June 29, 2009

To the Honorable Senate and House of Representatives:

Pursuant to Article LVI, as amended by Article XC, Section 3 of the Amendments to the Constitution of the Commonwealth of Massachusetts, I am returning to you for amendment Section 76 of House Bill No. 4129, "An Act Making Appropriations for the Fiscal Year 2010 for the Maintenance of the Departments, Boards, Commissions, Institutions and Certain Activities of the Commonwealth, for Interest, Sinking Fund and Serial Bond Requirements and for Certain Permanent Improvements."

Section 76 requires the Department of Public Health (DPH) to adopt regulations prohibiting health care facilities (hospitals and ambulatory surgery centers) from charging or seeking reimbursement for services provided as the result of an occurrence of a healthcare-associated infection (HAI). It amends section 51H of chapter 111 of the General Laws, as appearing in section 65 of chapter 451 of the Acts of 2008, which takes effect on October 1, 2012. I support this amendment, which will improve health care quality and reduce the costs associated with HAI.

My proposed budget and the House and Senate final budgets each also contained a section making an identical amendment to the current section 51H, as appearing in section 9 of chapter 305 of the Acts of 2008, which would require DPH to adopt these HAI non-payment regulations immediately. Perhaps inadvertently, the enacted budget omits this section.

To rectify this omission, and thereby authorize DPH to adopt HAI regulations immediately, I recommend that section 76 be amended by adding the following section:-

SECTION 76A. Said section 51H of said chapter 111, inserted by section 9 of chapter 305 of the acts of 2008, is hereby amended by striking out subsection (d) and inserting in place thereof the following subsection:-

(d) The department shall adopt regulations prohibiting a health care facility from charging or seeking reimbursement for services provided as a result of the occurrence of a health-care associated infection or serious reportable event. A health care facility shall not charge or seek reimbursement for a health-care associated infection or serious reportable event that the facility has determined, through a documented review process, and under regulations adopted by the department, was (i) preventable; (ii) within its control; and (iii) unambiguously the result of a system failure based on the health care provider's policies and procedures.

Respectfully submitted,

Deval Patrick

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