic benefit transfer cards in violation of this section shall be punished by a fine of not more than $500 for the first offense, a fine of not less than $500 nor more than $1,000 for the second offense, and a fine of not less than $1,000 for the third or subsequent offense.
Section 5J. Whoever embezzles, steals or obtains by fraud any funds, assets or property provided by the department of transitional assistance and whoever receives, conceals or retains such funds, assets or property for his own interest knowing such funds, assets or property have been embezzled, stolen or obtained by fraud shall, if such funds, assets or property are of a value of less than $100, be punished by a fine of not more than $1,000 or by imprisonment in a jail or house of correction for not more than 1 year, or both such fine and imprisonment, or if such funds, assets or property are of a value of $100 or more, by a fine of not more than $25,000 or by imprisonment in a jail or house of correction for not more than 2 ½ years, or both such fine and imprisonment."
Budget Amendment ID: FY2012-S3-445
EHS 445
PRESCRIPTION DRUG WASTE
Messrs. Tarr, Hedlund, Knapik, Ross and Moore moved that the proposed new text be amended by inserting, after Section __, the following new Sections:-
"SECTION __. Chapter 111 of the General Laws is hereby amended by striking out section 25I, as appearing in the 2008 Official Edition, and inserting in place thereof the following section:-
Section 25I. The department, in conjunction with the board of registration in pharmacy and the division of medical assistance, shall establish and implement methods to reduce medication waste in facilities licensed by the departments of public health, mental health and corrections. The department shall establish such methods, based on its review, that are determined to be effective in reducing waste without imposing unreasonable costs on the health care delivery system. Such methods may be based on, but not be limited to, the following: (1) current technology, standards and reimbursement mechanisms for dispensing and distributing medications to facilities; (2) other states' requirements for limiting prescription drug waste and any cost savings realized; (3) the commonwealth's standards for the return and re-dispensing of patient-specific schedule VI prescription drugs; and (4) possible incentive mechanisms to prevent the creation of prescription drug waste. The department shall promulgate regulations to implement this section.
SECTION __. The fifth paragraph of section 70E of said chapter 111, as so appearing, is hereby amended by adding the following subsection:-
(p) to obtain from the facility in charge of the patient’s care, upon discharge, any bulk medications that were prescribed for the patient during the patient’s stay including, but not limited to, aerosol inhalers, topical products such as creams and powders eye drops, insulins and special order items, provided that any such items are patient specific and personal and would not otherwise be used in the treatment of another patient. Upon discharge from the hospital, these bulk items shall be considered the personal property of the patient and at the prescribing physician’s discretion may include in discharge orders that the patient be provided with the specific bulk products that were used in the hospital with use directions. The department shall promulgate regulations to implement this section.
SECTION __. The department of public health, in consultation with the board of registration in pharmacy shall, as shall provide to the joint committee on health care financing and the joint committee on public health, on or before April 1, 2012 a report and legislative recommendations relative to issues of implementation of the programs established under subsection p of section 70E of chapter 111 and section 25I of chapter 111, including, but not limited to: savings and costs related to the implementation of the programs established and recommendations related to penalties for violations of subsection p of section 70E of chapter 111 and section 25I of chapter 111.
SECTION __. Notwithstanding any general or special law to the contrary, the department of public health, in consultation with the department of environmental protection, shall make an investigation and study regarding the issue of pharmaceutical drug waste and its effect on the environment in the Commonwealth. The department shall report on the following: (1) the estimated quantity of pharmaceutical drug waste in the Commonwealth; (2) the quantity of such waste that may be recovered prior to disposal; (3) the methods and techniques used in other states or local governments to reduce the amount of pharmaceutical drug waste, and identify model programs used to recover or recycle such waste; and (4) the efforts of pharmaceutical drug industry to mitigate waste through consumer support or take-back programs. The department shall make recommendations, consistent with its report, regarding: (1) the feasibility of expanding a drug recycling program similar to that prescribed in section 25I of chapter 111 to all consumers; (2) the feasibility of adopting similar programs adopted by other states or local governments to reduce drug waste; and (3) the feasibility of the department assisting municipal governments to establish local programs to reduce such waste. The department shall make its report and recommendations together with legislation to implement those recommendations by filing the same with the clerks of the senate and house not later than July 31, 2012."
Budget Amendment ID: FY2012-S3-446
EHS 446
PRESCRIPTION DRUG COUPONS
Messrs. Tarr, Hedlund, Knapik, Ross, Timilty and Finegold moved that the proposed new text be amended by inserting, after Section __, the following new Section:-
"SECTION __. Section 3 of chapter 175H of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by inserting at the end thereof the following two paragraphs:-
This section shall not apply to a discount, rebate, free product voucher or other reduction in out of pocket expenses, including but not limited to co-payments and deductibles on a prescription drug, biologic or vaccine provided by a pharmaceutical manufacturing company, as defined in section 1 of chapter 111N, that is made available to an individual, if such is provided directly or electronically to the individual or through a so-called “point of sale” or “mail-in” rebate, or through similar means; provided however, that a pharmaceutical manufacturing company shall neither exclude nor favor any individual pharmacy or restricted network of pharmacies in the design of such discount, rebate, free product voucher or other expense reduction offer to an individual; provided further, that this section does not negate the need for a written prescription as otherwise required by law, nor is it intended to constrain a carrier or a health maintenance organization, as defined in chapter 118G, with regard to how its plan design will treat such discounts, rebates, free product voucher or other reduction in out of pocket expenses, including but not limited to co-payments and deductibles.
For purposes of the Federal Health Insurance Portability and Accountability Act of 1996 and regulations issued there under, nothing in this section shall be deemed to require or allow the use or disclosure of health information in any manner that does not otherwise comply with such Act or such regulations."
Budget Amendment ID: FY2012-S3-446.1
Further EHS 446.1
Prescription Drug Coupons
Mr. Richard Moore moved that the amendment be amended by striking out the amendment in its entirety and inserting in place thereof the following amendment:-
SECTION _. Section 3 of chapter 175H of the General Laws, as so appearing, is hereby amended by inserting before the word “Any”, in line 1, the following:-- (a).
SECTION _. Said Section 3 of said chapter 175H, as so appearing, is hereby further amended by inserting after the word “rebate”, in line 7, the following words:-- , except as provided in subsection (b).
SECTION _. Said section 3 of said chapter 175H, as so appearing, is hereby further amended by adding the following 3 subsections:--
(b)(1) This section shall not apply to any discount or free product vouchers that a retail pharmacy provides to a consumer in connection with a pharmacy service, item or prescription transfer offer or to any discount, rebate, product voucher or other reduction in an individual’s out-of-pocket expenses, including co-payments and deductibles, on a prescription drug, biologic or vaccine, for which there does not exist a clinically proven generic equivalent, provided by a pharmaceutical manufacturing company, as defined in section 1 of chapter 111N, that is made available to an individual if the discount, rebate, product voucher or other reduction is provided directly or electronically to the individual or through a point of sale or mail-in-rebate, or through similar means; provided, however, that a pharmaceutical manufacturing company shall not exclude nor favor any pharmacy in the redemption of such discount, rebate, product voucher, or other expense reduction offer to a consumer.
(2) If a discount, rebate, product voucher or other reduction in an individual’s out-of-pocket expenses is applied to a consumer’s prescription, the discount, rebate, product voucher or other cost reduction shall be made available for all renewals thereof. Any consumer alleging a violation of this clause shall contact the department of public health or the office of consumer affairs and business regulation to report the violation. If a violation of this clause is found to have occurred, the pharmaceutical manufacturer or any intermediary which interfered with the availability of the discount, rebate, product voucher or other cost reduction shall make the discount, rebate, product voucher or other cost reduction available to the consumer for the life of the prescription and pay a fine of not more than $1,000 to the department of public health.
(c) Subsection (b) shall not: (i) restrict a pharmaceutical manufacturing company with regard to how it distributes a prescription drug, biologic, or vaccine; or (ii) restrict a carrier or a health maintenance organization, as defined in section 1 of chapter 118G, with regard to how its plan design will treat such discounts, rebates, product voucher or other reduction in out-of-pocket expenses.
(d) For purposes of the federal Health Insurance Portability and Accountability Act of 1996, hereinafter referred to as HIPAA, and regulations promulgated under HIPAA, nothing in this section shall be deemed to require or allow the use or disclosure of health information in any manner that does not otherwise comply with HIPAA or regulations promulgated under HIPAA.
SECTION _. The division of health care finance and policy, in consultation with the department of public health, shall conduct an analysis of the impact on health care costs of the use of discounts, rebates, product vouchers or other reductions for prescription drugs. The report shall include, but not be limited to, an analysis of the impact on commercial health insurance premiums and on premiums associated with the group insurance commission, and a comparison of any change in utilization of generic versus brand name prescription drugs. The division shall file a report of its findings with the clerks of the senate and house of representatives, the house and senate committees on ways and means and the joint committee on health care financing by not later than November 1, 2012.
Budget Amendment ID: FY2012-S3-448
EHS 448
MEDICAID UTILIZATION
Messrs. Tarr and Knapik moved that the proposed new text be amended by inserting, after Section __, the following new Sections:-
“Section __. The division of health care finance and policy shall, within eight months of the passage of this act, develop regulations to ensure the following: i) that Medicare-like claims editing is fully and effectively implemented and used to determine reimbursements from the Health Safety Net Trust Fund; and ii) that claims editing is effectively used to reduce the occurrence of payments for medically unnecessary services, medically unlikely events, and duplicate services.
Section __. The office of Medicaid shall, within eight months of the passage of this act, develop regulations to ensure that incentives or regulations are implemented to increase competition among MassHealth managed care organizations, reduce the size of some provider networks offered by managed care organizations, and/or to reduce cost of managed care organizations.”
Budget Amendment ID: FY2012-S3-449
EHS 449
MANDATORY PRESCRIPTION DRUG COVERAGE
Messrs. Tarr, Hedlund and Knapik moved that the proposed new text be amended by inserting, after Section __, the following new Section:-
“SECTION ___. Section 1 of chapter 111L, as added by section 12 of chapter 58 of the acts of 2006, is hereby amended by inserting at the end of the definition of the term “Creditable coverage” the following words:- ‘Minimum creditable coverage, as defined by the board under the authority granted herein, shall not require, in the case of individuals subject to section 2 of chapter 58 of the acts of 2006, coverage for prescription drugs.”
Budget Amendment ID: FY2012-S3-450
EHS 450
DURABLE MEDICAL EQUIPMENT
Messrs. Tarr, Hedlund and Knapik moved that the proposed new text be amended by inserting, after Section __, the following new Section:-
"SECTION ___. The Secretary of Administration and Finance and the Secretary of Health and Human services are hereby authorized and directed to evaluate the feasibility of contracting for recycling durable medical equipment purchased and issued by the Commonwealth through any and all of its medical assistance programs.
Said evaluation shall include but not be limited to a request for qualifications and/or proposals for entities capable of developing, implementing and operating a system of recycling whereby an inventory of such equipment is developed and managed so as to maximize the quality of service delivery to equipment recipients and to minimize costs and losses attributable to waste, fraud and/or abuse.
The Secretary of Administration and Finance shall report the findings of said evaluation, together with cost estimates for the operation of a recycling program, estimates of the savings it would generate, and legislative recommendations, no later than October 31, 2011."
Budget Amendment ID: FY2012-S3-451
EHS 451
DHCFP ASSESSMENT
Messrs. Tarr, Knapik and Ross moved that the proposed new text be amended in section 2, in item 4100-0060, by striking out the words “provided further, for the purposes of supporting the division’s expanded role in developing health care policies that benefit government entities, providers, purchasers, and consumers, the division shall assess surcharge payors as defined in section 34 of chapter 118G, not less than 10 per cent of the total estimated expenses appropriated for the division and the health safety net office, including indirect costs, in fiscal year 2012, less amounts projected to be collected in fiscal year 2011 from: (a) filing fees; (b) fees and charges generated by the division’s publication or dissemination of reports and information; and (c) federal financial participation received as reimbursement for the division’s administrative costs; provided further, that the assessment on surcharge payors shall be calculated in a manner similar to the assessment authorized under section 38 of chapter 118G, and shall be collected in a manner consistent with the provisions of chapter 118G and deposited in the General Fund”, and inserting in place thereof the following words:- “provided further, that funds may be expended for the purposes of a review of efforts by state agencies to decrease administrative complexity and costs on health care entities, including the effectiveness of such efforts to streamline administrative and regulatory requirements and the impact on lowering health care costs, and such review shall examine efforts by the Division, the Executive Office of Health and Human Services, the Division of Insurance, the Office of the Attorney General, the Group Insurance Commission, the Health Connector, and MassHealth; provided further that the Division shall file a report of its findings with the joint committee on health care financing no later than January 1, 2013, which may hold an oversight hearing on the study's findings”.
Budget Amendment ID: FY2012-S3-452
EHS 452
Meeting ADA Requirements
Ms. Chandler and Mr. Kennedy and Ms. Jehlen moved that the proposed new text be amended by inserting, after Section ___, the following new section:-
“SECTION ___. Section 16, Chapter 6A of the General Laws, as appearing in the 2006 Official Edition, is hereby amended by inserting the following paragraph:
“The secretary of the Executive Office of Administration & Finance Services shall develop standards to identify, earmark and recruit with intent to hire qualified applicants with disabilities; said standard shall apply to all vendors providing direct services under multiyear contracts or grants funded by agencies with the Secretariat; Standards shall include a commitment toward hiring people with disabilities, training all employees involved in hiring decision on the requirements of the Americans with Disabilities Act, and annual reporting on progress toward achieving employment goals”.
Budget Amendment ID: FY2012-S3-453
EHS 453
Assistive Technologies--Commission for the Blind
Ms. Chandler and Messrs. Eldridge and Kennedy and Ms. Jehlen moved that the proposed new text be amended in section 2, in item 4110-1000, by inserting after the word “network” the following:- “provided further that $100,000 be expended for assistive technologies,” and in said item by striking out the figures “$3,871,792” and inserting in place thereof the figures “$3,921,792”
Budget Amendment ID: FY2012-S3-454
EHS 454
Assistive Technologies--Deaf and Hard of Hearing
Ms. Chandler and Mr. Kennedy and Ms. Jehlen moved that the proposed new text be amended in section 2, in item 4125-0100, by inserting after the word “hearing” the following: “provided further that $50,000 be expended for assistive technologies,” and in said line item by striking out the figures “$4,722,631” and inserting in place thereof the figures “$4,772,631”.
