Consolidated Amendment "I" to H3400
Health and Human Services and Elder Services
Health and Human Services and Elder Affairs
Fiscal Note: $48,663,232
Amendments from the Health and Human Services: 41, 44, 71, 79, 86, 87, 115, 119, 143, 158, 180, 182, 191, 197, 204, 223, 245, 252, 287, 341, 344, 348, 435, 438, 439, 451, 482, 503, 518, 540, 546, 549, 552, 563, 609, 619, 644, 663, 711, 738, 743, 763, 766, 774, 780, 794, 818, 879, and 881.
Amendments from Elder Affairs: 122, 160, 289, 353, 512, 524, 543, 576, 593, 723, and 772.
Mr. Dempsey of Haverhill and others move to amend H.3400 in section 2, by striking out item 4000-0300 and inserting in place thereof the following item:
4000-0300For the operation of the executive office of health and human services, including the operation of the managed care oversight board; provided, that the executive office shall provide technical and administrative assistance to agencies under the purview of the secretariat receiving federal funds; provided further, that the executive office shall monitor the expenditures and completion timetables for systems development projects and enhancements undertaken by all agencies under the purview of the secretariat and shall ensure that all measures are taken to make such systems compatible with one another for enhanced interagency interaction; provided further, that the executive office shall ensure that any collaborative assessments for children receiving services from multiple agencies within the secretariat shall be performed within existing resources; provided further, that the Executive Office of Health and Human Services and its agencies, when contracting for services on the islands of Martha’s Vineyard and Nantucket, shall take into consideration the increased costs associated with the provision of goods, services, housing, and travel costs and shall provide no more than $30,000 for the increased costs associated with travelling to and from said islands; provided further, that funds appropriated in this item shall be expended for administrative and contracted services related to the implementation and operation of programs authorized by chapter 118E of the General Laws; provided further, that in consultation with the center for health information and analysis, no rate increase shall be provided to existing Medicaid provider rates without taking all measures possible under Title XIX of the Social Security Act to ensure that rates of payment to providers do not exceed the rates that are necessary to meet only those costs which must be incurred by efficiently and economically operated providers in order to provide services of adequate quality; provided further, that funds may be expended for the operation of the office of health equity within the executive office of health and human services; provided further, that no expenditures shall be made that are not federally reimbursable, including those related to Titles XIX or XXI of the Social Security Act or the MassHealth demonstration waiver approved under section 1115(a) of said Social Security Act or the community first section 1115 demonstration waiver, whether made by the executive office or another commonwealth entity, except as required for: (a) the equivalent of MassHealth Standard benefits for children under age 21 who are in the care or custody of the department of youth services or the department of children and families; (b) dental benefits provided to clients of the department of developmental services who are age 21 or over; or (c) cost containment efforts the purposes and amounts of which have been submitted to the executive office for administration and finance and the house and senate committees on ways and means 30 days prior to making these expenditures; provided further, that in calculating rates of payment for children enrolled in MassHealth receiving inpatient and outpatient services at acute care pediatric hospitals and pediatric specialty units as defined in section 8A of Chapter 118E of the General Laws, the executive office shall provide additional reimbursement to the pediatric acute hospital in the Commonwealth, above the base rates, to compensate for high-complexity pediatric care in an amount no less than $11,800,000 and to the pediatric specialty unit in the Commonwealth in an amount no less than $3,000,000; provided further, that the executive office of health and human services may continue to recover provider overpayments made in the current and prior fiscal years through the Medicaid management information system, and that these recoveries shall be considered current fiscal year expenditure refunds; provided further, that funds shall be provided in an amount not less than the total appropriated in item 1599-2009 in section 2 of chapter 182 of the acts of 2008; provided further, that the executive office may collect directly from a liable third party any amounts paid to contracted providers under chapter 118E of the General Laws for which the executive office later discovers another third party is liable if no other course of recoupment is possible; provided further, that no funds shall be expended for interpretive services directly or indirectly related to a settlement or resolution agreement with the office of civil rights or any other office, group or entity; provided further, that interpretive services currently provided shall not give rise to enforceable legal rights for any party or to an enforceable entitlement to interpretive services; provided further, $150,000 shall be expended for the work of the Massachusetts Unaccompanied Homeless Youth Commission to determine the scope of need among unaccompanied youth and young adults ages 24 and younger who are experiencing homelessness, and to identify and implement potential models for appropriate service delivery to unaccompanied homeless youth in urban, suburban, and rural areas of the Commonwealth; provided further, that notwithstanding any general or special law to the contrary, the commissioner of mental health shall approve any prior authorization or other restriction on medication used to treat mental illness in accordance with written policies, procedures and regulations of the department of mental health; provided further, not less than $500,000 shall be expended for a one time emergency department infrastructure and capacity building grant to a regional Medicare eligible disproportionate share, geographically isolated, community healthcare provider in Southern Worcester County affiliated with the University of Massachusetts Medical School that operates a 114-bed acute-care Hospital and satellite medical facilities across South Central Massachusetts, including a 24/7 Emergency Care Center, provided that said regional community healthcare provider shall provide a matching amount of a minimum of $500,000 in private funding, and further, that these funds shall be made available to said provider not later than December 31, 2013; provided further, that the office of Medicaid shall work with the managed care organizations that are under contract with the commonwealth to deliver managed care services to MassHealth enrollees and other relevant stakeholders to develop changes to Medicaid payment policies, quality improvement programs, and any other programmatic changes that would produce a minimum cost saving across the Medicaid