Amendment #18 to H4000

Study of ER Co-payments

Representatives Jones of North Reading, Peterson of Grafton, Hill of Ipswich, Poirier of North Attleborough and deMacedo of Plymouth move to amend the bill by adding the following section:-

“SECTION XX. (a) Notwithstanding any general or special law to the contrary, there shall be a special commission to be referred to as the MassHealth Cost Control Commission to investigate the use of co-payments for MassHealth members with the goal of encouraging the most cost effective use of health care resource. The investigation shall include, but not be limited to, the study of savings that would result from charging a small co-payment for the use of emergency care in non-emergency situations, in order to discourage the inappropriate use of health care resources. Inappropriate use of health care resources may be defined as an instance in which an individual seeks care in an emergency room department but whose medical needs do not warrant in-patient medical care.

(b) The commission shall investigate possible cost-savings for the MassHealth program and any positive and negative deterrent effects a co-payment will have on MassHealth members, in encouraging members to use primary care rather than emergency care in non-emergency situations.

(c) The MassHealth cost control commission shall consist of 9 members: 1 member who shall be a representative of a major hospital within the commonwealth, appointed by the Governor; 1 member who shall be an advocate for MassHealth members, appointed by the director of medicaid; 1 member who shall be an expert in national health care policy, appointed by the governor; 1 member who shall be a representative of MassHealth, appointed by the director of medicaid; 1 member who shall be a taxpayer’s advocate, appointed by the governor; 1 member of the senate, appointed by the senate president; 1 member, appointed by the senate minority leader; 1 member of the house of representatives, appointed by the speaker of the house; and 1 member, appointed by the house minority leader.

(d)  The commission shall submit its report and findings, along with any draft of legislation, to the house and senate committees on ways and means, the joint committee on health care financing, and the clerks of the house of representatives and the senate within 90 days of the passage of this act.”.