Budget Amendment ID: FY2012-S3-455
EHS 455
Assistive Technology--MA Rehabilitation Commission
Ms. Chandler and Mr. Kennedy and Ms. Creem and Ms. Jehlen moved that the proposed new text be amended in section 2, in item 4120-4000, by inserting after the word “services” the following: “provided further that $50,000 be expended for assistive technologies,” and in said line item by striking out the figures “$11,851,933” and inserting in place thereof the figures “$11,901,933”.
Budget Amendment ID: FY2012-S3-456
EHS 456
Long Term Care Insurance
Ms. Chandler moved that the proposed new text be amended by inserting, after Section ___, the following new section:-
"SECTION ___. SECTION 1. Chapter 118E of the General Laws is hereby amended by striking out section 33, as appearing in the 2008 Official Edition, and inserting in place thereof the following section:-
Section 33. No claim for costs of a nursing facility and other long-term care services may be made by the division under sections 31 or 32 if the individual receiving medical assistance was permanently institutionalized, had notified the division that he had no intention to return home and on the date of admission to the nursing facility or other medical institution, had long-term care insurance that, when purchased, met the requirements of 211 C.M.R. 65.00.
SECTION 2. The General Laws are hereby amended by inserting after chapter 176R the following chapter:-
CHAPTER 176S LONG TERM CARE INSURANCE
Section 1. The purpose of this chapter is to promote the public interest and the availability of long-term care insurance policies, to protect applicants for long-term care insurance from unfair or deceptive sales or enrollment practices, to encourage applicants’ choice of long term services in the least restrictive setting appropriate to their needs, to establish standards for long-term care insurance, to facilitate public understanding and comparison of long-term care insurance policies, and to promote flexibility and innovation in the development of long-term care insurance coverage.
Section 2. This chapter shall apply to policies delivered, or issued for delivery, in the commonwealth on or after January 1, 2012. This chapter is not intended to supersede the obligations of entities subject to this chapter to comply with applicable insurance laws insofar as they do not conflict with this chapter, except that laws and regulations designed and intended to apply to Medicare supplement insurance policies governed by Chapter 176K shall not apply to long-term care insurance.
Section 3. As used in this chapter, the following words shall, unless the context requires otherwise, have the following meanings:-
“Applicant”, in the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; or in the case of a group long-term care insurance policy, the proposed certificate holder.
“Certificate”, a certificate issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery within the commonwealth.
“Commissioner”, the commissioner of insurance.
“Group long-term care insurance”, a long-term care insurance policy that is delivered or issued for delivery within the commonwealth and issued to:
(1) one or more employers or labor organizations, or to a trust or to the trustees of a fund established by 1 or more employers or labor organizations, or a combination thereof, for employees or former employees, or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations; or
(2) any professional, trade or occupational association for its members or former or retired members, or combination thereof, if the association:
(i) is composed of individuals all of whom are, or were, actively engaged in the same profession, trade or occupation; and
(ii) has been maintained in good faith for purposes other than obtaining insurance; or
(3) an association, or a trust, or the trustees of a fund established, created or maintained for the benefit of members of one or more associations; but, before advertising, marketing or offering the policy within the commonwealth, the association, or the insurer of the association, shall file evidence with the commissioner that the association has at the outset a minimum of 100 persons and has been organized and maintained in good faith for purposes other than that of obtaining insurance; has been in active existence for at least 1 year; and have a constitution and bylaws that provide that:
(i) the association holds regular meetings not less than annually to further purposes of the members;
(ii) except for credit unions, the association collects dues or solicits contributions from members; and
(iii) the members have voting privileges and representation on the governing board and committees.
Thirty days after the filing, the association shall be considered to have satisfied the organizational requirements, unless the commissioner makes a finding that the association does not satisfy those organizational requirements.
(4) A group other than those described in paragraphs (1), (2) and (3) subject to a finding by the commissioner that:
(i) the issuance of the group policy is not contrary to the best interest of the public;
(ii) the issuance of the group policy would result in economies of acquisition or administration; and
(iii) the benefits are reasonable in relation to the premiums charged.
“Long-term care insurance”, any insurance policy or rider: (1) advertised, marketed, offered or designed to provide coverage for not less than 12 consecutive months for each covered person on an expense incurred, indemnity, prepaid or other basis; (2) for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance or personal care services including home and community care services; and (3) provided in a setting other than an acute care unit of a hospital. The term includes group and individual annuities and life insurance policies or riders that provide directly, or supplement, long-term care insurance. The term also includes a policy or rider that provides for payment of benefits based upon cognitive impairment or the loss of functional capacity. The term shall also include qualified long-term care insurance contracts. Long-term care insurance shall not include any insurance policy that is offered primarily to provide basic Medicare supplement coverage, basic hospital expense coverage, basic medical-surgical expense coverage, hospital confinement indemnity coverage, major medical expense coverage, disability income or related asset-protection coverage, accident only coverage, specified disease or specified accident coverage, or limited benefit health coverage. With regard to life insurance, this term shall not include life insurance policies that accelerate the death benefit specifically for 1 or more of the qualifying events of terminal illness, medical conditions requiring extraordinary medical intervention or permanent institutional confinement, and that provide the option of a lump-sum payment for those benefits and where neither the benefits nor the eligibility for the benefits is conditioned upon the receipt of long-term care. Notwithstanding any other provision of this chapter, any product advertised, marketed or offered as long-term care insurance shall be subject to this chapter.
“Policy”, any policy, contract, subscriber agreement, rider or endorsement delivered or issued for delivery within the commonwealth by an insurer authorized to issue policies upon the lives of persons in the commonwealth or to provide accident and health insurance under chapter 175; a fraternal benefit society authorized under chapter 176; a nonprofit hospital service corporation authorized under chapter 176A, a nonprofit medical service corporation authorized under chapter 176B or a health maintenance organization authorized under chapter 176G.
(1) “Qualified long-term care insurance contract” or “federally tax-qualified long-term care insurance contract” an individual or group insurance contract that meets the requirements of Section 7702B(b) of the Internal Revenue Code of 1986, as amended, as follows:-
(a) The only insurance protection provided under the contract is coverage of qualified long-term care services. A contract shall not fail to satisfy the requirements of this subparagraph by reason of payments being made on a per diem or other periodic basis without regard to the expenses incurred during the period to which the payments relate;
(b) The contract does not pay or reimburse expenses incurred for services or items to the extent that the expenses are reimbursable under Title XVIII of the Social Security Act, as amended, or would be so reimbursable but for the application of a deductible or coinsurance amount. The requirements of this subparagraph do not apply to expenses that are reimbursable under Title XVIII of the Social Security Act only as a secondary payor. A contract shall not fail to satisfy the requirements of this subparagraph by reason of payments being made on a per diem or other periodic basis without regard to the expenses incurred during the period to which the payments relate;
(c) The contract is guaranteed renewable, within the meaning of section 7702B(b)(1)(C) of the Internal Revenue Code of 1986, as amended;
(d) The contract does not provide for a cash surrender value or other money that can be paid, assigned, pledged as collateral for a loan, or borrowed except as provided in paragraph (e);
(e) All refunds of premiums, and all policyholder dividends or similar amounts, under the contract are to be applied as a reduction in future premiums or to increase future benefits, except that a refund on the event of death of the insured or a complete surrender or cancellation of the contract cannot exceed the aggregate premiums paid under the contract; and
(f) The contract meets the consumer protection provisions set forth in Section 7702B(g) of the Internal Revenue Code of 1986, as amended.
(2) “Qualified long-term care insurance contract” or “federally tax-qualified long term care insurance contract” also means the portion of a life insurance contract that provides long-term care insurance coverage by rider or as part of the contract and that satisfies the requirements of Sections 7702B(b) and (e) of the Internal Revenue Code of 1986, as amended and as set forth in (1) (a)-(f)..
Section 4. No group long-term care insurance policy may be offered to a resident of the commonwealth under a group policy issued in another state to a group described in clause (4) of the definition of Group long-term care insurance of section 3, unless the commonwealth or another state having statutory and regulatory long-term care insurance requirements substantially similar to those adopted in the commonwealth has made a determination that the requirements set forth in said clause (4) have been met.
Section 5. (a) A long-term care insurance policy shall not:
(1) be cancelled, non-renewed or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder;
(2) contain a provision establishing a new waiting period in the event existing coverage is converted to, or replaced by, a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or
(3) provide coverage for skilled nursing care only or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care.
(b) (1) A long-term care insurance policy or certificate, other than a policy or certificate thereunder issued to a group as defined in clause (1) of the definition of Group long-term care of section 3, shall not use a definition of “preexisting condition” that is more restrictive than the following: Preexisting condition means a condition for which medical advice or treatment was recommended by, or received from a provider of health care services, within 6 months preceding the effective date of coverage of an insured person.
(2) A long-term care insurance policy or certificate other than a policy or certificate thereunder issued to a group as defined in clause (1) of the definition of Group long-term care of section 3 shall not exclude coverage for a loss or confinement that is the result of a preexisting condition unless the loss or confinement begins within 6 months following the effective date of coverage of an insured person.
(3) Notwithstanding this subsection (c), an insurer may use an application form designed to elicit the complete health history of an applicant, and, on the basis of the answers on that application, underwrite in accordance with that insurer’s established underwriting standards. Unless otherwise provided in the policy or certificate, a preexisting condition, regardless of whether it is disclosed on the application need not be covered until the waiting period described in subsection (b) (2) expires. No long-term care insurance policy or certificate may exclude or use waivers or riders of any kind to exclude, limit or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period described in subsection (2).
(c) A long-term care insurance policy shall not be delivered or issued for delivery in this state if the policy:
(1) conditions eligibility for any benefits on a prior hospitalization requirement;
(2) conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or
(3) conditions eligibility for any benefits other than waiver of premium, post-confinement, post-acute care or recuperative benefits on a prior institutionalization requirement.
(d) The commissioner may adopt regulations establishing loss ratio standards for long-term care insurance policies provided that a specific reference to long-term care insurance policies is contained in the regulation.
(e) Long-term care insurance applicants shall have the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Long-term care insurance policies and certificates shall have a notice prominently printed on the first page or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, other than a certificate issued pursuant to a policy issued to a group defined in clause (1) of the definition of Group long-term care of section 3, the applicant is not satisfied for any reason. This subsection shall also apply to denials of applications and any refund must be made within 30 days of the return or denial.
(f) (1) An outline of coverage shall be delivered to a prospective applicant for long-term care insurance through means that prominently direct the attention of the recipient to the document and its purpose. In the case of producer solicitations, an insurance producer shall deliver the outline of coverage prior to the presentation of an application or enrollment form. In the case of direct response solicitations, the outline of coverage shall be presented in conjunction with any application or enrollment form. In the case of a policy issued to a group defined in clause (1) of the definition of Group long-term care of section 3, an outline of coverage shall not be required to be delivered, provided that the information described in clauses (i) to (vi), inclusive, of paragraph (2) is contained in other materials relating to enrollment. Upon request, these other materials shall be made available to the commissioner.
(2) The commissioner shall prescribe a standard format, including style, arrangement and overall appearance, and the content of an outline of coverage. The outline of coverage shall include:-
(i) a description of the principal benefits and coverage provided in the policy or certificate;
(ii) a statement of the principal exclusions, reductions and limitations contained in the policy or certificate;
(iii) a statement of the terms under which the policy or certificate, or both, may be continued in force or discontinued, including any reservation in the policy of a right to change premium; continuation or conversion provisions of group coverage shall be specifically described;
(iv) a statement that the outline of coverage is a summary only, not a contract of insurance, and that the policy or group master policy contains governing contractual provisions;
(v) a description of the terms under which the policy or certificate may be returned and premium refunded;
(vi) a brief description of the relationship of cost of care and benefits; and
(vii) a statement that discloses to the policyholder or certificate holder whether the policy is intended to be a federally tax-qualified long-term care insurance contract under 7702B(b) of the Internal Revenue Code of 1986, as amended.
(g) A certificate issued pursuant to a group long-term care insurance policy that is delivered or issued for delivery in this state shall include:-
(1) a description of the principal benefits and coverage provided in the policy;
(2) a statement of the principal exclusions, reductions and limitations contained in the policy; and
(3) a statement that the group master policy determines governing contractual provisions and that the policy is available for viewing in the offices of the policyholder and will be copied for the certificate holder upon request at no cost.
(h) If an application for a long-term care insurance contract or certificate is approved, the issuer shall deliver the contract or certificate of insurance to the applicant no later than 30 days after the date of approval.
(i) At the time of policy delivery, a policy summary shall be delivered for an individual life insurance policy that provides long-term care benefits within the policy or by rider. In the case of direct response solicitations, the insurer shall deliver the policy summary upon the applicant’s request, but regardless of request shall make delivery no later than at the time of policy delivery. In addition to complying with all applicable requirements, the summary shall also include:-
(1) an explanation of how the long-term care benefit interacts with other components of the policy, including deductions from death benefits;
(2) an illustration of the amount of benefits, the length of benefit, and the guaranteed lifetime benefits if any, for each covered person;
(3) any exclusions, reductions and limitations on benefits of long-term care including elimination or probationary periods and any preexisting condition limitations;
(4) a statement indicating whether any long term care inflation protection option required by law is available under this policy;
(5) if applicable to the policy type, the summary shall also include:-
(i) a disclosure of the effects of exercising other rights under the policy;
(ii) a disclosure of guarantees related to long-term care costs of insurance charges; and
(iii) current and projected maximum lifetime benefits; and
(6) the policy summary listed above may be incorporated into a basic illustration or into the life insurance policy summary which is required to be delivered in accordance with applicable regulation.
(j) Any time a long-term care benefit, funded through a life insurance vehicle by the acceleration of the death benefit, is in benefit payment status, a monthly report shall be provided to the policyholder. The report shall include:-
(1) any long-term care benefits paid out during the month;
(2) an explanation of any changes in the policy including death benefits or cash values, due to long-term care benefits being paid out; and
(3) the amount of long-term care benefits existing or remaining.
(k) If a claim under a long-term care insurance contract is denied, the issuer shall, within 60 days of the date of a written request by the policyholder or certificate holder, or a representative thereof:-
(1) provide a written explanation of the reasons for the denial; and
(2) make available all information directly related to the denial.
(l) Any policy or rider advertised, marketed or offered as long-term care or nursing home insurance shall comply with the provisions of this chapter.
