Budget Amendment ID: FY2020-S3-564

EHS 564

Value Assessment Frameworks

Mr. Moore moved that the proposed new text be amended by inserting after section ____ the following section:-

"SECTION XX. Notwithstanding the provisions of Chapter 118, MassHealth shall not any develop or employ a dollars per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual's disability, as a threshold to establish what type of health care is cost effective or recommended. MassHealth shall not utilize such an adjusted life year, or such a similar measure, as a threshold to determine coverage, reimbursement, or incentive programs.

Notwithstanding the provisions of Chapter 175, no health insurance carrier shall develop or employ a dollars per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual's disability, as a threshold to establish what type of health care is cost effective or recommended. No health insurance carrier shall utilize such an adjusted life year, or such a similar measure, as a threshold to determine coverage, reimbursement, or incentive programs.

Notwithstanding the provisions of Chapter 176A, no hospital service corporation shall develop or employ a dollars per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual's disability, as a threshold to establish what type of health care is cost effective or recommended. No hospital service corporation shall utilize such an adjusted life year, or such a similar measure, as a threshold to determine coverage, reimbursement, or incentive programs.

Notwithstanding the provisions of Chapter 176B, no medical service corporation shall develop or employ a dollars per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual's disability, as a threshold to establish what type of health care is cost effective or recommended. No medical service corporation shall utilize such an adjusted life year, or such a similar measure, as a threshold to determine coverage, reimbursement, or incentive programs.

Notwithstanding the provisions of Chapter 176G, no health maintenance organization shall develop or employ a dollars per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual's disability, as a threshold to establish what type of health care is cost effective or recommended. No health maintenance organization shall utilize such an adjusted life year, or such a similar measure, as a threshold to determine coverage, reimbursement, or incentive programs".