Amendment #538 to H5150

MassHealth Reimbursement

Mr. Donahue of Worcester moves to amend the bill, H. 5150, by adding at the end thereof the following new section:

SECTION ##. Chapter 118E of the general laws is hereby amended by adding at the end thereof the following new Section:

SECTION ##. To ensure appropriate and responsible use of drug testing, for laboratories providing toxicology testing, the Office of Medicaid is authorized to require that these providers demonstrate a functional and operational test-utilization and test-frequency control program that will ensure compliance with MassHealth’s utilization and frequency requirements for clinical drug testing.

Notwithstanding any general or special law to the contrary, an independent clinical laboratory, licensed under the Clinical Laboratory Improvement Amendments (CLIA) by the U.S. Centers for Medicare and Medicaid (CMS) that is located out-of-state and accredited by both the College of American Pathologists (CAP) and the New York State Clinical Laboratory Evaluation Program (CLEP), and providing and being reimbursed for managed Medicaid services in Massachusetts, shall be deemed eligible and qualified to participate as a MassHealth fee-for-service provider and eligible for payment for clinical toxicology testing purposes.  Payments made to qualified laboratories under this section will only apply when a qualified laboratory provides toxicology test results to the referring health care provider within two business days of receipt of the test specimen

Additional co-sponsor(s) added to Amendment #538 to H5150

MassHealth Reimbursement