Section6. (a) For a policy or certificate that has been in force for less than 6 months an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is material to the acceptance for coverage.
(b) For a policy or certificate that has been in force for at least 6 months but less than 2 years an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is both material to the acceptance for coverage and which pertains to the condition for which benefits are sought.
(c) After a policy or certificate has been in force for 2 years it is not contestable upon the grounds of misrepresentation alone; the policy or certificate may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured’s health.
(d). A long term care insurance policy or certificate may be field issued if the compensation to the field issuer is not based on the number of policies or certificates issued. For purposes of this subsection the term “field issued” means a policy or certificate issued by a producer or a third-party administrator pursuant to the underwriting authority granted to the producer or third party administrator by an insurer and using the insurer’s underwriting guidelines.
(e) If an insurer has paid benefits under the long-term care insurance policy or certificate, the insurer may not recover the benefit payments if the policy or certificate is rescinded.
(f) In the event of the death of the insured, this section shall not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care. In this situation, the remaining death benefits under these policies shall be governed by section 132 of chapter 175. In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care.
Section7. (a) Except as provided in subsection (b), a long-term care insurance policy shall not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate that includes a non-forfeiture benefit. The offer of a non-forfeiture benefit may be in the form of a rider that is attached to the policy. In the event the policyholder or certificate holder declines the non-forfeiture benefit, the insurer shall provide a contingent benefit upon lapse that shall be available for a specified period of time following a substantial increase in premium rates.
(b) When a group long-term care insurance policy is issued, the offer required in subsection (a) shall be made to the group policyholder. However, if the policy is issued as group long-term care insurance to a group defined in clause (4) the definition of Group long-term care of section 3, other than to a continuing care retirement community or other similar entity, the offering shall be made to each proposed certificate holder.
Section 8. (a) (1) An individual may not sell, solicit or negotiate long-term care insurance unless the individual is licensed as an insurance producer for accident and sickness or life and has completed a one-time training course. The training shall meet the requirements set forth in section 9(b).
(2) An individual already licensed and selling, soliciting or negotiating long-term care insurance on the effective date of this Act may not continue to sell, solicit, or negotiate long term care insurance unless the individual has completed a one-time training course as set forth in section 9(b), on or before July 2, 2012.
(3) In addition to the one-time training course required in paragraphs (1) and (2), an individual who sells, solicits or negotiates long-term care insurance shall complete ongoing training as set forth in section 9(b).
(4) The training requirements of section 9(b) may be approved as continuing education courses under section 177E of chapter 175.
(b) (1) The one-time training required by this Section shall be no less than 8 hours and the ongoing training required by this Section shall be no less than 4 hours every 24 months and said hours under this section shall be included as part of the required continuing education hours as set forth in clause B of section 177E of chapter 175.
(2) The training required under section 9(b)(1) shall consist of topics related to long-term care insurance, long term care services and, Massachusetts minimum long term care coverage requirements for certain asset and liability exemptions under the Massachusetts MassHealth Program, including:-
(A) State and federal regulations and requirements and the relationship between asset and liability exemptions under the Massachusetts MassHealth Program and other public and private coverage of long-term care services, including MassHealth;
(B) Available long-term services and providers;
(C) Changes or improvements in long-term care services or providers;
(D) Alternatives to the purchase of private long-term care insurance;
(E) The effect of inflation on benefits and the importance of inflation protection; and
(F) Consumer suitability standards and guidelines.
(3) The training required by this section shall not include training that is insurer or company product specific or that includes any sales or marketing information, materials or training other than those required by state or federal law.
(c) (1) Insurers subject to this chapter shall obtain verification that a producer receives training required by section 9(a) before a producer is permitted to sell, solicit or negotiate the insurer’s long-term care insurance products, maintain records subject to the state’s record retention requirements, and make that verification available to the commissioner upon request.
(2) Insurers subject to this chapter shall maintain records with respect to the training of its producers concerning the distribution of its policies intended to satisfy Massachusetts’ minimum long term care coverage requirements for certain asset and liability exemptions under the Massachusetts MassHealth Program that will allow the division of insurance to provide assurance to the Department of Medical Assistance that producers have received the training contained in section 9 (b)(2)(A) as required by section 9(a) and that producers have demonstrated an understanding of the policies and their relationship to public and private coverage of long-term care, including MassHealth, in the commonwealth. These records shall be maintained in accordance with the state’s record retention requirements and shall be made available to the commissioner upon request.
(D) The satisfaction of these training requirements in any state shall be deemed to satisfy the training requirements in this state.
Section 9. (a) The commissioner shall, in accordance with chapter 30A, promulgate rules and regulations which, at a minimum, are consistent with those set forth in the 2009 National Association of Insurance Commissioners Long-Term Care Model Regulation including standards for:-
(1) full and fair disclosure setting forth the manner, content and required disclosures for the sale of long-term care insurance policies and certificates;
(2) policy definitions and provisions, terms of renewability; initial and subsequent conditions of eligibility; benefit triggers; home health and community care benefits; non-duplication of coverage provisions; coverage of dependents; preexisting conditions; termination of insurance; continuation or conversion; limitations; exceptions; reductions; elimination and probationary periods; requirements for replacement; and unintentional lapse protection;
(3) the promotion of premium adequacy, protections for the policyholder or certificate holder in the event of a substantial rate increase and disclosure;
(4) the offer of inflation and nonforfeiture coverage including rules for a contingent benefit upon lapse;
(5) marketing practices, suitability and producer professional education;
(6) filing requirements, reporting practices and requirements, reserve standards, independent review of benefit determinations, and penalties.
(b) The division of insurance shall update, on a biennial basis, the consumer guide for long term insurance. The division shall maintain a list of insurance companies selling long term care insurance in the Commonwealth and their Massachusetts rate increase history for the last 10 years on their website.
Section 10. In addition to the penalties provided in chapters 175 and 176D, any insurer and any insurance producer found to have violated any requirement of this chapter or any rules or regulations promulgated hereunder, relating to the regulation of long-term care insurance or the marketing of such insurance, shall be subject to a fine of up to 3 times the amount of any commissions paid for each policy involved in the violation or up to $10,000, whichever is greater.
SECTION 5. The commissioner shall conduct an investigation as to the best methods to stabilize rates and prevent exceptional rate increases with input from the Life Insurance Association of Massachusetts, the Massachusetts Association of Health Underwriters, the National Association of Insurance and Financial Advisers, the National Academy of Elder Law Attorneys, Massachusetts Chapter, the American Academy of Actuaries, and AARP. The commissioner shall also seek information on the experience of other states relative to rate stabilization.
The commissioner shall report to the general court the results of his investigation and his recommendations, if any, together with drafts of legislation necessary to carry his recommendations into effect, by filing the same with the clerks of the senate and the house of representatives who shall forward the same to the senate president and the speaker of the house of representatives on or before January 1, 2013
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Budget Amendment ID: FY2012-S3-457-R1
Redraft EHS 457
Senior Care Options
Ms. Chandler and Ms. Jehlen and Mr. Michael Moore and Ms. Clark and Messrs. Richard Moore, Downing, Tarr and Petruccelli moved that the proposed new text be amended by inserting, after Section 61, the following new Section:-
""SECTION 61A. Paragraph (3) of subsection (e) of section 9D of chapter 118E of the General Laws, as so appearing, is hereby amended by adding the following paragraph:-
Notwithstanding any general or special law to the contrary, MassHealth shall provide to each beneficiary age 65 and over an annual notice of options available for enrollment in voluntary programs including Program of All Inclusive Care for the Elderly plans, MassHealth Senior Care Options, Frail Elder Home and Community Based Waiver Program and any other voluntary elected benefit to which such beneficiary is entitled to supplement or replace such beneficiary’s MassHealth benefits. Upon approval from the Centers for Medicare and Medicaid Services, MassHealth shall include in such annual notice the names and contact information for the program providers, general contact information for MassHealth and a general description of the benefits of joining particular programs. The notice shall be written in clear and simple language and shall include instructions for requesting a copy of such notice in a language other than English. The notice shall include a method for the beneficiary to request from MassHealth additional information on any program described in the notice. Before the content and format of the annual notice is finalized, the proposed draft thereof shall be forwarded to the providers under contract with MassHealth to provide the programs described the proposed annual notice for review and comment prior to the printing and dissemination of the annual notice. MassHealth will work with the program providers and other appropriate stakeholders to assess whether and to what extent barriers to program enrollment shall be alleviated through modifications to the program and or the enrollment process. MassHealth may charge the providers of these benefits for the costs associated with provision of the annual notice if such provider’s program is described therein.”; and
by inserting after Section 146 the following section:-
“SECTION 146A. The executive office of health and human services shall adopt regulations to implement section 61A not later than December 31, 2011.”
Budget Amendment ID: FY2012-S3-458
EHS 458
Ophthalmic Care
Mr. Joyce moved that the proposed new text be amended by inserting after Section 152, the following new Section:-
"Section ____. Section 36 of Chapter 118E of the Massachusetts General Laws is hereby amended by inserting the following after the last paragraph of said section:
"The MassHealth Program is hereby directed to immediately promulgate regulations to allow single specialty ambulatory surgery centers which are licensed by the Department of Public Health as clinics to provide ophthalmic procedures, to enroll in the MassHealth as Medicaid providers."
Budget Amendment ID: FY2012-S3-459
EHS 459
Massachusetts Hospital School Beds
Mr. Joyce moved that the proposed new text be amended in section 2, in item 4590-0915, the bill in Section 2, in item 4590-0915, by adding the following:
“Provided further, that the Massachusetts hospital school shall maintain not less than 120 beds for clients in its inpatient setting;
Budget Amendment ID: FY2012-S3-460
EHS 460
Individual Development Account Program
Mr. Eldridge and Ms. Fargo moved that the proposed new text be amended by inserting after item 7004-9316 the following item:-
7004-9317 -For the Individual Development Account (IDA) program, so-called, participants for the purposes of this pilot program shall be any individual or family who is at or below 80% of the area median income, as defined from time to time by the United States department of housing and urban development, in the community in which they live, as defined by the department, for more than three years; provided, that funds shall be awarded to community-based organizations to establish local IDA programs; provided further, that funds may be used for administrative costs to operate an IDA program for financial literacy and asset-specific training and as a match for program participant savings for qualified acquisition costs with respect to a qualified principal residence for a qualified first-time homebuyer, as defined by the department; provided further, the department may determine other qualified match uses consistent with the guidelines established in federal IDA guidelines pursuant to PL 105-285, 42 USC 604; provided further, that funds may be used to secure federal asset building program funds…………………….. $250,000
Budget Amendment ID: FY2012-S3-462
EHS 462
Preventing Blighted Properties
Ms. Chandler and Messrs. Eldridge, DiDomenico and McGee moved that the proposed new text be amended in section 2, in item 4510-0100, by adding at the end thereof the following: "provided further, that, notwithstanding any general or special law or regulation to the contrary, on or before September 30, 2011, the department shall amend its regulations at 105 CMR 410.020, or any successor regulations defining “owner” for purposes of the State Sanitary Code, to clarify that a mortgagee of a dwelling that has filed a complaint or served notice to authorize foreclosure pursuant to the Servicemembers Civil Relief Act, or such mortgagee’s agents, assigns or mortgage servicers, shall be deemed to have care, charge or control of all tenant-occupied or vacant dwelling units, and associated common areas of such dwelling except when such dwelling is a condominium."
Budget Amendment ID: FY2012-S3-463-R1
Redraft EHS 463
Department of Mental Health Facilities
Mr. Pacheco moved that the proposed new text be amended in section 2, in item 5095-0015, by inserting at the end thereof the following words:- “; provided further, that the department shall submit a plan to the chairs of the house and senate committees on ways and means and the chairs of the joint committee on mental health and substance abuse 120 days before opening more than 50 beds in a new facility; provided further, that the plan shall include, but shall not be limited to the following: the number of beds in operation at the new facility; the number of beds affected at existing facilities; the department’s efforts to proportionally assess bed closures across the geographic regions of the state; the department’s efforts to maintain staffing levels within existing geographic regions; and assessment of the inpatient bed capacity, both public and private, in each geographic region, both prior to the new facility’s operation and following the opening of the new facility; provided further, that the department shall not reduce beds at existing facilities prior to the submission of the plan; and provided further, that said plan shall not substantially impact any region in the state disproportionately”
Budget Amendment ID: FY2012-S3-464-R4
4th Redraft EHS 464
MA Health Adult Dental I
Ms. Chandler and Messrs. Knapik and Richard Moore and Ms. Jehlen and Mr. Montigny and Ms. Creem, Ms. Chang-Diaz, Ms. Spilka and Ms. Fargo and Messrs. Michael Moore and Wolf and Ms. Candaras and Messrs. McGee and DiDomenico moved that the proposed new text be amended in section 2, item 4000-0300, by adding the following words: - “provided further, that the secretary of health and human services shall report semi-annually to the house and senate committees on ways and means relative to the impact of the reductions in adult dental services in MassHealth; and provided further, that such semi-annual reports shall include, but not be limited to, a detailed itemization of covered services and service utilization by service type, utilization of health safety net services, geographical location of the member receiving the service and the number of MassHealth clients unable to receive restorative dental health services who are pregnant, developmentally disabled, medically compromised patients or with HIV/AIDS, data detailing the time that elapses between a member’s request for services and commencement of services and semi-annual data on utilization rates of emergency room visits related to dental health.”
Budget Amendment ID: FY2012-S3-466
EHS 466
State Facilities
Mr. Michael O. Moore moved that the proposed new text be amended in section 2, in item 5930-1000, by striking out the figure "142,156,836" and inserting in place thereof the following figure:- "149,993,472".
Budget Amendment ID: FY2012-S3-467
EHS 467
Children's Autism Medicaid Waiver
Ms. Creem and Ms. Fargo and Messrs. Welch, DiDomenico, Kennedy, Tolman and Eldridge and Ms. Candaras and Messrs. Donnelly, Joyce and McGee moved that the proposed new text be amended in section 2, in item 5920-3010, by striking out the words “the amount authorized in fiscal year 2010” and inserting in place thereof the following figure, "$3,000,000"; and in said item, by striking out the figure, "$4,134,809" and inserting in place thereof the following figure, "$4,621,177"
Budget Amendment ID: FY2012-S3-468
EHS 468
Substance Abuse Services
Mr. Downing moved that the proposed new text be amended in section 2, in item 4512-0200, by inserting after the word “clients” the following:- “; provided, that programs shall receive the same percentage of funding in fiscal year 2012 as received in fiscal year 2011”
Budget Amendment ID: FY2012-S3-469
EHS 469
CHRONIC DISEASE HOSPITALS RATE METHODOLOGY
Mr. Tolman moved that the proposed new text be amended in section 2, in item 4100-0060, by inserting after “deposited in the General Fund;” the following:- “and provided further, that the division 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 healthcare 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 will the rates of payment be lower than the rates in effect for such facility in the prior fiscal year;”.
