Budget Amendment ID: FY2014-S3-599-R1
Redraft EHS 599
Healthcare Sustainability Study
Messrs. Knapik, Tarr, Hedlund and Ross moved that the proposed new text be amended <w:p><w:r><w:t xml:space="preserve">by, inserting after section 144, the following new section:-
Section XX. Notwithstanding any general or special law to the contrary, there shall be a special commission established within the Health Policy Commission, as described in Chapter 224 of the Acts of 2012, to study and report on the future of health care provider financing. The commission shall consist of the executive director of health policy commission or a designee, who shall chair the commission; three appointees of the chair; one shall represent an academic medical center, one shall represent a safety net hospital, and one shall represent a community health center; representatives from the Massachusetts League of Community Health Centers, Blue Cross and Blue Shield of Massachusetts, the Massachusetts Medical Society, the Massachusetts Association of Health Plans, and the Massachusetts Hospital Association; the secretary of the executive office of health and human services, or a designee; the secretary of the executive office of administration and finance, or a designee; the executive director of the commonwealth health information and analysis (CHIA), or a designee; the commissioner of the department of insurance, or a designee; the house and senate chairs of the committee on health care financing, or their designees; the house and senate chair of ways and means, or their designees; the house and senate chairs of the committee on financial services, or their designees; and the house and senate minority leaders, or their designees.
The commission shall look at all audited and unaudited cost reports of hospitals and community health centers filed with the CHIA, all reports of layoffs and strikes in the health care marketplace, all reports of receiverships, all reports of missed payrolls, all reports of providers falling below positive operating margins, and all reports of declining revenues.
The commission shall study the near and long term impacts of the Federal Affordable Care Act including but not limited to the loss of funding for Graduate Medical Education, the loss of reimbursement for bad debt, the impact on a per hospital basis of sequestration, the impact of a restructured insurance marketplace on providers, the federal reductions in Medicare rates, the federal reductions in Medicaid rates, the federal reductions in Disproportionate Share Rates, the federal reductions in Medicare physician rates, the potential loss of the Area Wage Index “rural floor”, the impact of federal plan design changes, the impact of purchasing health insurance through the “Exchange’, the potential shift away from employer sponsored coverage, the new plans’ impact on provider participation in new Medicaid-like, commercial or blended plans, the potential for payor mix changes, and the reaction to premium volatility for the small group market on providers by state regulators.
The commission shall explore the layered impact of assessments on providers to run an expanded state bureaucracy, the impact of using 2008 as a base year for Medicaid rates, the underfunding of MMCO contracts on providers that contract with MMCO’s, the utilization of Federal Medicaid Assistance Percentages revenues in the Commonwealth, the impact of 1115 Waiver Spending on providers, the impact of tiered plans on struggling providers, the impact of limited networks on struggling providers and the non-coordinated use of funds available to assist distressed providers.
The commission shall analyze provider based programs that are not fully reimbursed by Medicaid and other governmental entities such as in-patient psychiatry, dental, addiction services, outliers and others.
The commission shall report its findings, recommendations, and plan for the Commonwealth to address where, how, and by whom critical services such as Neonatal Intensive Care, Burn Units, In-Patient Psychiatry and others will be funded, and how the Commonwealth maintains access to quality health care in the midst of existing and looming revenue losses by providers in the Commonwealth, to the joint committee on healthcare financing, the joint committee on financial services, and the house and senate committees on ways and means, together with drafts of legislation necessary to carry the recommendations into effect by filing the same with the clerks of the senate and house of representatives on or before January 1, 2014.