Budgetary Direct Appropriations

DIVISION OF MEDICAL ASSISTANCE ADMINISTRATION
4000-0300	For the administration of the division of medical assistance, hereinafter referred to as the division, including costs related to the implementation and operation of programs authorized by sections 9A, 9B, 9C,16B, and 16C of chapter 118E of the General Laws; provided, that in consultation with the division of health care finance and policy, the division of medical assistance shall not approve any increase in existing Medicaid provider rates without taking all measures possible under Title XIX of the Social Security Act to ensure that rates of payment to providers do not exceed such rates as are necessary to meet only those costs which must be incurred by efficiently and economically operated providers in order to provide services of adequate quality; provided further, that expenditures for the purposes of each item appropriated to the division by this act shall be accounted for according to such purpose in the Massachusetts management, accounting and reporting system not more than ten days after such expenditures have been made by the Medicaid management information system; provided further, that the division shall not make expenditures that are not federally reimbursable, except as specifically authorized herein, or unless made for cost containment efforts the purposes and amounts of which have been submitted to the house and senate committees on ways and means 30 days prior to making such expenditures; provided further, that the division may continue to recover provider overpayments made in the current and prior fiscal years through the Medicaid management information system, and such recoveries shall be deemed current fiscal year expenditure refunds, so called; and provided further, that notwithstanding the provisions of any general or special law to the contrary, federal reimbursements received for administrative expenditures made pursuant to the provisions of this item shall be credited proportionally to the General Fund and to the Children's and Seniors' Health Care Assistance Fund established pursuant to section 2FF of chapter 29 of the General Laws in the same percentages as expenditures are made from this item from said funds; provided, however, that all federal revenues received pursuant to an enhanced rate of reimbursement authorized pursuant to the provisions of Title XXI of the federal Social Security Act shall be credited to said Children's and Seniors' Health Care Assistance Fund	49,071,124
	General Fund 85.84% Children's and Seniors' Health Care Assistance Fund 14.16%

DIVISION OF MEDICAL ASSISTANCE CONTRACTED SERVICES
4000-0310	For administrative support and related services purchased contractually by the division of medical assistance, including contracted services necessary for the implementation and operation of programs authorized by sections 9A, 9B, 9C, 16B, and 16C of chapter 118E of the General Laws; provided, that no funds appropriated herein shall be scheduled in or expended from the AA subsidiary, so called; provided further, that the division may expend an amount not to exceed $3,000,000 for the purpose of enhancing outreach efforts to uninsured families and children as provided under the federal Personal Responsibility and Work Opportunity Act of 1996, by entering into contracts with the Massachusetts Hospital Association and the League of Community Health Centers, or their members, for the purpose of providing such outreach, and may retain and expend for purposes of this item all federal revenues received as a result of expenditures under such contracts; provided further, that the division may retain and expend for purposes of this item any hospital or community health center donations, in a total amount not to exceed $300,000, received as contributions to offset the division's costs associated with out-stationed eligibility workers; provided further, that the federal financial participation received from claims filed by the division, pursuant to an agreement specifically referencing this line item language, for the costs of outreach and eligibility activities performed by certain hospitals or by community health centers which are funded in part or in whole by federally permissible in-kind services or provider donations from said hospitals or health centers, shall be credited to this item and may be expended without further appropriation, in an amount specified in said agreement between the division and each donating provider hospital or health center; provided further, that the federal financial participation received from claims filed by the division based on in-kind administrative services related to outreach and eligibility activities performed by certain community organizations, under the auspices of the so-called "covering kids initiative" and in accordance with the federal revenue criteria set forth in 45 CFR 74.23 or any other federal regulation which provides a basis for federal financial participation, shall be credited to this item and may be expended, without further appropriation, on administrative services including those covered under an agreement between the division and the organizations participating in said initiative; and provided further, that notwithstanding the provisions of any general or special law to the contrary, federal reimbursements received for administrative expenditures made pursuant to the provisions of this item shall be credited proportionally to the General Fund and to the Children's and Seniors' Health Care Assistance Fund established pursuant to section 2FF of chapter 29 of the General Laws in the same percentages as expenditures are made from this item from said funds; provided, however, that all federal revenues received pursuant to an enhanced rate of reimbursement authorized pursuant to the provisions of Title XXI of the federal Social Security Act shall be credited to said Children's and Seniors' Health Care Assistance Fund	49,257,079
	General Fund 85.84% Children's and Seniors' Health Care Assistance Fund 14.16%