Budget Amendment ID: FY2012-S3-470-R3
3rd Redraft EHS 470
Green Pool
Mr. Tolman and Ms. Fargo moved that the proposed new text be amended in section 2, in item 5930-1000, by inserting at the end thereof: -
provided further; that notwithstanding any other general or special law or rule or regulation to the contrary, the division of capital asset management shall not close the pool facilities located at the Walter E. Fernald Developmental Center, 200 Trapelo Road, Waltham, until a comparable site has been arranged for individuals from the community who use the pool. A “comparable site” shall be defined as a site which maintains therapeutic pool qualities, including but not limited to maintaining a pool temperature of 90-94 degrees, providing proper chair lifts and ramps, and the presence of qualified staff trained in water safety, lifeguarding and specialized aquatic exercise. A comparable site shall be located within a reasonable and accommodating distance from the Fernald Development Center.
Budget Amendment ID: FY2012-S3-471
EHS 471
Boys & Girls Clubs
Messrs. Hart, Moore, Finegold, DiDomenico and Rodrigues moved that the proposed new text be amended in section 2, in item 4590-1507, by striking out:
"For matching grants to the Alliance of Massachusetts YMCAs, the Massachusetts Alliance of Boys & Girls Clubs and YWCA organizations: provided, that the Massachusetts Alliance of Boys & Girls Clubs shall distribute funds to all Boys and Girls Clubs that received grants from this item in fiscal year 2011 ……………………………………..……..$1,300,000"
and inserting:
For matching grants to the Massachusetts Alliance of Boys & Girls Clubs, the Alliance of Massachusetts YMCAs, the YWCA organizations, nonprofit community centers, and youth development programs; provided, that the department of public health shall award the full amount of each grant to each organization previously included in the youth-at-risk grants, upon commitment of matching funds from such organizations; provided further, that each organization previously included in the youth-at-risk grants shall receive in fiscal year 2012 a grant amount not less than that received in fiscal year 2011; and provided further, that any allocation less than $2,000,000 to a recipient of a youth-at-risk grant must be distributed equally between said recipient’s member organizations…...$1,700,000
Budget Amendment ID: FY2012-S3-472
EHS 472
Increased Funding DDS Facilities
Mr. Hart moved that the proposed new text be amended in section 2, in item 5930-1000, by striking the figure “$142,156,836” and inserting the figure “149,156,836”.
Budget Amendment ID: FY2012-S3-472.1-R1
Redraft Further EHS 472.1
Further Regulating Treatment of Disabled Persons
Mr. Joyce moved that the amendment be amended <w:p><w:r><w:t xml:space="preserve">that the amendment be amended (No. 472 by Mr. Hart) by striking the amendment in its entirety and inserting in place thereof the following:“
after Section 130, the following section:-
"SECTION 130A. Notwithstanding any general or special law or rule or regulation to the contrary, the department of developmental services shall review 115 CMR 5:14 governing behavior modification and adopt amendment thereto, pursuant to its authority under section 2 of chapter 123B. The new regulation shall include, but not be limited to, prohibiting the use of Level III Aversive Interventions, as defined by the 115 CMR 5:14(3); provided, however, that the department may grant a 1-year, individual-specific exemption to an individual who, as of September 1, 2011, is subject to a pre-existing court-approved treatment plan which includes the use of Level III Aversive Interventions to reduce or modify behavior; provided further, that such exception may not be renewed if such individual is no longer subject to a court-approved treatment plan or if such individual’s court-approved treatment plan no longer authorizes the use of Level III Aversive Interventions.”
Budget Amendment ID: FY2012-S3-473
EHS 473
JULIE’S FAMILY LEARNING CENTER
Mr. Hart moved that the proposed new text be amended in section 2, in item 4800-0038, by inserting after the words “Young Parent Programs” the following:
“; provided further, that not less than $ 250,000 shall be expended for a contract with Julie’s Family Learning Program in the South Boston section of the city of Boston”
Budget Amendment ID: FY2012-S3-474
EHS 474
Placement Program for Homeless Elderly
Mr. Hart and Ms. Fargo moved that the proposed new text be amended in section 2, By inserting after item 9110-1660 the following item:
9110-1700 for a residential assessment and placement program for homeless elders…. $ 136,000
Budget Amendment ID: FY2012-S3-475-R1
Redraft EHS 475
DPH Funding for Community Health Centers
Mr. Hart and Ms. Fargo and Mr. DiDomenico moved that the proposed new text be amended in section 2, in item 4510-0110, by inserting at the end thereof the following words:- “; provided, that not less than $250,000 shall be expended on a statewide program of technical assistance to community health centers to be provided by a state primary care association qualified under section 330(f)(1) of the United States Public Health Service Act, 42 U.S.C. section 254c(f)(1)”; and in said item 4510-0110, by striking the figure”$713,949” and inserting in place thereof the following figure:-“$963,949”
Budget Amendment ID: FY2012-S3-476
EHS 476
PEDIATRIC DISPROPORTIONATE SHARE HOSPITALS
Mr. Tolman moved that the proposed new text be amended in section 2, in item 4000-0500, by inserting after the words “expenditures made to these providers;” the following: - “provided further, that not less than $10,000,000 shall be expended as payments for pediatric specialty hospitals and units, including pediatric chronic rehabilitation hospitals; provided further, that $8,000,000 of said $10,000,000 shall be expended for disproportionate share payments for inpatient services provided at pediatric specialty hospitals and units, including pediatric chronic and rehabilitation long-term care hospitals as allowable under federal law; provided further, that $2,000,000 of said $10,000,000 shall be expended for a grant to said pediatric chronic and rehabilitation long-term care hospitals for which federal financial participation and federal approval need not be obtained;"
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.”
Budget Amendment ID: FY2012-S3-479
EHS 479
Cigar Bars
Mr. Petruccelli moved that the proposed new text be amended by inserting, after Section , the following new Section:-
“SECTION . A local board of health in a city or town with a population of more than 150,000 residents may not prohibit smoking bars licensed to operate as of January 1, 2011, as long as they continue to comply with applicable state and local laws in effect as of January 1, 2011.”
Budget Amendment ID: FY2012-S3-480
EHS 480
Restoring funding for Employment Assistance Services for Severely Disabled
Mr. Hart moved that the proposed new text be amended in section 2, in item 4120-3000, by striking the figure $2,362,792 and inserting in place thereof the figure $2,462,792.
Budget Amendment ID: FY2012-S3-481
EHS 481
Pediatric Home Care Services
Mr. Michael O. Moore moved that the proposed new text be amended in section 2, in item 4000-0600, by inserting after the word "Income" the following words:-
“; provided further that for purposes of providing convenient, efficient, and cost-effective health services to children in the home setting, the Division of Health Care Finance & Policy shall amend the formula used to determine continuous skilled nursing care rates for singe and multi-patient home health service pursuant to chapter 118G of the General Laws by attributing no less than 30 percent of the rate to the indirect cost component used to determine payment to agencies; and no more than 10 percent of the rate to the indirect cost component used to determine payment to an individual practitioner. Further, the Division of Health Care Finance & Policy shall not establish rates to reimburse for continuous skilled nursing care provided by Licensed Practical Nurses relative to 114.3 CMR 50.04 (2)(2)(b) to three patients or more".
Budget Amendment ID: FY2012-S3-482-R1
Redraft EHS 482
Project SAFE
Messrs. Petruccelli and DiDomenico moved that the proposed new text be amended in section 2, in item 4401-1000, by inserting the following text:- "; and (e) Project SAFE"
And in the same item by striking out the figure "$4,279,933" and inserting in place thereof the following figure:- "$4,464,633"
Budget Amendment ID: FY2012-S3-483
EHS 483
Home Health Rates
Mr. Michael O. Moore moved that the proposed new text be amended in section 2, in item 4000-0600, by inserting after the word "Income" the following words:- “provided further, that funding from this item shall be provided for the purpose of recruitment and retention of home health nurses in accordance with 114.3 CMR 50.00, and that said funds authorized herein shall be restorative to said regulation prior to its amendment made in accordance with MGL c. 29 § 9C and effective December 1, 2008, and shall be in addition to any amount appropriated in this item for the purpose of providing Title XIX services to patients; and provided further that the funds authorized herein shall be eligible for federal financial participation”; and in said item by striking the figure “2,495,602,264” and inserting in place thereof the following figure “2,502,702,264”.
Budget Amendment ID: FY2012-S3-484
EHS 484
Self Esteem Boston
Mr. Petruccelli moved that the proposed new text be amended in section 2, in item 4512-0200, by adding at the end thereof the following:- “provided that not less than $125,000 shall be expended for Self Esteem Boston’s substance abuse direct service prevention, and provider training programs”
Budget Amendment ID: FY2012-S3-485
EHS 485
PROTECTING NURSING HOME RESIDENT BEDHOLD DAYS DURING MEDICAL LEAVES
Mr. Montigny and Ms. Jehlen and Messrs. Finegold, Kennedy and Eldridge and Ms. Chandler and Messrs. Moore and DiDomenico and Ms. Fargo and Messrs. Tarr and McGee moved that the proposed new text be amended in section 2, in item 4000-0640, by inserting after the word “purposes” the following: -
“provided further, that funds shall be expended in an amount not less than that appropriated in fiscal year 2011 for purposes of reimbursing nursing facilities for up to 10 bedhold days for patients of the facility on medical and non-medical leaves of absence;”
Budget Amendment ID: FY2012-S3-486
EHS 486
Mental Health Jail Diversion
Mr. Tolman moved that the proposed new text be amended in section 2, in item 5046-0000, by inserting after the word "facilities" the following new text:-
"; provided further, that the same level of funding be expended in fiscal year 2012 as expended in the prior fiscal year for jail diversion programs in municipalities that provide equal matching funds from other public or private sources."
Budget Amendment ID: FY2012-S3-487
EHS 487
DDS Community Residential
Ms. Candaras and Mr. Donnelly and Ms. Fargo and Messrs. Kennedy and Eldridge moved that the proposed new text be amended in section 2, in item 5920-2000, Ms. Candaras moved that the bill be amended, in section 2, in item 5920-2000, by striking out the figure "$751,797,120" and inserting in place thereof the following figure- "$759,549,620."
Budget Amendment ID: FY2012-S3-488-R1
Redraft EHS 488
Infrastructure and Capacity Building
Ms. Candaras and Mr. Knapik and Ms. Flanagan and Messrs. Welch, Wolf and Kennedy moved that the proposed new text be amended in section 2, in item 4000-0500, Ms. Candaras and Mr. Knapik and Ms. Flanagan and Mr. Welch moved that the bill be amended , in section 2, in item 4000-0500, by inserting after the words “to the recipients in prior fiscal years” the following words :-
"; provided further, that $10,000,000 shall be expended from this item or item 4000-0700, if necessary to achieve maximum federal financial participation, to enhance the ability of hospitals, community health centers and primary care clinicians to serve populations in need more efficiently and effectively; provided further, that these funds may be allocated using the standards used in fiscal year 2010; provided further, that these funds shall be disbursed not later than April 1, 2012; provided further, that funds may be expended from this item or item 4000-0700, if necessary, to enhance the ability of hospitals to address emergency room capacity issues due to individuals with mental illness who are awaiting placement in an acute care bed”;
and in said Section 2, in said item 4000-0500, by striking out the figure “3,754,835,669” and inserting in place thereof the following figure: - “3,764,835,669”.
Budget Amendment ID: FY2012-S3-489-R1
Redraft EHS 489
Infrastructure and Capacity Building Funding
Ms. Candaras and Mr. Knapik and Ms. Flanagan and Messrs. Welch, Finegold, Wolf and Keenan moved that the proposed new text be amended in section 2, in item 4000-0700, Infrastructure and Capacity Building Funding
Ms. Candaras and Mr. Knapik and Ms. Flanagan and Messrs. Welch and Finegold moved that the bill be amended , in section 2, in item 4000-0700, by inserting after the word “years;” the following words:-
"provided further, that funds may be expended from this item, or item 4000-0500, if necessary to achieve maximum federal financial participation, to enhance the ability of hospitals, community health centers and primary care clinicians to serve populations in need more efficiently and effectively; provided further, that these funds may be allocated using the standards used in fiscal year 2010; provided further, that these funds shall be disbursed not later than April 1, 2012; provided further, that funds may be expended from this item or 4000-0500, if necessary, to enhance the ability of hospitals to address emergency room capacity issues due to individuals with mental illness who are awaiting placement in an acute care bed "
Budget Amendment ID: FY2012-S3-490
EHS 490
STEP Program
Mr. Petruccelli moved that the proposed new text be amended in section 2, in item 4512-0200, by adding at the end thereof the following:- “for the division of substance abuse services, including a program to reimburse driver alcohol education programs for services provided for court adjudicated indigent clients; provided, that programs shall receive the same percentage of funding in fiscal year 2012 as received in fiscal year 2011”; and in said item, by striking out the figures “$74,685,802” and inserting in place thereof the figures “$75,185,802”
Budget Amendment ID: FY2012-S3-491
EHS 491
Department of Youth Services Teachers Salaries
Ms. Candaras moved that the proposed new text be amended in section 2, in item 4200-0500, Ms. Candaras moved that the bill be amended, by striking in section 2, in item 4200-0500 the figure "$2,000,000" and inserting in place thereof the following figure:- "$2,500,000"
Budget Amendment ID: FY2012-S3-492
EHS 492
MassHealth Reimbursement Rates
Mr. Michael O. Moore moved that the proposed new text be amended by inserting, after Section ____, the following new Sections:-
"SECTION ____. Section 12 of Chapter 118E of the General Laws is hereby amended by inserting at the beginning of the section the following new definitions:
“Managed Care Organization”, any entity with which the Commonwealth contracts to provide managed care services to eligible MassHealth enrollees on a capitated basis.
