Amendment #339 to H4400

MassHealth Control Board

Mr. Lyons of Andover moves to amend the bill by adding the following section:

SECTION XXXXX.  As used in sections 1 to 8, the following words shall have the following meanings unless the context clearly requires otherwise:

“MassHealth”, the Medicaid and the Children’s Health Insurance Programs are combined into one program named MassHealth which is administered by the Executive office of Health and Human Services.

“Control board”, the MassHealth fiscal and management control board.

“Department”, the Executive office of Health and Human Services.

“Secretary”, the Secretary of Health and Human Services

SECTION 2.  (a) There shall be within the department and reporting to the secretary a control board.

(b)  The control board shall consist of 5 members to be appointed by the governor, 1 member of the Department, 1 of whom shall have experience in healthcare insurance and 1 of whom shall have experience in healthcare operations, and 2 at discretion of the Governor. Each member shall serve for the entire time that the control board exists unless removed with or without cause by the governor.  Any vacancy in the control board shall be filled in the same manner as the original appointment of the member being replaced. The secretary shall designate the chair of the control board, and may fix annual time and expense reimbursements of not more than $6,000 to be paid to members of the control board from funds of the department.  The control board shall meet as regularly as necessary to ensure the stability of authority operations and finances but not less than 3 times per month.

(c)  Notwithstanding sections 3 and 7 of chapter 161A of the General Laws or any other general or special law to the contrary, the control board shall be afforded all powers, responsibilities and obligations relative to the department that are vested in the board, except as otherwise provided in this act, and those powers, responsibilities and obligations set forth in this act.

(d)  Meetings of the control board shall be subject to sections 18 to 25, inclusive, of chapter 30A of the General Laws. Records of the control board shall be subject to section 10 of chapter 66 of the General Laws.

(e)  The control board may employ, retain and supervise managerial, professional and clerical staff as may be necessary to carry out its responsibilities. The control board may set the compensation, terms and conditions of employment of its staff. Staff hired under this subsection shall be employees of the department except employees that the control board formally designates as independent contractors; provided, however, that the independent contractors shall be treated as executives under section 26 of said chapter 161A.

(f)  The control board shall initiate and assure the implementation of appropriate measures to secure the fiscal, operational and managerial stability of the authority and shall continue in existence until June 30, 2020 and thereafter for an additional period of 2 years upon the recommendation by the control board to the governor in writing based upon specific findings that such 2-year period is in the best interest of the public and necessary to achieve operational stability and establish performance metrics for the authority; provided, however, that the recommendation shall be approved in writing by the governor not later than June 30, 2020; and provided further, that the control board shall in no event continue beyond June 30, 2022.  The recommendations and findings by the control board, if any, and the governor’s approval, if any, shall be filed with the clerks of the house of representatives and senate, the chairs of the house and senate committees on ways and means.

SECTION 3.  (a) The control board may delegate any powers, responsibilities and obligations specifically afforded to it to the Secretary of Health and Human Services unless otherwise provided in this act.

(b)  The Secretary or Assistant Secretary for MassHealth shall at least monthly provide the control board with information on the status of the revenues and expenses for the operating budget and on the status of revenues, contracting, procurement and authorized and actual spending for the capital program and changes to eligibility for MassHealth program.  The Secreatry shall at least quarterly provide the control board with data on progress toward achieving key performance management targets. The reports shall be submitted to the secretary of administration and finance, the clerks of the house of representatives and senate, the chairs of the house and senate committees on ways and means.

SECTION 4.  (a) The control board shall formulate and recommend a plan to the secretary to stabilize and strengthen the finances, management, operations and asset condition of MassHealth.   The control board shall develop performance metrics and measure items included in the plan.  The plan shall: (i) provide a safe, reliable and sustainable Medicaid and the Children’s Health Insurance Programs; (ii) establish fiscal stability, including short-term and long-term planning to ensure that the departments budgets are aligned to not exceed 30% of that state budget; (iii) facilitate sound management (iv) develop a financially responsible, long-range approach to preserving and modernizing the MassHealth program edibility and finding ways to reducing the per person cost of care.

