Amendment ID: S2529-40-R2
2nd Redraft Amendment 40
Corrections to Health Policy Commission and Center for Health Information and Analysis Assessments
Ms. Friedman moves to amend the bill by inserting after section 4 the following section:-
“SECTION 4A. Chapter 6D of the General Laws, is hereby amended by striking out section 6, as appearing in section 5 of chapter 342 of the acts of 2024, and inserting in place thereof the following section:-
Section 6. (a) Each acute hospital, ambulatory surgical center, pharmaceutical manufacturing company and pharmacy benefit manager shall pay to the commonwealth an amount for the estimated expenses of the commission.
(b) The assessed amount for acute hospitals and ambulatory surgical centers shall be not less than 30 per cent nor more than 40 per cent of the amount appropriated by the general court for the expenses of the commission minus amounts collected from: (i) filing fees; (ii) fees and charges generated by the commission; and (iii) federal matching revenues received for these expenses or received retroactively for expenses of predecessor agencies. Each acute hospital and ambulatory surgical center shall pay such assessed amount multiplied by the ratio of the acute hospital’s and ambulatory surgical center's gross patient service revenues to the total gross patient service revenues of all such hospitals and ambulatory surgical centers. Each acute hospital and ambulatory surgical center shall make a preliminary payment to the commission on October 1 of each year in an amount equal to 1/2 of the previous year’s total assessment. Thereafter, each acute hospital and ambulatory surgical center shall pay, within 30 days’ notice from the commission, the balance of the total assessment for the current year based upon its most current projected gross patient service revenue. The commission shall subsequently adjust the assessment for any variation in actual and estimated expenses of the commission and for changes in acute hospital and ambulatory surgical center gross patient service revenue. Such estimated and actual expenses shall include an amount equal to the cost of fringe benefits and indirect expenses, as established by the comptroller under section 5D of chapter 29. In the event of late payment by any such acute hospital or ambulatory surgical center, the treasurer shall advance the amount of due and unpaid funds to the commission prior to the receipt of such monies in anticipation of such revenues up to the amount authorized in the then current budget attributable to such assessments and the commission shall reimburse the treasurer for such advances upon receipt of such revenues. This section shall not apply to any state institution or to any acute hospital which is operated by a city or town.
(c) To the maximum extent permissible under federal law, and provided that such assessment will not result in any reduction of federal financial participation in Medicaid, the assessed amount for pharmaceutical manufacturing companies shall be not less than 5 per cent nor more than 10 per cent of the amount appropriated by the general court for the expenses of the commission minus amounts collected from: (i) filing fees; (ii) fees and charges generated by the commission; and (iii) federal matching revenues received for these expenses or received retroactively for expenses of predecessor agencies. As calculated using information from MassHealth and the all-payer claims database, each pharmaceutical manufacturing company shall pay such assessed amount multiplied by the ratio of total outpatient prescription drug spending of the manufacturer in the commonwealth to the total outpatient prescription drug spending of all manufacturers within the commonwealth.
(d) To the maximum extent permissible under federal law, and provided that such assessment will not result in any reduction of federal financial participation in Medicaid, the assessed amount for pharmacy benefit managers shall be not less than 5 per cent nor more than 10 per cent of the amount appropriated by the general court for the expenses of the commission minus amounts collected from: (i) filing fees; (ii) fees and charges generated by the commission; and (iii) federal matching revenues received for these expenses or received retroactively for expenses of predecessor agencies. Each pharmacy benefit manager shall pay such assessed amount multiplied by the ratio of the claims paid by the pharmacy benefit manager attributed to residents of the commonwealth for whom it manages pharmaceutical benefits on behalf of carriers to the total of all such claims paid by all pharmacy benefit managers attributed to residents of the commonwealth for whom they manage pharmaceutical benefits on behalf of carriers.
(e) Each pharmaceutical manufacturing company and each pharmacy benefit manager shall make a preliminary payment to the commission annually on October 1 in an amount equal to 1/2 of the previous year's total assessment. Thereafter, each pharmaceutical manufacturing company and each pharmacy benefit manager shall pay, within 30 days of receiving notice from the commission, the balance of the total assessment for the current year as determined by the commission.”; and
by inserting after section 5 the following section:-
“SECTION 5A. Chapter 12C of the General Laws is hereby amended by striking out section 7, as appearing in section 21 of chapter 342 of the acts of 2024, and inserting in place thereof the following section:-
Section 7. (a) Each acute hospital, ambulatory surgical center, pharmaceutical manufacturing company and pharmacy benefit manager, shall pay to the commonwealth an amount for the estimated expenses of the center and for the other purposes described in this chapter which shall include any transfer made to the Community Hospital Reinvestment Trust Fund established in section 2TTTT of chapter 29.
