Amendment #1397 to H4400

EOHHS Technical Changes

Ms. Hogan of Stow moves to amend the bill, in section 2, by striking out item 1595-1068 and inserting in place thereof the following item:

“1595-1068 For an operating transfer  to the MassHealth provider payment account in the Medical Assistance Trust Fund established in section 2QQQ of chapter 29 of the General Laws; provided, that these funds shall be expended for services provided during state or federal fiscal year 2018 or 2019 or for public hospital transformation and incentive initiative payments for state fiscal year 2018 or 2019 or for Medicaid care organization payments under 42 CFR 438.6(c) for rate year 2018 or 2019; provided further, that all payments from the Medical Assistance Trust Fund shall be: (i) subject to the availability of federal financial participation; (ii) made only under federally-approved payment methods; (iii) consistent with federal funding requirements and all federal payment limits as determined by the secretary of health and human services; and (iv) subject to the terms and conditions of an agreement with the executive office of health and human services; and provided further, that the secretary of health and human services will utilize funds from the Medical Assistance Trust Fund to make payments of up to $443,750,000 to the Cambridge public health commission or to Medicaid care organizations for payment to the Cambridge public health commission if the Cambridge public health commission, in anticipation of receiving such payments, first voluntarily transfers an amount equal to the non-federal share of such payments to the Medical Assistance Trust Fund using a federally-permissible source of funds…$452,450,000”;

and in line 9110-1455, in line number 2, by inserting after the words “General Laws” the following: “and for the operations of the consolidated MassOptions, prescription advantage and 800-age-info customer service centers”;

and in item 4000-0300, in line number 2, by striking out “provided further, that no expenditures, whether made by the executive office or another commonwealth entity, shall be made that are not federally reimbursable, including those related to Titles XIX or XXI of the Social Security Act, as codified at 42 U.S.C. chapter 7, subchapters XIX or XXI, the MassHealth demonstration waiver under section 1115(a) of the Social Security Act, as codified at 42 U.S.C. section 1315(a) or the community first demonstration waiver under section 1115 of the Social Security Act, as codified at 42 U.S.C section 1315 except as required for: (a) the equivalent of MassHealth standard benefits for children under 21 years of age 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 21 years of age 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 before making these expenditures;” and inserting in place thereof:

““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 the act or the community first section 1115 demonstration waiver, whether made by the executive office or another commonwealth entity, except as required for administration of the executive office, for 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, for dental benefits provided to clients of the department of developmental services who are age 21 or over, for managed care capitation payments for any MassHealth members who are residents of Institutions for Mental Disease for more than 15 days in any calendar month, and otherwise as explicitly authorized, or unless made for the purposes and amounts 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;”;

and in item 400-0500, in line 2, by striking out the words “primary care clinician, mental health and substance addiction plan or through a health maintenance organization under contract with the executive office of health and human services” and inserting in place thereof the following: “managed care delivery systems, including  a behavioral health contractor, the Primary Care Clinician Plan, Primary Care Accountable Care Organizations, MassHealth managed care organizations, and Accountable Care Partnership Plans; ”;

and in item 4000-0641, in line 12, by striking out the words “not later than March 1, 2019, MassHealth shall report to the house and senate ways and means committees an analysis” and inserting in place thereof the following: “not later than  June 30, 2019, MassHealth shall report to the house and senate ways and means committees an interim analysis”; and in line 19, by striking out the words “not later than January 30, 2019, MassHealth shall report to the house and senate committees on ways and means an analysis” and inserting in place thereof the following: “not later than December 31, 2019, MassHealth shall report to the house and senate committees on ways and means a final analysis”;

and in item 4000-0700, in line 13, by striking out the words “family incomes” and inserting in place thereof the  following words:- “household incomes”;  and in line 31 by striking out the words “shall expend not less than $13,000,000 to provide an additional 5 percent to its inpatient adjudicated payment amount per discharge and an additional 5 percent to its outpatient adjudicated payment amount per episode of care to any acute care hospital that has greater than 63 percent of its gross patient service revenue from governmental payers and free care as determined by the executive office of health and human services”  and inserting in place thereof the following words:-“may expend an additional $13,000,000 in the aggregate for acute care hospitals that  have greater than 63 percent of their gross patient service revenue from governmental payers and free care as determined by the executive office;”; and in line 50, by inserting after the words “activities relating to” the following words:- “customer  service,”;

and in item 4000-0940, in line 4, by striking out the words “family incomes” and inserting in place thereof the following: “household incomes”;

and in line item 4000-0990, line 1, by striking out the words “children’s medical security plan to provide primary and preventive health services for uninsured children from birth to age 18” and inserting in place thereof the following words:- “ executive office of health and human services to expend for the children's medical security plan  to provide health services for uninsured children from birth through age 18”; and by striking out the words “the maximum benefit levels for”.