"Network'', a grouping of health care providers who contract with a managed care organization to provide services to MassHealth enrollees covered by the managed care organization’s plans, policies, contracts or other arrangements.
“Non-network provider”, a health care provider who has not entered into a contract with a managed care organization to provide services to MassHealth enrollees.
SECTION ____. Section 12 of Chapter 118E of the General Laws is further amended by inserting at the end of the section the following new language:
For emergency, post-stabilization, and certain other services that have received a prior approval by a managed care organization contracting with the Commonwealth to provide managed care services to MassHealth enrollees, health care providers not included in a managed care organization’s network, must accept a rate equal to the rate paid by Medicaid for the same or similar services. Nothing in this section shall prohibit a managed care organization from denying payment for unapproved services conducted by a non-network provider.
SECTION ____. Chapter 118H of the General Laws is hereby amended by the addition of a new Section 7, as follows:
Section 7. For emergency, post-stabilization, and certain other services that have received a prior approval by a carrier or managed care organization contracting with the Connector to provide managed care services to Commonwealth Care Health Insurance Program enrollees, health care providers not included in a managed care organization’s network, must accept a rate equal to the rate paid by Medicaid for the same or similar services. Nothing in this section shall prohibit a carrier or managed care organization from denying payment for unapproved services conducted by a non-network provider."
Budget Amendment ID: FY2012-S3-493-R1
Redraft EHS 493
Rate Stabalization
Ms. Candaras and Messrs. Welch and Knapik moved that the proposed new text be amended in section 2, in item 7004-0102, by striking out, in line 5, the figure “$12.92” and inserting in place thereof the following figure:- “$20”; and in said item 7004-0102 by striking out the figure “$37,292,852” and inserting in place thereof the following figure:- “$37,733,331”
Budget Amendment ID: FY2012-S3-495-R1
Redraft EHS 495
Phoenix House
Mr. Hart moved that the proposed new text be amended in section 2, in item 4512-0200, by inserting at the end thereof the following words:-
“; provided, that funds may be expended for programs that received funding in fiscal year 2011”.
Budget Amendment ID: FY2012-S3-497-R1
Redraft EHS 497
LGBT Elders and Caregivers
Mr. Eldridge and Ms. Jehlen and Ms. Fargo and Mr. DiDomenico moved that the proposed new text be amended in section 2, in item 9110-1630, <w:p><w:r><w:t xml:space="preserve">by inserting after "services", in line 20, the following words:-"; provided further, that funding shall be expended for provider training and outreach to lesbian, gay, bisexual and transgender elders and caregivers";
and in said section 2, in item 9110-9002 by striking out the words “and provided further, that funding shall be expended for provider training and outreach for lesbian, gay, bisexual and transgender elders and caregivers”.
Budget Amendment ID: FY2012-S3-500
EHS 500
DCF Fair Hearings
Ms. Creem and Ms. Jehlen and Messrs. Eldridge, Rodrigues, DiDomenico and McGee and Ms. Candaras moved that the proposed new text be amended in section 2, in item 4800-0015, by inserting after “recoupment amounts recommended by the state auditor;” the following:
“provided further, that by October 3, 2011, the department shall issue draft revised regulations for public comment which shall ensure that the department maintains an independent, timely and fair administrative hearings system and shall issue final regulations by December 1, 2011; provided further, that not later than October 1, 2011, the department shall; (a) revise its procedures to ensure that newly requested administrative hearings are scheduled and decided upon on a timely basis; and (b) submit to the joint committee on children, families and persons with disabilities a plan for eliminating its backlog of administrative hearing requests; provided further, that the plan shall identify the number of fair hearing requests that were pending as of July 1, 2011, and shall set quarterly benchmarks for elimination of the backlog; provided further, that the department shall submit quarterly reports to the joint committee on children, families, and persons with disabilities on the status of the backlog;”
Budget Amendment ID: FY2012-S3-501-R1
Redraft EHS 501
Special Commission on Unaccompanied Homeless Youth
Ms. Clark, Ms. Chang-Diaz and Ms. Flanagan and Mr. Kennedy and Ms. Spilka and Mr. Keenan and Ms. Candaras and Mr. McGee moved that the proposed new text be amended by inserting, after section __, the following new section:-
“Section _ Notwithstanding any general or special law to the contrary, there shall be a special commission for the purpose of studying the adequacy and limitations of current services to meet the safety, support, housing, health, education, and quality of life needs of unaccompanied homeless or unstably housed youth as defined under the McKinney-Vento Homeless Assistance Act, 42 U.S.C. §§ 11431-11435 (2002). The commission is charged with identifying and addressing barriers to housing, services and education for unaccompanied youth experiencing homelessness. Two working groups shall be established within the commission to ensure a full and comprehensive report addressing the needs of all subpopulations of unaccompanied homeless youth; one working group focusing on the specific needs of youth under 18 years of age and a second group focusing on the needs of youth 18 to 22 years of age. The Commission’s report shall include recommendations for addressing the needs of non-system involved youth as well as unstably housed youth with the goal of ensuring a comprehensive and effective response to the unique needs of this population. The commission, in formulating its recommendations, shall take account of the best policies and practices in other states and jurisdictions.
The commission shall include the Secretary of the Executive Office of Health and Human Services or designee, the Commissioner of Department of Children and Families or designee, the Commissioner of Department of Public Health or designee, the Commissioner of Department of Mental Health or designee, the Commissioner of the Department of Youth Services or designee, the Commissioner of the Department of Elementary and Secondary Education or designee, the Commissioner of the Department of Early Education and Care or designee, the Undersecretary for the Department of Housing and Community Development or designee, two members of the Senate, two members of the House of Representatives, three youth who have experienced homelessness, a representative from each of the following organizations: Massachusetts Coalition for the Homeless, Children’s League of Massachusetts, Task Force on Youth Aging Out of Department of Children and Families Care, Massachusetts Appleseed Center for Law and Justice, the Massachusetts Commission on Gay, Lesbian, Bisexual and Transgender Youth, and the Massachusetts Housing and Shelter Alliance, and seven persons to be appointed by the Governor, five of whom shall be unaccompanied youth service providers.
The commission shall submit a report to the Governor, the Speaker of the House of Representative, the President of the Senate, and the Joint Committee on Children, Families and Persons with Disabilities no later than 9 months after the passage of this Act, setting forth the commission’s conclusions on how to improve access to services for unaccompanied homeless or unstably housed youth, 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 31 of each year to the Governor, the Speaker of the House of Representatives, the President of the Senate, and the Joint Committee on Children, Families and Persons with Disabilities 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.
Budget Amendment ID: FY2012-S3-502
EHS 502
User Fees
Messrs. Pacheco, Moore and Knapik moved that the proposed new text be amended by inserting, after Section_____, the following new Section:-
"Section _____. “Chapter 118G, Section 25 subsection (b) of the Massachusetts General Laws is hereby amended by inserting at the end thereof the following: “Notwithstanding any general or special law or regulation or administrative bulletin to the contrary, a public nursing facility shall be granted an exemption from paying any assessments hereunder. Such exemption shall have priority over all other exemptions that have not been granted as of the enactment date of this section. For purposes of this exemption, a “public nursing facility” shall be defined as a nursing facility operated by a municipality or a geriatric authority located in Bristol County, City of Taunton; Hampden County, City of Holyoke; Nantucket County, Town of Nantucket; or Worcester County, City of Milford.”"
Budget Amendment ID: FY2012-S3-504
EHS 504
Veterans Suicide Prevention Program
Messrs. Petruccelli, Wolf and DiDomenico and Ms. Donoghue and Mr. Moore moved that the proposed new text be amended in section 2, in item 4513-1026, by striking out the figures “$2,248,776” and inserting in place thereof the figures “$3,569,444”.
Budget Amendment ID: FY2012-S3-505
EHS 505
Line item 7004-0101 Homelessness Prevention
Messrs. Keenan and Eldridge and Ms. Spilka, Ms. Jehlen, Ms. Chang-Diaz and Ms. Fargo and Messrs. Wolf and DiDomenico moved that the proposed new text be amended in section 2, in item 7004-0101, Senator John Keenan moves to amend line item 7004-0101 by inserting after “provided further, however, that any family whose income exceeds 115 per cent of the federal poverty level while the family is receiving assistance funded by this item shall not become ineligible for assistance due to exceeding the income limit for a period of 6 months from the date that the 115 per cent level was exceeded” the following language
“ … provided further, that $5,000,000 shall be expended for homelessness prevention services and resources for families who have incomes at or below 115 per cent of the federal poverty limit and include a child under age 21 or a pregnant woman; provided further, that such prevention services shall be administered by community action agencies and other community based organizations, shall be provided on first-come, first-serve basis and shall include landlord/tenant mediation, legal assistance to prevent eviction, housing search services, stabilization services, and financial assistance to pay up to 3 months of rental arrearages to landlords who have issued a notice to quit but who agree to withdraw the notice and extend the tenancy if payment is provided;”
Budget Amendment ID: FY2012-S3-506
EHS 506
DVS Elders Pension Recovery Budgetary Account
Messrs. Keenan and DiDomenico moved that the proposed new text be amended in section 2, moves that the bill be amended in section 2, by inserting item 1410-0100 as follows: “1410-0100 For the revenue maximization project of the executive office of elder affairs to identify individuals eligible for veterans’ pensions who are currently receiving home health care services $96,350.”
Budget Amendment ID: FY2012-S3-508
EHS 508
Community Hospital Relief Plan (CHRP)
Messrs. Keenan, Wolf, Knapik, Downing and Welch and Ms. Fargo and Ms. Candaras moved that the proposed new text be amended in section 2E, in item 1595-5819, by adding after the words “using sources distinct from the funding made available to the Health Safety Net Trust Fund” the following:
Provided further for the purpose of this line item, Massachusetts nonprofit disproportionate share hospitals with a Medicare payer mix percentage greater than 43% of Total Gross Patient Service Revenue (GPSR) using FY09 403 cost report payer data shall be defined as a public service hospital under 114.1 CMR 36.02; further provided that of the public service hospitals qualifying under this line item Boston Medical Center shall receive 50% of the Public Service Hospital Safety Net Care Payments available and the other qualifying public service hospitals shall receive an equal payment of the remaining 50% of said public service hospital safety net care payment monies. Municipal Hospitals shall be exempt from the provisions of this section.
Budget Amendment ID: FY2012-S3-509
EHS 509
Payment Amount Per Episode
Messrs. Wolf, Keenan and Knapik and Ms. Fargo, Ms. Flanagan, Ms. Candaras and Ms. Clark moved that the proposed new text be amended in section 2, in item 4000-0500, Mr. Wolf moves to amend the bill, in item 4000-0500 by adding at the end the following:
; and provided further that the PAPE (Payment Amount Per Episode) rate for ER mental health visits including substance abuse in not for profit community hospitals shall be 2 times the PAPE rate as established by MassHealth for FY2012.
Budget Amendment ID: FY2012-S3-510
EHS 510
Social Worker Caseloads
Ms. Clark and Messrs. Rosenberg and DiDomenico moved that the proposed new text be amended in section 2, in item 4800-1100, by striking out the figure “159,452,441” and inserting in place thereof the figure:- “161,022,453”.
Budget Amendment ID: FY2012-S3-511-R1
Redraft EHS 511
Mental Health services for children
Mr. Keenan moved that the proposed new text be amended in section 2, in item 4000-0950, by inserting at the end thereof the following: and provided further, that $2,000,000 may be allocated from this item 5042-5000 to support the department of mental health’s role in implementing the children’s behavioral health initiative”
Budget Amendment ID: FY2012-S3-512-R1
Redraft EHS 512
Day Habilitation
Mr. Joyce and Ms. Clark and Mr. Donnelly and Ms. Jehlen and Messrs. Kennedy, Rodrigues and Keenan and Ms. Spilka and Ms. Chang-Diaz and Mr. Michael O. Moore and Ms. Fargo and Messrs. Tolman, Finegold, DiDomenico, Hedlund, Montigny, Timilty, Welch, Wolf, Eldridge, Hart, Downing and McGee and Ms. Donoghue and Ms. Creem and Mr. Pacheco moved that the proposed new text be amended in section 2, in item 4000-0700, in section 2, in item 4000-0300 by inserting after the words “projected exhaustion of funding;” the following words:- “provided further, that MassHealth shall notify the house and senate committees on ways and means not less than 60 days in advance of any change in services or rates paid to providers of adult day habilitation services;”
and in item 4000-0700 by striking out the figures “$2,026,206,633” and inserting in place thereof the figures “$2,030,206,633”
Budget Amendment ID: FY2012-S3-513-R3
3rd Redraft EHS 513
Emergency Psychiatric Care (EPC) Plan
Messrs. Keenan and Wolf and Ms. Fargo and Messrs. Welch and Knapik and Ms. Candaras moved that the proposed new text be amended by inserting after Section ____, the following new Section:-
"Section ____. Notwithstanding any general or special law to the contrary, any person admitted to a hospital emergency room in the Commonwealth for the treatment of mental illness or substance abuse and a determination has been made that an inpatient admission is required either by an ESP team, psychiatrist or the Emergency Department physician, the person’s insurance and any entity with whom they contract to manage behavioral health benefits, including the Medicaid managed care organizations and any entity with whom they contract to manage behavioral health benefits for MassHealth members, shall be required to participate in the location of an appropriate bed within 24 hours after the determination has been made. If an appropriate bed is not located within 24 hours, the inpatient psychiatric per diem rate shall be paid to the emergency department upon billing until an appropriate bed is located; provided further, that while the patient is boarded in the emergency department, psychiatric care by licensed mental health professionals shall commence and said licensed mental health professional shall be compensated for such services under appropriate billing codes; provided further that ESP teams shall be compensated for every follow-up encounter with patients awaiting inpatient admission after more than 24 hours in an Emergency Department.
Budget Amendment ID: FY2012-S3-514
EHS 514
Elder Protective Services
Ms. Clark and Mr. Rodrigues and Ms. Jehlen and Messrs. Knapik, Donnelly, Eldridge and DiDomenico and Ms. Chang-Diaz, Ms. Flanagan and Ms. Candaras and Mr. Moore and Ms. Fargo and Ms. Donoghue and Messrs. McGee, Montigny and Pacheco moved that the proposed new text be amended in section 2, in item 9110-1636, by striking out the figure “$15,250,554” and inserting in place thereof the following figure:- “$16,250,554”.