(b) The assessed amount for acute hospitals and ambulatory surgical centers shall be not less than 30 per cent nor more than 40 per cent of the amount appropriated by the general court for the expenses of the center and for the other purposes described in this chapter which shall include any transfer made to the Community Hospital Reinvestment Trust Fund established in section 2TTTT of chapter 29 minus amounts collected from: (i) filing fees; (ii) fees and charges generated by the center’s publication or dissemination of reports and information; and (iii) federal matching revenues received for these expenses or received retroactively for expenses of predecessor agencies. Each acute hospital and ambulatory surgical center shall pay such assessed amount multiplied by the ratio of the acute hospital’s or ambulatory surgical center's gross patient service revenues to the total gross patient services revenues of all such hospitals and ambulatory surgical centers. Each acute hospital and ambulatory surgical center shall make a preliminary payment to the center on October 1 of each year in an amount equal to 1/2 of the previous year’s total assessment. Thereafter, each acute hospital and ambulatory surgical center shall pay, within 30 days’ notice from the center, the balance of the total assessment for the current year based upon its most current projected gross patient service revenue. The center shall subsequently adjust the assessment for any variation in actual and estimated expenses of the center and for changes in acute hospital and ambulatory surgical center gross patient service revenue. Such estimated and actual expenses shall include an amount equal to the cost of fringe benefits and indirect expenses, as established by the comptroller under section 5D of chapter 29. In the event of late payment by any such acute hospital or ambulatory surgical center, the treasurer shall advance the amount of due and unpaid funds to the center prior to the receipt of such monies in anticipation of such revenues up to the amount authorized in the then current budget attributable to such assessments and the center shall reimburse the treasurer for such advances upon receipt of such revenues. This section shall not apply to any state institution or to any acute hospital which is operated by a city or town.
(c) To the maximum extent permissible under federal law, and provided that such assessment will not result in any reduction of federal financial participation in Medicaid, the assessed amount for pharmaceutical manufacturing companies shall be not less than 5 per cent nor more than 10 per cent of the amount appropriated by the general court for the expenses of the center minus amounts collected from: (i) filing fees; (ii) fees and charges generated by the center’s publication or dissemination of reports and information; and (iii) federal matching revenues received for these expenses or received retroactively for expenses of predecessor agencies. As calculated using information from MassHealth and the all-payer claims database, each pharmaceutical manufacturing company shall pay such assessed amount multiplied by the ratio of total outpatient prescription drug spending of the manufacturer in the commonwealth to the total outpatient prescription drug spending of all manufacturers within the commonwealth.
(d) To the maximum extent permissible under federal law, and provided that such assessment will not result in any reduction of federal financial participation in Medicaid, the assessed amount for pharmacy benefit managers shall be not less than 5 per cent nor more than 10 per cent of the amount appropriated by the general court for the expenses of the center minus amounts collected from: (i) filing fees; (ii) fees and charges generated by the center’s publication or dissemination of reports and information; and (iii) federal matching revenues received for these expenses or received retroactively for expenses of predecessor agencies. Each pharmacy benefit manager shall pay such assessed amount multiplied by the ratio of the claims paid by the pharmacy benefit manager attributed to residents of the commonwealth for whom it manages pharmaceutical benefits on behalf of carriers to the total of all such claims paid by all pharmacy benefit managers attributed to residents of the commonwealth for whom they manage pharmaceutical benefits on behalf of carriers.
(e) Each pharmaceutical manufacturing company and each pharmacy benefit manager shall make a preliminary payment to the center annually on October 1 in an amount equal to 1/2 of the previous year’s total assessment. Thereafter, each pharmaceutical manufacturing company and each pharmacy benefit manager shall pay, within 30 days’ notice from the center, the balance of the total assessment for the current year as determined by the center.”; and
by inserting after section 32 the following 2 sections:-
“SECTION 32A. The definition of “Center for health information and analysis revenue amount” in section 64 of said chapter 118E, as appearing in section 29 of chapter 342 of the acts of 2024, is hereby amended by striking out the words “, ambulatory surgical centers and non-hospital provider organizations” and inserting in place thereof the following words:- and ambulatory surgical centers.
SECTION 32B. The definition of “Health policy commission revenue amount” in said section 64 of said chapter 118E, as appearing in section 30 of chapter 342 of the acts of 2024, is hereby amended by striking out the words “, ambulatory surgical centers and non-hospital provider organizations” and inserting in place thereof the following words:- and ambulatory surgical centers.”; and
by inserting after section 70 the following sections:-
“SECTION 70A. Section 38 of chapter 342 of the acts of 2024 are hereby repealed.
SECTION 70B. Section 81 of chapter 343 of the acts of 2024 are hereby repealed.”; and
by inserting after section 71 the followings section:-
“SECTION 71A. The assessments required under section 6 of chapter 6D of the General Laws, as amended by section 4A, and section 7 of chapter 12C of the General Laws, as amended by section 5A, shall apply to the budgets for the health policy commission and the center for health information and analysis, respectively, beginning in fiscal year 2027; provided, however, that each pharmaceutical manufacturing company and each pharmacy benefit manager shall make a preliminary payment to the commission on October 1, 2026 in an amount equal to 1/2 of the initial year’s total assessment, as determined by the commission and center, respectively, and thereafter shall pay, within 30 days of receiving notice, the balance of the total assessment for the initial year.”