Budget Amendment ID: FY2017-S4-21

OTH 21

Provider Pricing Commission

Ms. Donoghue moved that the proposed new text be amended by inserting at the end thereof the following new section:-

“SECTION XX. There shall be a special commission to review variation in prices among providers in the Commonwealth. The commission shall conduct a rigorous, evidence based analysis to make targeted recommendations to reduce health care price variation, including identifying justifiable and non-justifiable reasons for health care price variation, and to produce a functioning health care market. The commission shall consist of 5 members: the chair of the health policy commission, who shall serve as chair; the attorney general, or designee; 1 member appointed by the governor who shall be a health care economist that has served on the Medicare payment advisory commission; 1 member appointed by the speaker of the house who shall be a health care economist with demonstrated expertise in health care delivery and health care management at a senior level; and 1 member appointed by the senate with demonstrated expertise in health care consumer advocacy who has served on the health policy commission.

The commission’s examination shall, analyzing all state reports and data available on provider price variation, identify the factors contributing to price variation to determine what, if any factors are justifiable reasons for variation in health care prices and what remedies are available to address the findings. The commission shall consider efforts in other states aimed at controlling health care costs and reducing variation and develop a set of targeted recommendations that reduce the variation between health care providers in the commonwealth without raising health care costs. The commission may consider all possible market-based and government interventions, including, but not limited to rate compression, price variation based on a set of permissible factors, a waiver from national payment methods, and other such recommendations that the commission finds will successfully reduce provider price variation. The center for health information and analysis shall provide the commission with any additional data that it may request for its evaluation; provided, however, that such data shall be confidential and shall not be a public record under clause Twenty-sixth of section 7 of chapter 4 of the General Laws.

The commission shall file its recommendations, including any needed legislation to carry out its recommendations with the health policy commission and the clerks of the house of representatives and the senate who shall forward a copy of the recommendations to the house and senate committees on ways and means and the joint committee on health care financing not later than December 31, 2016."