Budget Amendment ID: FY2012-S3-515
EHS 515
EHS Consolidated IT Funding
Mr. Joyce moved that the proposed new text be amended in section 2, in item 4000-1700, in section 2, in item 4000-1700 by striking out the figure “81,762,075” and inserting in place thereof the following:- "$83,197,047"
Budget Amendment ID: FY2012-S3-516
EHS 516
Geriatrics Program
Mr. Joyce moved that the proposed new text be amended in section 2, in item 9110-1900, in section 2, in item 9110-1900, by inserting the following:- “provided further, that funds shall be expended for the purpose of continuing the administration of a geriatrics program, previously funded in line item 9110-1900 of Section 2 of Chapter 182 of the Acts of 2008.”
Budget Amendment ID: FY2012-S3-517-R1
Redraft EHS 517
Naturally Occurring Retirement Communities (NORC)
Ms. Creem and Ms. Spilka and Mr. McGee moved that the proposed new text be amended in section 2, in item 9110-1660, by inserting at the end thereof:- "; provided, that funds shall be expended for naturally occurring retirement communities funded from item 9110-1660 of chapter 182 of the acts of 2008 at not less than 31% of their appropriations therein,” and by striking out the figure “$1,503,617” and inserting in place thereof the figure “$1,717,617”
Budget Amendment ID: FY2012-S3-518
EHS 518
Massachusetts Hospital School
Mr. Joyce moved that the proposed new text be amended in section 2, in item 4590-0915, in Section 2, item 4590-0915, by striking out the figure, "$139,397,307" and inserting in place thereof the figure, "$143,397,307".
Budget Amendment ID: FY2012-S3-519-R1
Redraft EHS 519
Massachusetts Child Psychiatry Access Project
Mr. Keenan moved that the proposed new text be amended in section 2, by inserting after item 5042-5000, the following item:
5042-6000.. For the operation of a statewide program to provide mental health consultations by telephone, available for a minimum of five days a week, to pediatricians, family physicians, nurse practitioners and youth serving primary care practices for persons under the age of 19 who exhibit a possible mental health or substance use disorder; provided, that notwithstanding any general or special law to the contrary, the costs of this program may be assessed on surcharge payers under section 38 of chapter 118G of the General Laws and may be collected in a manner consistent with said chapter 118………………………………$2,000,000
Budget Amendment ID: FY2012-S3-520
EHS 520
GROW Associates
Mr. Joyce moved that the proposed new text be amended in section 2, in item 5911-2000, in section 2, in item 5911-2000, by inserting after "by the department" the following “provided further, that not less than $100,000 shall be expended for services to the developmentally disabled provided by Grow Associates, Inc. in the town of Avon.”
Budget Amendment ID: FY2012-S3-521
EHS 521
Substance Abuse Treatment
Messrs. Keenan and DiDomenico moved that the proposed new text be amended in section 2, in item 4512-0200, by striking out the figures "$74,685,802" and inserting in place thereof the figures "$75,185,802".
Budget Amendment ID: FY2012-S3-522
EHS 522
Milton Hospital IT
Mr. Joyce moved that the proposed new text be amended in section 2, in item 4000-1700, in section 2, in item 4000-1700, by inserting the following:- "provided further that not less than $1,000,000 shall be expended to Milton Hospital to initiate health information technology improvements including but not limited to, e-prescribing, patient portal, continuity of care document, data repository, dose tracker, new hardware and technicians"
Budget Amendment ID: FY2012-S3-523-R1
Redraft EHS 523
CLOTHING ALLOWANCE
Mr. DiDomenico and Ms. Chang-Diaz, Ms. Candaras and Ms. Chandler moved that the proposed new text be amended in section 2, in item 4403-2000, <w:p><w:r><w:t xml:space="preserve">by striking the words “children’s clothing allowance in the amount of $40 shall be provided to each child eligible under this program in September 2011” and inserting in place thereof the following words:- “children’s clothing allowance in the amount of $150 shall be provided to each child eligible under this program in September 2011, to the extent feasible within appropriation; provided further, that the non-recurring clothing allotment in fiscal year 2012 shall not be less than $75”;
and in said section 2, in said item 4403-2000, by striking out the figure "$315,980,979" and inserting in place thereof the following figure:- "$318,730,614”
Budget Amendment ID: FY2012-S3-525
EHS 525
DVS Administration
Messrs. McGee and DiDomenico moved that the proposed new text be amended in section 2, in item 1410-0010, by striking out the figure “2,133,506” and inserting in place thereof the following:- $2,387,778."
Budget Amendment ID: FY2012-S3-526
EHS 526
Medicaid 1115 Waiver
Messrs. Rosenberg, Downing, Knapik, Welch, Wolf and Tarr and Ms. Candaras and Ms. Chandler and Mr. Moore moved that the proposed new text be amended by inserting, after Section_____, the following new Section:
"SECTION____. And provided further prior to the Commonwealth of Massachusetts signing an agreement with the Centers for Medicaid and Medicare Services for an extension of the Medicaid 1115 Waiver for Waiver years 15, 16 and 17, there shall be a joint hearing of the House and Senate Committees on Ways and Means and the Joint Committee on Health Care Financing on the details of the provisions of and any hospital funding formulas in the negotiated waiver. Said Committees my jointly or separately make recommendations to the Legislature, the Governor and his Administration on matters of concern or interest as a result of the hearing for their approval. The Governor may not sign the 1115 Waiver Extension for Waiver Years 15,16, & 17 without the approval of the Legislature."
Budget Amendment ID: FY2012-S3-527
EHS 527
VIETNAM MOVING WALL
Ms. Spilka and Mr. Ross moved that the proposed new text be amended in section 2, in item 1410-0010, by inserting after the words “Veterans memorials;” the following: “provided further, that not less than $15,000 shall be expended for the Vietnam Veterans Moving Wall project in the metro west region;” and further amend the item by striking out the figure “$2,133,506” and inserting in place thereof the following figure, “$2,148,506”.
Budget Amendment ID: FY2012-S3-528
EHS 528
School Nurses and School Based Health Centers
Ms. Flanagan moved that the proposed new text be amended in section 2, in item 4590-0250, by inserting after the words "department of elementary and secondary education" the following:-
"provided further, that funds shall be expended for school nurses and school based health center programs".
Budget Amendment ID: FY2012-S3-529
EHS 529
Medical Respite Program for the Homeless
Ms. Chang-Diaz and Mr. Hart moved that the proposed new text be amended in section 2, in item 4000-0500, by inserting at the end thereof the following words:- "and provided further, that the executive office shall maintain the FY 2011 overall reimbursement rate for the commonwealth’s only medical respite program for the homeless"
Budget Amendment ID: FY2012-S3-531
EHS 531
HEALTH CARE ACCESS AND OUTREACH GRANTS
Mr. DiDomenico and Ms. Fargo and Mr. Donnelly moved that the proposed new text be amended in section 2, by inserting after item 4000-0320 the following item:
“4000-0352 for EOHHS Health Care Reform Enrollment, Outreach and Access to Care grants to public and private nonprofit groups to be administered by the executive office in consultation with the Health Care Reform Outreach and Education Unit; provided, that grants shall be awarded to groups statewide, with emphasis in areas and populations in which the division of health care finance and policy has determined a high percentage of uninsured and unenrolled individuals and areas in which there are limited health care providers; provided that the grants shall support efforts by the grantees to provide outreach, enrollment and re-enrollment assistance, education on effective and appropriate use of health care coverage, and coverage retention activities directly to consumers who may be eligible for programs including, but not limited to, MassHealth, the Commonwealth Care Health Insurance Program, the Commonwealth Choice program, Prescription Advantage, the Medical Security Plan, the Children’s Medical Security Plan, Healthy Start, and the Health Safety Net and who may require individualized support due to geography, ethnicity, race, culture, linguistic capacity, age, economic status, immigration status, or disease status; provided that in awarding the grants, the unit shall provide written guidance to selected grantees with specific strategies of how to expend funds in the most efficient manner to target populations and avoid duplication of activities, including examples of best practices among prior year outreach grant recipients; provided that the grants shall support technical assistance that includes informational updates, trainings, and the sharing of best practices for grantee organizations conducting outreach, enrollment assistance, education and coverage retention activities for programs including, but not limited to, MassHealth, the Commonwealth Care Health Insurance Program, the Commonwealth Choice program, Prescription Advantage, the Medical Security Plan, the Children’s Medical Security Plan, Healthy Start, and the Health Safety Net; provided further, that the executive office may fund all or part of the grants through transfers from the Commonwealth Health Insurance Connector Authority or other authorities of the Commonwealth, federal or foundation grant funds, donated funds or other sources; and provided further, that the secretary shall report to the house and senate committees on ways and means on the exact amounts distributed in fiscal year 2012, and the extent to which any portion of resulting expenditures are eligible for federal reimbursement ........................................ 2,500,000”
Budget Amendment ID: FY2012-S3-532
EHS 532
DDS DAY AND EMPLOYMENT SERVICES
Ms. Spilka and Messrs. Moore, Donnelly and Keenan and Ms. Fargo and Mr. Eldridge moved that the proposed new text be amended in section 2, in item 5920-2025, by striking out the figure “$123,267,971” and inserting in place thereof the following figure:- “$125,969,796”.
Budget Amendment ID: FY2012-S3-533-R1
Redraft EHS 533
Classroom-based Domestic Violence Prevention Programs
Mr. Rodrigues moved that the proposed new text be amended in section 2, in item 4513-1130, by inserting at the end thereof the following words:- “and provided further, that funds may be expended for classroom-based domestic violence prevention education programs administered in item 0340-0900 in fiscal year 2009”.
Budget Amendment ID: FY2012-S3-535
EHS 535
INCOME-ELIGIBLE CHILD CARE
Ms. Spilka and Mr. Moore and Ms. Chang-Diaz and Messrs. Knapik, DiDomenico and Kennedy and Ms. Fargo and Ms. Clark and Messrs. Montigny, Keenan and Welch moved that the proposed new text be amended in section 2, in item 3000-4060, by striking out the figure “227,965,287” and inserting in place thereof the following figure:- “237,397,940”.
Budget Amendment ID: FY2012-S3-537
EHS 537
Commission for the Deaf and Hard of Hearing
Messrs. Welch, Knapik, Keenan and Montigny moved that the proposed new text be amended in section 2, in item 4125-0100, by striking out the figures “$4,722,631” and inserting in place thereof the figures “$5,783,000”.
Budget Amendment ID: FY2012-S3-538
EHS 538
Home Care Case Management
Ms. Jehlen and Mr. Rodrigues and Ms. Clark and Messrs. DiDomenico, Eldridge and Donnelly and Ms. Chang-Diaz, Ms. Chandler and Ms. Candaras moved that the proposed new text be amended in section 2, in item 9110-1633, by striking the figure "35,000,000" and inserting in place thereof, the figure "$35,738,377".
Budget Amendment ID: FY2012-S3-540-R1
Redraft EHS 540
Pre-admission Counseling and Assessment
Ms. Jehlen, Messrs. DiDomenico and Eldridge, Ms. Spilka, Ms. Chandler, Messrs. Donnelly and Michael O. Moore and Ms. Candaras moved that the proposed new text be amended in section 2, in item 4000-0600, by inserting after the words “Supplemental Security Income;” the following words:- “provided further, that funds shall be expended from this item to implement the pre-admission counseling and assessment program under the third paragraph of section 9 of chapter 118E of the General Laws, which shall be implemented on a statewide basis through aging and disability resource consortia;”
Budget Amendment ID: FY2012-S3-541
EHS 541
Department of Transitional Assistance Domestic Violence Specialists
Mr. Keenan and Ms. Spilka and Ms. Candaras moved that the proposed new text be amended in section 2, by inserting item 4400-1025 as follows: “4400-1025 For domestic violence specialists at local area offices $748,734”.
Budget Amendment ID: FY2012-S3-542
EHS 542
Councils on Aging
Ms. Jehlen and Messrs. DiDomenico, Keenan, Kennedy, Donnelly, Moore and Knapik and Ms. Creem, Ms. Spilka and Ms. Chandler and Messrs. Joyce, Pacheco and McGee and Ms. Fargo moved that the proposed new text be amended in section 2, in item 9110-9002, by striking the figure "$7,904,327" and inserting in place thereof, the figure "$8,254,237".
Budget Amendment ID: FY2012-S3-543
EHS 543
RESIDENTIAL TREATMENT PROGRAMS FOR DYS YOUTH
Ms. Spilka moved that the proposed new text be amended in section 2, in item 4200-0300, by striking out the figure “$93,039,491” and inserting in place thereof the following figure:- “$96,421,853”.
Budget Amendment ID: FY2012-S3-545
EHS 545
Service Coordination and Administration
Messrs. Donnelly and Eldridge moved that the proposed new text be amended in section 2, in item 5911-1003, by striking out the figure "$57,613,847" and inserting in its place thereof the following:- $60,672,283.
Budget Amendment ID: FY2012-S3-546
EHS 546
Commonwealth Care Restoration
Ms. Chang-Diaz and Messrs. Eldridge and Donnelly and Ms. Fargo and Mr. McGee moved that the proposed new text be amended in section 2E, in item 1595-5819, by striking out the figure “$751,511,822” and inserting in place thereof the following figure:- “$809,511,822”
And in Section 111 by striking out said section and inserting in place thereof the following paragraph:- “SECTION 111. Individuals enrolled as of June 30, 2011 in the Commonwealth Care Bridge program created pursuant to section 95 of Chapter 359 of the Acts of 2010, and who are otherwise eligible for Commonwealth Care, shall remain enrolled in Bridge until they are transferred to Commonwealth Care on or after July 1, 2011 and the secretary of administration and finance, the secretary of health and human services and the executive director of the commonwealth health insurance connector authority are authorized to make expenditures from the Commonwealth Care Trust Fund for continued operation of the Bridge program on or after July 1, 2011 for the limited purpose of avoiding a period without insurance for said individuals.”
Budget Amendment ID: FY2012-S3-547
EHS 547
Elder Home Care Purchase of Services
Ms. Jehlen and Messrs. Rodrigues and Knapik and Ms. Clark and Messrs. DiDomenico, Eldridge and Donnelly and Ms. Chandler and Mr. McGee and Ms. Candaras and Mr. Montigny moved that the proposed new text be amended in section 2, in item 9110-1630, by striking the figure "$96,780,898" and inserting in place thereof, the figure "$97,780,898".
