Amendment #55 to H4219

Community Care Pilot

Ms. Higgins of Leominster moves to amend the bill in section 2A by inserting after item 1599-4500 the following item:-

“xxxx-xxxx For a one year Community Care pilot program operated by MassHealth for individuals who meet the eligibility criteria for Home and Community Based Waiver, under 42 USC 1396a(10)(a)(ii)(VI), or a PACE Program, under 42 USC 1396u-4 or 42 USC 1395eee, except that the individual’s gross income is greater than 300% of the federal benefit rate but less than the average monthly cost of nursing home care, as calculated by the division, and for said individuals, MassHealth shall charge a monthly premium equal to the difference between the individual’s gross income and 300% of the federal  benefit rate. For the duration of the pilot program, said pilot program enrollees will not be subject to a deductible in accordance with 42 CFR 435.726(c).  Individuals eligible for the “special income eligibility group”, established under 42 CFR 435.217 and pursuant to federal regulations at 42 CFR 435.726, are not eligible for said pilot program. MassHealth shall submit a report on the pilot program to the house and senate committees on ways and means and the joint committee on health care finance no later than January 1, 2023 detailing 1) the administrative costs of implementing said pilot program, 2) the number of applicants and enrollees participating in said pilot, 3) the total cost to the Commonwealth for the pilot program enrollees, and 4) the average cost of care for each enrollee. Said pilot program will conclude one year following the passage of this act…………………. $100,000."

Additional co-sponsor(s) added to Amendment #55 to H4219

Community Care Pilot