SECTION 5.  In addition to those powers otherwise provided in this act, the control board may: (i) establish separate operating and capital budgets each with clearly designated revenue sources and uses and establish policies and procedures to ensure that no funds are commingled between operating and capital budgets; (ii) establish 1-year and 5-year operating budgets beginning with fiscal year 2019, which are balanced primarily through a combination of internal cost controls, operation improvements, and eligibility requirement changes; (iii) establish a rigorous performance management system and performance metrics and targets that address, among other things, increasing revenues from non-disable participants and those participants earning above the federal poverty level; (iv) review any contract for the provision of services entered into by the department, including contracts entered into before the establishment of the fiscal and management control board, including, but not limited to, healthcare providers, insurance companies, hospitals, urgent care facilities, medial offices, technology providers, outsourced administration, and amend those contracts, as necessary, in accordance with their terms; and    (v) establish, increase, or decrease any fee, rate, or charge for any service, license or activity within the scope of the authority subject to and consistent with subsection (d) of section 61 of chapter 46 of the acts of 2013.

SECTION 6.  Notwithstanding any general or special law to the contrary, the control board may: (i)  reorganize or consolidate departments, divisions or entities of the authority, in whole or in part; (ii)  establish any new departments, divisions, or entities as it considers necessary; and (iii) transfer the duties, powers, functions and appropriations of 1 department, division or entity, to another. Any reorganization or consolidation that affects the department shall not be effective unless approved by the Secretary of Health and Human Services and the Secretary of Administration and Finance.

SECTION 7.  The control board shall provide updates to the Secretary of Health and Human Services and the Secretary of Administration and Finance not less than once per month.

SECTION 8.  (a) Within 60 days after all of the members of the control board have been appointed, the control board shall submit a preliminary report to the secretary, the secretary of administration and finance, the clerks of the house of representatives and senate, and the chairs of the house and senate committees on ways and means.  The report shall include a preliminary analysis of and management plans to address MassHealth’s rising costs and operating inefficiencies

(b)  Annually, not later than December 15, the control board shall report on MassHealth’s own source revenue, operating budget, capital plan and progress toward meeting performance metrics and targets to the secretary, the secretary of administration and finance, the clerks of the house of representatives and senate, the house and senate chairs of the house and senate committees on ways and means.  The report shall include an update on the authority’s progress in: (i) establishing separate operating and capital budgets each with clearly designated revenue sources and uses and establish policies and procedures to ensure that no funds are commingled between operating and capital budgets; (ii) establishing 1-year and 5-year operating budgets beginning with fiscal year 2019, which are balanced primarily through a combination of internal cost controls, operation improvements, and eligibility requirement changes; (iii) establishing a rigorous performance management system and performance metrics and targets that address, among other things, increasing revenues from non-disable participants and those participants earning above the federal poverty level; (iv) reviewing any contract for the provision of services entered into by the department, including contracts entered into before the establishment of the fiscal and management control board, including, but not limited to, healthcare providers, insurance companies, hospitals, urgent care facilities, medial offices, technology providers, outsourced administration, and amending those contracts, as necessary, in accordance with their terms; and    (v) establishing, increase, or decrease any fee, rate, or charge for any service, license or activity within the scope of the authority subject to and consistent with subsection (d) of section 61 of chapter 46 of the acts of 2013.

SECTION 208.  Notwithstanding any other section of this act, no existing rights of the holders of bonds, notes and other financing obligations issued by or on behalf of the authority under chapter 161A of the General Laws shall be impaired and nothing in this act shall be construed to alter or grant the power to alter existing agreements securing the bonds or other obligations, hedge agreements or investment contracts pertaining thereto, other than in accordance with their terms. The authority shall maintain the covenants and agreements of the trust agreements, bond resolutions and other instruments pertaining to such bonds and other obligations secured thereunder so long as such bonds and other obligations shall remain outstanding. The control board shall not control and shall not have the power to alter or otherwise impair the trust imposed in the third paragraph of subsection (a) of section 35T of chapter 10 of the General Laws and shall not have the power to alter or otherwise impair the other commonwealth covenants set forth in said third paragraph of said subsection (a) of said section 35T of said chapter 10. The commonwealth hereby re-affirms such trust and other covenants.

Additional co-sponsor(s) added to Amendment #339 to H4400

MassHealth Control Board