program sufficient to offset increased provider rates incurred by Medicaid managed care organizations as a result of fiscal year 2014 base hospital rate increases; provided further, that not later than January 17, 2014 the executive office of health and human services shall submit a report to the house and senate committees on ways and means detailing the methodology used to project caseload and utilization in fiscal year 2013 and fiscal year 2014; provided further, that funds shall be expended to support the functions of the office of performance management in carrying out the executive order, no. 540 entitled "Improving the Performance of State Government by Implementing a Comprehensive Strategic Planning and Performance Management Framework in the Executive Departments"; provided further, that not later than December 20, 2014 the executive office of health and human services shall submit a report to the house and senate committees on ways and means and house and senate committees on healthcare financing detailing the criteria for determining increased hospital payments for transitioning to alternative payment methodologies; provided further, that any projection of deficiency in item 4000-0430, 4000-0500, 4000-0600, 4000-0700, 4000-0870, 4000-0875, 4000-0880, 4000-0890, 4000-0895, 4000-0940, 4000-0950, 4000-0990, 4000-1400 or 4000-1405 shall be reported to the house and senate committees on ways and means not less than 90 days before the projected exhaustion of funding; and provided further, that any unexpended balance in these accounts shall revert to the General Fund on June 30, 2014 $88,785,816
And further amend said section 2, in item 4000-0500, by adding after “federal poverty
level” the following:-
; provided further, that MassHealth shall provide not less than $1,000,000 in the Fiscal Year 14 capitated rate for the PCC mental health and substance abuse plan for inpatient behavioral health providers;
And further amend said item by striking out the figure “$4,499,411,804” and inserting in place thereof the following figure:- $4,500,411,804;
And further amend said section 2, in item 4000-0600, by striking out the words “up to” and inserting in place thereof the following:- of;
And further amend said section 2, in item 4000-0640, by inserting after the date “June 30, 2002” the following:-
; provided further that effective July 1, 2013 for the fiscal year ending June 30, 2014, the executive office of health and human services shall establish nursing facility MassHealth rates that fully recognize the Medicaid share of the nursing home assessment established by section 63 of chapter 118E of the General Laws; provided further, that not less than $2,800,000 shall be expended as incentive payments to nursing facilities meeting the criteria determined under the MassHealth Nursing Facility Pay-for-Performance Program and that have established and participated in a cooperative effort in each qualifying nursing facility between representatives of employees and management that is focused on implementing that criteria and improving the quality of services available to MassHealth members and that shall decide jointly how to expend such incentive payments; and provided further that the MassHealth agency shall adopt all additional regulations and procedures necessary to carry out this section;
And further amend said item by striking out the figure “$288,600,000” and inserting in place thereof the following figure:- $319,300,000;
And further amend said section 2, in item 4000-0700, by striking out the figure “$2,145,499,061” and inserting in place thereof the following figure:- $2,158,899,061;
And further amend said section 2, in item 9110-1500, by striking out the figure “$47,266,383” and inserting in place thereof the following figure:- $48,766,383;
And further amend said section 2, in item 9110-1660, by striking out the words “not receive less than” and inserting in place thereof the following:- receive $50,000 more than;
And further amend said section by striking out the figure “$1,824,616” and inserting in place thereof the following figure:- 1,874,616;
And further amend said section 2, in item 9110-1700, by striking out the figure “$136,000” and inserting in place thereof the following figure:- $186,000;
And further said section 2, in item 9110-1900, by striking out the words “funds” and inserting in place thereof the following:- not less than $50,000;
And further amend said section 2, in item 9110-9002, by striking out the figure “$9,216,768” and inserting in place thereof the following figure:- $10,500,000;
And further amend the bill by inserting after section 38 the following section:-
SECTION 38A. Subsection (e) of section 9D of Chapter 118E of the General Laws, as appearing in the 2010 Official Edition, is hereby amended by inserting following paragraph:-
(6) The executive office shall direct MassHealth to provide each beneficiary age 65 and over with an annual notice of the options for enrolling in voluntary programs including Program of All Inclusive Care for the Elderly (PACE) plans, SCO plans, Frail Elder Home and Community Based Waiver Program or any other voluntary elected benefit to which they are entitled to supplement or replace their MassHealth benefits. Provided that MassHealth receives approval from the Centers for Medicare and Medicaid Services, MassHealth shall arrange that such annual notice include 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 in clear and simple language and method to request for the same information in a language other than English. Such notice shall include a method for the beneficiary to indicate interest in receiving additional information for any programs identified as of interest to them. A draft of the proposed language and format for providing information to beneficiaries will be circulated to the providers contracted to provide each of these programs for review and comment prior to finalization. In addition, the division 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.
And further amend the bill in section 100 by striking out the words “section 51” and inserting in place thereof the following:- Sections 38A and 51.
And further amend the bill by adding the following sections:
SECTION XX. Section 270 of the acts of 2012 is hereby amended by inserting after the word “ methodologies” the following:- “including but not limited to standard payment per discharge (SPAD) and payment per episode (PAPE) to disproportionate share hospitals with gross patient service revenue (GSPR) greater than 63% from governmental payers and free care, as determined by executive office of health and human services”
SECTION XX. The executive office of health and human services shall study the feasibility of expanding adult dental services within MassHealth covered services under chapters 118E of the General Laws. The investigation and study shall include, but not be limited to, the administration and cost of expanding coverage of non-preventative adult dental services and restorative dental services for adults with disabilities, and the development of a funding mechanism to maximize federal reimbursement at such time that it may become available. The office shall provide a report, including recommendations for any legislation, to the house and senate committees on ways and means no later than January 1, 2014.