Amendment ID: S2529-43

Amendment 43

Expanded Eligibility for Acute Care Hospital Relief

Mr. O'Connor moves to amend the bill by striking item 4000-1202 and inserting thereof the following:-

"4000-1202 For the distribution of funds for fiscally strained hospitals; provided, that notwithstanding any general or special law to the contrary, the executive office of health and human services shall direct payments to eligible acute care hospitals in the form of enhanced Medicaid payments, supplemental payments or other appropriate mechanisms; provided further, that not less than $75,000,000 shall be distributed to eligible acute care hospitals licensed under section 51 of chapter 111 of the General Laws that have: (i) a public payer mix greater than 75 per cent, as calculated by the center for health information and analysis according to hospital fiscal year 2023 data published in its Massachusetts Acute Hospital Profiles Databook; (ii) statewide relative price less than 1.0, as calculated by the center for health information and analysis according to calendar year 2022 data published in its Relative Price and Provider Price Variation Databook; and (iii) a negative operating margin, as calculated by the center for health information and analysis according to hospital fiscal year 2024 data published in its Massachusetts Acute Hospital and Health System Financial Performance Databook; provided further, that not less than $50,000,000 shall be distributed to eligible acute care hospitals licensed under said section 51 of said chapter 111 that have: (a) a public payer mix greater than 63 per cent and not more than 75 per cent, as calculated by the center for health information and analysis according to hospital fiscal year 2023 data published in its Massachusetts Acute Hospital Profiles Databook; (b) a statewide relative price not more than 1.0, as calculated by the center for health information and analysis according to calendar year 2022 data published in its Relative Price and Provider Price Variation Databook; and (c) a negative operating margin, as calculated by the center for health information and analysis according to hospital fiscal year 2024 data published in its Massachusetts Acute Hospital and Health System Financial Performance Databook; provided further, that not less than $30,000,000 shall be distributed to eligible acute care hospitals licensed under said section 51 of said chapter 111 that: (1) have a public payer mix greater than 63 per cent, as calculated by the center for health information and analysis according to hospital fiscal year 2023 data published in its Massachusetts Acute Hospital Profiles Databook; (2) have a statewide relative price not more than 1.0, as calculated by the center for health information and analysis according to calendar year 2022 data published in its Relative Price and Provider Price Variation Databook; and (3) are not otherwise eligible for funding pursuant to the prior provisos; provided further, that not less than $19,000,000 shall be distributed to eligible acute care hospitals licensed under said section 51 of said chapter 111 that: (A) have a public payer mix greater than 63 per cent, as calculated by the center for health information and analysis according to hospital fiscal year 2023 data published in its Massachusetts Acute Hospital Profiles Databook; and (B) are not otherwise eligible for funding under this item pursuant to prior provisos; provided further, that the total payment amount to each eligible acute care hospital under this item shall be calculated based on the total amount available for the group of eligible acute care hospitals multiplied by a fraction, the numerator of which is the acute care hospital’s Medicaid gross patient service revenue as calculated by the center for health information and analysis according to hospital fiscal year 2023 data published in its Massachusetts Acute Hospital Profiles Databook and the denominator of which is the total amount of Medicaid gross patient service revenue for the group of acute care hospitals eligible for said amount available as calculated by the center for health information and analysis according to hospital fiscal year 2023 data published in its Massachusetts Acute Hospital Profiles Databook; provided further, that said payments shall not be used in subsequent years by the executive office to calculate any other payment to eligible acute care hospitals; provided further, that said payments shall not offset existing Medicaid or other state payments which an eligible acute care hospital may be qualified to receive; provided further, that the secretary of health and human services may require as a condition of receiving payment under this item any reasonable condition of payment that the secretary determines necessary to ensure the availability, to the extent possible, of federal financial participation for the payments, and the executive office may incur expenses and the comptroller may certify amounts for payment in anticipation of expected receipt of federal financial participation for the payments; provided further, that the executive office may promulgate regulations as necessary to implement this item; provided further, that not later than March 2, 2026, the executive office shall submit a report to the joint committee on health care financing and the house and senate committees on ways and means detailing: (I) the schedule of payments to hospitals under this item delineated by acute care hospital, hospital system and payment amount; and (II) each hospital’s intended use of funds provided under this item; and provided further, that eligible acute care hospitals shall provide the executive office with information necessary for the report……………$174,000,00"