Budget Amendment ID: FY2012-S3-548
EHS 548
Massachusetts Alliance of Boys & Girls Clubs
Messrs. Donnelly, DiDomenico, Rodrigues, Knapik, Eldridge and Kennedy and Ms. Spilka and Mr. Welch and Ms. Chang-Diaz and Mr. Richard Moore and Ms. Clark and Mr. Michael Moore and Ms. Creem, Ms. Flanagan and Ms. Donoghue and Messrs. McGee and Pacheco moved that the proposed new text be amended in section 2, in item 4590-1507, by striking the section and inserting in place thereof the following section:- for matching grants to the Massachusetts Alliance of Boys & Girls Clubs, the Alliance of Massachusetts YMCAs, and YWCA organizations: provided, that the department of public health shall award the full amount of each grant to each organization upon commitment of matching funds from said organizations; provided further, that each organization listed in this line item shall receive in fiscal year 2012 a grant amount not less than that received in fiscal year 2011; and provided further, that any allocation less than $2,000,000 to a recipient of a grant under this line item must be distributed equally between said recipient’s member organizations.
Budget Amendment ID: FY2012-S3-549
EHS 549
DCF Admin Account
Messrs. Rodrigues and Rosenberg moved that the proposed new text be amended in section 2, in item 4800-0015, by striking out the figures “62,616,711” and inserting in place thereof the figures:- “63,677,819”.
Budget Amendment ID: FY2012-S3-550
EHS 550
QUALITY NURSING HOME CARE INITIATIVE
Mr. DiDomenico and Ms. Chang-Diaz, Ms. Jehlen and Ms. Clark moved that the proposed new text be amended in section 2, in item 4000-0600, by adding at the end thereof the following: provided further, that not less than $2,800,000 shall be expended as fiscal year 2012 incentive payments to nursing facilities meeting the criteria determined by the MassHealth Nursing Facility Pay for Performance Program in 114.2 CMR 6.07 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.
Budget Amendment ID: FY2012-S3-551
EHS 551
DCF In Home Assistance
Messrs. Rodrigues, Rosenberg, McGee and Donnelly and Ms. Jehlen and Ms. Fargo and Mr. Pacheco moved that the proposed new text be amended in section 2, in item 4800-0040, by striking out the figures “34,789,000” and inserting in place thereof the following figures:- “39,750,000”.
Budget Amendment ID: FY2012-S3-553
EHS 553
Health care safety and quality
Ms. Jehlen moved that the proposed new text be amended in section 2, in item 4510-0710, by striking in line item 4510-0710 the figure “$6,493,455” and inserting in place thereof figure :-“$6,774,419”.
Budget Amendment ID: FY2012-S3-554
EHS 554
Operation of Veterans' cemeteries in Agawam and Winchendon
Mr. Welch moved that the proposed new text be amended in section 2, in item 1410-0630, by striking out the figures “$899,451” and inserting in place thereof the figures “$948,313”.
Budget Amendment ID: FY2012-S3-555
EHS 555
Workforce Competitiveness Trust Fund
Messrs. Donnelly, DiDomenico, Eldridge, Moore, Montigny and McGee moved that the proposed new text be amended in Outside Section 129 by inserting after the words "Chapter 23I of the General Laws; and," in line 5, the following words:- provided further the comptroller shall transfer $8,000,000 from the General Fund to the Workforce Competitiveness Trust Fund established by section 2WWW of chapter 29 of the Acts of 2008.
Budget Amendment ID: FY2012-S3-556-R1
Redraft EHS 556
Adult Foster Care
Mr. Rodrigues, Ms. Jehlen, Messrs. Tolman and Richard T. Moore, Ms. Spilka, Ms. Clark, Mr. Finegold, Ms. Chang-Diaz, Messrs. Kennedy, Donnelly, Knapik, Timilty, Welch, Eldridge and DiDomenico, Ms. Chandler, Ms. Candaras, Messrs. Michael O. Moore, Keenan and Montigny, Ms. Creem, Ms. Fargo, Messrs. Tarr and McGee moved that the proposed new text be amended in section 2, in item 4000-0300, by inserting after the words “projected exhaustion of funding;” the following words:- “provided further, that MassHealth shall notify the house and senate committees on ways and means not less than 60 days in advance of any change in the rates paid to providers of adult foster care and group adult foster care services;”
Budget Amendment ID: FY2012-S3-557-R1
Redraft EHS 557
MassHealth Auditing
Messrs. Petruccelli and Michael O. Moore moved that the proposed new text be amended in section 2, in item 4000-0309, by inserting after the words “Medicaid fraud prior to payment” the following words:-
“; provided further, that the state Medicaid office may employ strategies to improve systems for detection and may allow for the use of external data sources;”
Budget Amendment ID: FY2012-S3-558-R2
2nd Redraft EHS 558
DCF Foster Care Clothing Allowance
Messrs. Rodrigues, Rosenberg, Michael O. Moore and McGee moved that the proposed new text be amended in section 2, in item 4800-0015, by inserting after the figure “1997” the following words:- “provided further, that if the number of foster children under the care of the department in the third quarter is lower than the number of foster children under the care of the department for the first and second quarters, foster children in the care of the department may receive a clothing allowance for the fourth quarter at an amount up to the amount provided in Fiscal Year 2011.
Budget Amendment ID: FY2012-S3-559
EHS 559
Teen Living Shelter Program
Messrs. Finegold, Knapik and DiDomenico and Ms. Fargo and Messrs. McGee and Kennedy moved that the proposed new text be amended in section 2, in item 4403-2119, by striking out the figure ”$6,436,708” and inserting in place thereof the figure “$6,576,576”.
Budget Amendment ID: FY2012-S3-560
EHS 560
Maintain Medicaid Disproportionate Share Hospital
Messrs. Welch, Knapik, DiDomenico, Finegold and Hart moved that the proposed new text be amended in section 2, in item 4000-0500, by inserting after the word "herein" the following:- “; provided that, the Executive Office of Health and Human Services from funds within this item shall maintain the adjustment in the RY2011 Acute Hospital RFA, Reimbursement System Section, D. 5.a. in the RY2012 Acute Hospital RFA Medicaid standard payment amount per discharge for any hospital that has greater than 63% of its gross patient service revenue from governmental payers and free care."
Budget Amendment ID: FY2012-S3-561
EHS 561
Public Health Facilities
Mr. Finegold moved that the proposed new text be amended in section 2, in item 4590-0915, by striking out the figure ”$139,397,307” and inserting in place thereof the following figure:- “$139,847,307”.
Budget Amendment ID: FY2012-S3-562
EHS 562
Community-based Residential Services
Mr. Finegold moved that the proposed new text be amended in section 2, in item 5920-2010, by striking out the figure “$164,194,179” and inserting in place thereof the following figure:- “$164,790,661”.
Budget Amendment ID: FY2012-S3-563
EHS 563
State Lab Funding
Messrs. Donnelly and DiDomenico and Ms. Clark and Mr. Pacheco and Ms. Fargo moved that the proposed new text be amended in section 2, in item 4516-1000, by striking the figure “$13,243,542” and inserting in its place the following :- $14,743,542.
Budget Amendment ID: FY2012-S3-564-R1
Redraft EHS 564
FAIR HEARINGS
Ms. Spilka, Mr. Rodrigues, Ms. Jehlen, Mr. Eldridge, Ms. Chang-Diaz, Mr. Donnelly and Ms. Fargo moved that the proposed new text be amended in section 2, in item 7004-0108, by inserting after the words “aid pending a timely appeal pursuant to said chapter 23B;” the following words:-
“; provided further, that families who are denied assistance under this item may appeal pursuant to the provisions of said chapter 23B, including section 30(F), and implementing regulations;”
Budget Amendment ID: FY2012-S3-565
EHS 565
Maintain Medicaid DSH Payments
Mr. Hart moved that the proposed new text be amended in section 2, in item 4000-0500, by inserting after the word “herein” the following:- “; provided that, the Executive Office of Health and Human Services from funds within this item shall maintain the adjustment in the RY2011 Acute Hospital RFA, Reimbursement System Section, D. 5.d. in the RY2012 Acute Hospital RFA Medicaid standard payment amount per discharge for any public service hospital which provides more than 10% of the statewide inpatient Medicaid days "
Budget Amendment ID: FY2012-S3-566
EHS 566
Mass Health program changes 1
Ms. Jehlen and Mr. Eldridge moved that the proposed new text be amended by striking out section 62.
Budget Amendment ID: FY2012-S3-567
EHS 567
DTA Employment Services Program 4401-1000
Messrs. Rodrigues and Wolf and Ms. Spilka and Messrs. Knapik, Hedlund and Petruccelli and Ms. Creem and Messrs. DiDomenico, Montigny, Finegold, Moore and Eldridge and Ms. Candaras and Mr. McGee moved that the proposed new text be amended in section 2, in item 4401-1000, by inserting at the end thereof the following: “and (e) for providers with whom the department entered into service agreements with in fiscal year 2011 as procured under the Competitive Integrated Employment Services program.”; and in said item by striking out the figures “$4,279,933” and inserting in place thereof the figures “$12,621,513”.
Budget Amendment ID: FY2012-S3-569
EHS 569
DYS Juvenile Courts - Education
Mr. Kennedy moved that the proposed new text be amended in section 2, in item 4200-0500, Mr. Kennedy moved to amend the bill in section 2, in item 4200-0500, by striking out the figure “$2,000,000” and inserting in place thereof the following figure:- “$2,500,000”
Budget Amendment ID: FY2012-S3-570
EHS 570
Mass Health program changes 2
Ms. Jehlen and Mr. Eldridge moved that the proposed new text be amended by striking out Section 64.
Budget Amendment ID: FY2012-S3-571
EHS 571
TAFDC Clothing Allowance
Mr. Rodrigues and Ms. Jehlen, Ms. Spilka and Ms. Fargo and Messrs. Kennedy, Montigny, Eldridge and Donnelly and Ms. Creem and Messrs. Keenan and DiDomenico and Ms. Candaras moved that the proposed new text be amended in section 2, in item 4403-2000, by striking out the words “children’s clothing allowance in the amount of $40” and inserting the following words:- “children’s clothing allowance in the amount of $150”.
Budget Amendment ID: FY2012-S3-572
EHS 572
Medicaid Processing Accuracy
Mr. Kennedy moved that the proposed new text be amended Mr. Kennedy moved that the bill be amended by inserting, after Section ___, the following new Section:-
"SECTION __. Payments made by the Executive Office of Health and Human Services to providers for services payable under Title XIX of the Social Security Act shall be processed in a manner that maximizes federal financial participation. Notwithstanding any general or special law to the contrary, the Executive Office of Health and Human Services shall process all such payments to MassHealth providers and recoupments from MassHealth providers in accordance with the policies and procedures established under a Medicaid Management Information System (“MMIS”) that has received express Federal approval under Title XIX of the Social Security Act.
(a) Any determination (including any determination for which an appeal is pending pursuant to 130 CMR 450.241 et seq.) that an overpayment has been made to a non-acute hospital, as defined in Massachusetts General Laws Chapter 118G, Section 1, with respect to services to patients who are eligible for benefits under both Titles XVIII and XIX of the Social Security Act and for which funds have not been recouped from the non-acute hospital, shall not be recovered, recouped or deemed final unless: (1) the determination of the overpayment was made in accordance with the policies and procedures of a Federally-approved MMIS; (2) the Executive Office of Health and Human Services has provided the non-acute hospital with documentation, which shall include patient-specific remittance advices which are sufficient in form and substance for approval by Medicare auditors of the overpayment amount as an allowable bad debt under Title XVIII of the Social Security Act; and, (3) the non-acute hospital has received interim payments under Title XVIII of the Social Security Act based upon the non-acute hospital’s claim of bad debt reimbursement relating to the overpayment.
(b) Any determination (including any determination for which an appeal is pending pursuant to 130 CMR 450.241 et seq.) than an overpayment has been made to a hospital, as defined in Massachusetts General Law Chapter 118G, Section 1, with respect to services to patients who are eligible for benefits under both Titles XVIII and XIX of the Social Security Act and for which funds already have been recouped without first being processed through a Federally-approved MMIS: (1) shall result in a reversal of the prior determination and, (2) shall not be deemed final unless: (A) a new determination of overpayment is made in accordance with the policies and procedures of a Federally-approved MMIS; (B) the Executive Office of Health and Human Services has provided the hospital with documentation, which shall include patient-specific remittance advices which are sufficient in form and substance for approval by Medicare auditors of the newly-determined overpayment amount as an allowable bad debt under Title XVIII of the Social Security Act; and, (C) the hospital has received interim payments under Title XVIII of the Social Security Act based upon the hospital’s claim of bad debt reimbursement relating to the newly-determined overpayment."
Budget Amendment ID: FY2012-S3-573
EHS 573
Commission on GLBT Youth
Ms. Chang-Diaz and Messrs. DiDomenico and Eldridge and Ms. Fargo and Mr. Petruccelli and Ms. Jehlen and Messrs. Rodrigues and Donnelly and Ms. Clark, Ms. Chandler and Ms. Creem and Mr. Wolf moved that the proposed new text be amended in section 2, by inserting after item 0950-0000 the following item:-
"0950-0050 For the commission on gay, lesbian, bisexual, and transgender youth; provided that funds shall be used to address issues related to the implementation of the state's anti-bullying law (Chapter 92 of the Acts of 2010)...........$100,000"
Budget Amendment ID: FY2012-S3-574
EHS 574
HIV/AIDS
Ms. Chang-Diaz and Ms. Jehlen and Mr. Eldridge and Ms. Chandler and Messrs. Montigny, Moore and Donnelly and Ms. Fargo and Messrs. Wolf, Knapik and DiDomenico moved that the proposed new text be amended in section 2, in item 4512-0103, by striking out the figure "$31,097,810" and inserting in place thereof the following figure:- "$33,597,810"
Budget Amendment ID: FY2012-S3-575
EHS 575
DDS Respite Family Supports
Mr. Rodrigues and Ms. Spilka and Mr. Kennedy and Ms. Jehlen and Messrs. Donnelly, Keenan and Moore and Ms. Chang-Diaz and Ms. Fargo and Messrs. Knapik, Welch, DiDomenico and McGee moved that the proposed new text be amended in section 2, in item 5920-3000, by striking out the figure “32,592,372” and inserting in place thereof the following figure:- “41,004,298”.
