Amendment #808 to H4200

Regarding Conflict Free Assessments

Representatives Sannicandro of Ashland, Benson of Lunenburg, Cariddi of North Adams, Cutler of Duxbury, DiZoglio of Methuen, Galvin of Canton, Gentile of Sudbury, Gordon of Bedford, Kaufman of Lexington, Koczera of New Bedford, McMurtry of Dedham, Moran of Lawrence, Parisella of Beverly, Rosa of Leominster and Toomey of Cambridge move that the bill be amended by inserting the following section:-

SECTION XX. Chapter 118E of the General Laws is hereby further amended by adding after section 9F,  the following new subsection: --

9G. Accountable Care Organizations  providing  MassHealth long term supports and services, shall offer, as a member benefit, a conflict free assessment and person-centered care coordination for long term care services and supports, hereinafter referred to as LTSS. The ACO shall not have a direct or indirect financial ownership interest in an entity that serves as a conflict free care coordinator. The executive office of health and human services shall promulgate regulations defining these functions, including options for enrollee choice of entities and individuals to perform conflict free assessments and care coordination, and defining who shall be a participant in the member's care team. If the same entity that provides LTSS also performs assessments or conducts care coordination, the Secretary shall implement mitigation strategies to reduce conflicts of interest to the extent feasible. The executive office of health and human services shall, after consultation with groups representing people with disabilities, MassHealth members, providers of long term care services and supports and others,  promulgate culturally competent conflict free care  coordination regulations incorporating the principles outlined in the affordable care act, and best practices outlined by the federal Centers for Medicare and Medicaid Services in implementing conflict free case management. The executive office  shall, after such consultation, further establish metrics for LTSS that include outcome measures of consumer choice, consumer control and effectiveness of LTSS in achieving consumer established goals. The conflict free care coordinator shall ensure that LTSS services are integrated with the overall care plan in a culturally appropriate manner, monitor the provision of said services and make necessary recommendations for adjustments to the service plan in a manner that supports the ability of a participant to live in the least restrictive setting of his or her choice.

Additional co-sponsor(s) added to Amendment #808 to H4200

Regarding Conflict Free Assessments