Budget Amendment ID: FY2012-S3-577
EHS 577
Mass Commission for the Blind
Messrs. Kennedy and Downing moved that the proposed new text be amended in section 2, in item 4110-0001, Mr. Kennedy moved to amend the bill in section 2, in item 4110-0001, by striking out the figure “$911,811” and inserting in place thereof the following figure:- “$963,848”
Budget Amendment ID: FY2012-S3-578
EHS 578
DPH Technical Correction
Mr. Richard T. Moore moved that the proposed new text be amended by inserting, after Section X, the following new Section:--
SECTION X. Section 222 of chapter 111, as so appearing, is hereby further amended by adding at the end thereof the following:— The provisions of subsections (a) and (b) shall become effective sixty days after the promulgation of regulations by the Department of Public Health.
Budget Amendment ID: FY2012-S3-579
EHS 579
Disproportionate Share Hospitals
Mr. Kennedy moved that the proposed new text be amended Mr. Kennedy moved that the bill be amended by inserting, after Section ___, the following new Section:-
"SECTION ___. Notwithstanding any general or special law or regulation to the contrary, the Executive Office of Health and Human Services shall maintain the adjustment in the RY2011 Acute Hospital REA, Reimbursement System Section, D. 5.a. in the RY2012 Acute Hospital REA Medicaid standard payment amount per discharge for any hospital that has greater than 63% of its gross patient service revenue from governmental payers and free care.”
Budget Amendment ID: FY2012-S3-580
EHS 580
HIV/AIDS Drug Program Manufacturer Rebates Retained Revenue
Ms. Chang-Diaz and Ms. Jehlen and Mr. Eldridge and Ms. Chandler and Messrs. Michael O. Moore, Donnelly and Knapik moved that the proposed new text be amended in section 2, in item 4512-0106, by striking out the following line item language:
4512-0106 For the department of public health which may expend for the human immunodeficiency virus and acquired immune deficiency syndrome drug assistance program an amount not to exceed $4,000,000 from revenues received from pharmaceutical manufacturers participating in the section 340B rebate program of the Public Health Service Act, administered by the federal Health Resources and Services Administration and Office of Pharmacy Affairs.........................................................................................................................$4,000,000
and replacing it with the following:-
4512-0106 For the department of public health which may expend for the human immunodeficiency virus and acquired immune deficiency syndrome drug assistance program an amount not to exceed $7,500,000 from revenues received from pharmaceutical manufacturers participating in the section 340B rebate program of the Public Health Service Act, administered by the federal Health Resources and Services Administration and Office of Pharmacy Affairs.........................................................................................................................$7,500,000
Budget Amendment ID: FY2012-S3-582
EHS 582
Mass Office on Disability
Messrs. Kennedy and Pacheco moved that the proposed new text be amended in section 2, in item 1107-2400, Mr. Kennedy moved to amend the bill in section 2, in item 1107-2400, by striking out the figure “$539,539” and inserting in place thereof the following figure:- “$556,129”
Budget Amendment ID: FY2012-S3-583
EHS 583
Homemakers Services for People with Disabilities
Mr. Kennedy moved that the proposed new text be amended in section 2, in item 4120-5000, Mr. Kennedy moved to amend the bill in section 2, in item 4120-5000, by striking out the figure “$4,287,006” and inserting in place thereof the following figure:- “$4,337,006”
Budget Amendment ID: FY2012-S3-584-R1
Redraft EHS 584
Health Promotion and Disease Prevention
Messrs. Richard T. Moore, Montigny, Rodrigues, Knapik and DiDomenico moved that the proposed new text be amended in section 2, in item 4513-1111, by adding, after the words "National Multiple Sclerosis Society:" the following:- "colorectal cancer prevention; hepatitis C prevention and management" and in said item, by striking out the figures "$3,383,981" and inserting in place thereof the figures "$3,508,981"
Budget Amendment ID: FY2012-S3-585
EHS 585
Health Safety Net Shortfall
Mr. Richard T. Moore moved that the proposed new text be amended in section 2E, in item 1595-5819, by inserting at the end thereof the following:- "provided further, that the executive office, in consultation with the executive office of administration and finance and the Massachusetts Hospital Association, shall submit a report to the house and senate committees on ways and means, not later than September 30, 2011, that shall including the following: (a) an estimate of the projected funding uses and sources of Health Safety Net funding in fiscal years 2011 and 2012, including an estimate of the funding shortfall in each year; (b) an estimate of federal revenue generated by the Health Safety Net Fund expenditures in fiscal years 2011 and 2012 and an explanation of how such revenue is expended; (c) a plan to dedicate an increased portion of existing federal matching revenues to the fiscal year 2012 Health Safety Net Fund to minimize the shortfall burden on the hospital community."
Budget Amendment ID: FY2012-S3-586
EHS 586
MassHealth & Medicare Dual Eligible Demonstration Program
Mr. Kennedy moved that the proposed new text be amended in section 2, in item 4000-0300, Mr. Kennedy moved to amend the bill in Section 2, in item 4000-0300, by adding the following:
“provided further, in any new demonstration program for a population that is dually eligible for Medicare and Medicaid, the executive office or its contractors shall not reimburse hospitals, physicians, or home health care providers at a level below current Medicare payment rates.”
Budget Amendment ID: FY2012-S3-587
EHS 587
Fuel Assistance Forward Funding
Mr. Kennedy and Ms. Candaras moved that the proposed new text be amended in section 2, Mr. Kennedy moved that the bill be amended in section 2, by inserting after item 7004-___ the following item:
"xxxx-xxxx. For the purposes of providing advanced funding no later than 30 days after the start of the fiscal year to community based nonprofit organizations and other entities that administer the federal Low Income Home Energy Assistance Program described in item 7004-2033 to allow said organizations and entities to begin start up operations of the federal Low Income Home Energy Assistance Program described in item 7004-2033; provided, that the department and said organizations and entities may expend a portion of these funds for reasonable administrative costs consistent with the current or prior year's state plan submitted by the department of housing and community development in accordance with the federal program; provided further that, that the department and said organizations and entities may, after November 1, expend a portion of these funds to assist low-income elders, working families and other households with the purchase of heating oil, propane and natural gas and electricity and other primary or secondary heating sources; provided further that, said advanced funding be subject to reimbursement by funds described in item 7004-2033.............$10,000,000."
Budget Amendment ID: FY2012-S3-588
EHS 588
Primary Care Recruitment
Mr. Moore and Ms. Candaras moved that the proposed new text be amended in section 2, by inserting after item 4000-0050 the following item:
"4000-0265 For a primary care workforce development and loan forgiveness grant program at community health centers, for the purpose of enhancing recruitment and retention of primary care physicians and other clinicians at community health centers throughout the commonwealth; provided, that the grant shall be administered by the Massachusetts League of Community Health Centers in consultation with the secretary of health and human services and relevant member agencies; provided further, that the funds shall be matched by other public and private funds; provided further, that the League of Community Health Centers shall work with said secretary and said agencies to maximize all sources of public and private funds.......$400,000"
Budget Amendment ID: FY2012-S3-589-R4
4th Redraft EHS 589
Adult Day Health
Messrs. Richard T. Moore, Tarr and Eldridge, Ms. Jehlen, Mr. Rodrigues, Ms. Clark, Mr. Knapik, Ms. Chang-Diaz, Ms. Creem, Messrs. Downing and Donnelly, Ms. Chandler, Ms. Flanagan, Messrs. Hart, Montigny, Kennedy, Michael O. Moore and Welch, Ms. Fargo, Messrs. Timilty and DiDomenico, Ms. Candaras and Messrs. McGee and Finegold moved that the proposed new text be amended in section 2, in item 4000-0300, by inserting after the words “projected exhaustion of funding;” the following words:- “provided further, that MassHealth shall notify the house and senate committees on ways and means not less than 60 days in advance of any change in the clinical eligibility criteria or rates paid to providers of adult day health services; provided further, that MassHealth shall adopt regulations by September 30, 2011, establishing a minimum criteria for licensure of an adult day health provider which shall set forth a standard of quality measures for services provided to members as a condition of licensure; provided further, that MassHealth shall adopt regulations establishing a process for the periodic inspection of adult day health providers by the agency to ensure compliance with said standards; provided further, that said regulations shall be the subject of one or more public hearings prior to their adoption; provided further, that MassHealth shall file a report with the house and senate committees on ways and means, the joint committee on health care financing, and the clerks of the senate and house of representatives, relative to the impact of said regulations upon the service to current members, and any legislation which may be required to comply with the provisions of this item.”
Budget Amendment ID: FY2012-S3-590
EHS 590
Immunizations
Mr. Richard T. Moore moved that the proposed new text be amended by inserting, after Section X, the following new Section:--
SECTION X. Notwithstanding any general or special law to the contrary, health insurers shall pay to health care providers 100% of the reasonable and customary charges for routine childhood immunizations for Massachusetts residents and immunizations for Massachusetts residents who are 18 years of age and under according to the most recent schedules recommended by the advisory Committee on Immunization Practices of the United States department of health and human services, excluding those costs covered by the commonwealth or the federal government, and any reasonable and customary costs associated with the administration of the vaccines. Said health insurer shall provide such reimbursement to any health care provider who administers covered immunizations in any facility, health care provider’s office or any other setting in the commonwealth and shall not limit such reimbursement to providers that are participating providers.
Budget Amendment ID: FY2012-S3-591
EHS 591
Youth-At-Risk Grant Programs
Ms. Chang-Diaz and Mr. McGee moved that the proposed new text be amended in section 2, in item 4590-1507, by striking out item 4590-1507 and inserting in place thereof the following item:-
“4590-1507 For matching grants to the Massachusetts Alliance of Boys & Girls Clubs, and the Alliance of Massachusetts YMCAs and YWCA organizations, nonprofit community centers and youth development programs; provided, that the department of public health shall fund each organization previously included in the youth-at-risk grants, upon commitment of matching funds from those organizations...................................$2,000,000
Budget Amendment ID: FY2012-S3-592-R1
Redraft EHS 592
High Acuity Cases at Pediatric Hospitals
Messrs. Kennedy and Tolman, Ms. Clark and Messrs. DiDomenico and McGee moved that the proposed new text be amended in section 2, in item 4000-0300, Mr. Kennedy moved to amend the bill in section 2, in item 4000-0300, by inserting at the end thereof the following:—
“provided further, that in calculating rates of payment for children enrolled in MassHealth receiving inpatient services at acute care pediatric hospitals and pediatric subspecialty units as defined in section 1 of chapter 118G of the General Laws, the executive office may make a supplemental payment sufficient to assure that inpatient SPAD and outlier payments for discharges with a case mix acuity greater than 3.5 shall be at least equal to 85 per cent of the expenses incurred in providing services to those children.”
Budget Amendment ID: FY2012-S3-593-R1
Redraft EHS 593
Telehealth
Messrs. Richard T. Moore, Montigny and Tarr moved that the proposed new text be amended in section 2, in item 4000-0500, by adding the following words:- "; provided further, that for purposes of long-term health care cost savings and enhanced patient care, the commonwealth shall recognize telehealth remote patient monitoring provided by home health agencies as a service to clients otherwise reimbursable through Medicaid".
Budget Amendment ID: FY2012-S3-594-R1
Redraft EHS 594
Living allowance for dependent adult children
Mr. Joyce moved that the proposed new text be amended <w:p><w:r><w:t xml:space="preserve">by inserting, after Section __, the following new Section:-
SECTION__. Notwithstanding any general or special law to the contrary, the executive office of health and human services shall request a written opinion from the federal Centers for Medicare and Medicaid Services about the availability of a waiver to allow individuals qualifying for medicaid and entering a nursing home to provide a living allowance and an asset waiver for dependent adult children when there is no living community spouse as defined under 42 U.S.C. Section 1396r-5. The executive office shall report to the house and senate committees on ways and means not later than February 1, 2012 on the availability of a waiver and, if applicable, the estimated net state cost of a waiver that would allow individuals qualifying for medicaid and entering a nursing home to provide a living allowance and asset waiver for dependent adult children when there is no living community spouse.
Budget Amendment ID: FY2012-S3-595
EHS 595
Nursing Home MassHealth Rates
Mr. Kennedy and Ms. Chandler and Messrs. Rodrigues, Finegold, Knapik, Joyce, Donnelly and Richard Moore and Ms. Clark, Ms. Creem and Ms. Flanagan and Messrs. Michael Moore, Hart and Welch and Ms. Fargo and Messrs. Wolf, Pacheco and DiDomenico and Ms. Donoghue and Ms. Candaras moved that the proposed new text be amended in section 2, in item 4000-0600, Mr. Kennedy moved to amend the bill in section 2, in item 4000-0600, by inserting at the end thereof the following:-
“provided further that effective July 1, 2011 for the fiscal year ending June 30, 2012, the division of health care finance and policy shall establish nursing facility MassHealth rates that are $30 million in payments above the payments made to nursing facilities for the fiscal year ended 2011.”
Budget Amendment ID: FY2012-S3-596
EHS 596
DCF REGIONAL ADMINISTRATION AMENDMENT
Ms. Spilka and Mr. Rodrigues moved that the proposed new text be amended in section 2, in item 4800-0030, by striking out the figure “9,300,000” and inserting in place thereof the figure:- “10,300,000”.
Budget Amendment ID: FY2012-S3-597
EHS 597
Maintaining Patient Access
Mr. Kennedy and Ms. Candaras moved that the proposed new text be amended in section 2, Mr. Kennedy moved to amend the bill by inserting, after Section ___, the following new Section:-
"SECTION ___. Notwithstanding any general or specific law to the contrary, MassHealth Managed Care Organizations and Commonwealth Care health plans shall be prohibited from restricting from their networks Signature Healthcare-Brockton Hospital, and their related physicians that have historically served a large proportion of these plan enrollees, and that are willing to contract according to the terms and conditions of other independent providers in the health plan network for all covered benefits and specific facility type, and provided further, that the Commonwealth Health InsuranceConnector Authority and the Executive Office of Health and Human Services shall ensure the implementation of this provision through its contractual and oversight authority."
Budget Amendment ID: FY2012-S3-599
EHS 599
CONTRACTED HEALTH INFORMATION
Mr. Tarr moved that the proposed new text be amended by inserting, after Section __, the following new Section:-
"SECTION__. any agency or authority of the commonwealth seeking to issue a contract for the procurement of the creation or dissemination of information relating to human reproduction shall, not less than 30 days prior to issuing such contract, submit such contract to the joint committee on public health and joint committee on health care financing and the house and senate committees on ways and means."