DIVISION OF MEDICAL ASSISTANCE SYSTEMS
4000-0325	For the non-personnel systems costs of the division of medical assistance, including such costs incurred to implement and operate programs authorized by sections 9A, 9B, 9C, 16B, and 16C of chapter 118E of the General Laws; provided, that 50 per cent of the cost of provider point of service eligibility verification devices purchased by the division shall be assumed by the providers utilizing said devices; and provided further, that notwithstanding the provisions of any general or special law to the contrary, federal reimbursements received for administrative expenditures made pursuant to the provisions of this item shall be credited proportionally to the General Fund and to the Children's and Seniors' Health Care Assistance Fund established pursuant to section 2FF of chapter 29 of the General Laws in the same percentages as expenditures are made from this item from said funds; provided, however, that all federal revenues received pursuant to an enhanced rate of reimbursement authorized pursuant to the provisions of Title XXI of the federal Social Security Act shall be credited to said Children's and Seniors' Health Care Assistance Fund	23,707,382
	General Fund 85.84% Children's and Seniors' Health Care Assistance Fund 14.16%

COMMONHEALTH PLAN FOR THE DISABLED
4000-0430	For the commonhealth program to provide primary and supplemental medical care and assistance to disabled adults and children pursuant to sections 9A, 16, and 16A of chapter 118E of the General Laws; provided, that not more than $8,000,000 shall be expended for health care services provided to said disabled adults and children in prior fiscal years; provided further, that the division of medical assistance shall maximize federal reimbursement for expenditures from this item; provided further, that children shall be determined eligible for said medical care and assistance if they meet the disability standards as defined by the division, and that said disability standards shall be no more restrictive than the standards in effect on July 1, 1996; and provided further, that the commissioner of medical assistance may, with the approval of the secretary of administration and finance, transfer a total amount not to exceed 10 per cent of the sum appropriated herein to items 4000-0500, 4000-0600, and 4000-0700	45,330,000

MANAGED CARE PLANS
4000-0500	For health care services provided to MassHealth members under the division of medical assistance's primary care clinician/mental health and substance abuse plan or through a health maintenance organization under contract with the division; provided, that not more than $180,000,000 shall be expended from this item for health care services provided to said members in prior fiscal years; provided further, that for the purpose of enhancing MassHealth members' access to, and quality of, dental services, funds from this item shall be used to increase the rates of payment for services delivered to MassHealth members by participating MassHealth dental providers; provided further, that the amount of such rate increases and the specific services to which they apply shall be determined by the division of health care finance and policy in cooperation with the division of medical assistance; provided further, that said initiative shall be directed toward increasing the participation of dental providers in MassHealth and of addressing the difficulty that MassHealth members currently face in obtaining necessary dental care; provided further, that said dental reform initiative shall include administrative improvements, to be determined by the division of medical assistance; provided further, that not less than $1,100,000 shall be expended for the further training of medical interpreters and the further development of medical interpreter services provided to MassHealth members within acute care hospitals; provided further, that no payment for special provider costs shall be made from this item without the prior written approval of the secretary of administration and finance; provided further, that expenditures from this item shall be made only for the purposes expressly stated herein; and provided further, that the commissioner of medical assistance may, with the approval of the secretary of administration and finance, transfer a total amount not to exceed 10 per cent of the sum appropriated herein to items 4000-0430, 4000-0600, and 4000-0700	1,603,200,000
	General Fund 99.93% Tobacco Settlement Fund 0.07%

SENIOR CARE PLANS
4000-0600	For health care services provided to MassHealth members under the division of medical assistance's senior care plan; provided, that not more than $255,000,000 shall be expended from this item for health care services provided to said members in prior fiscal years; provided further, that no payment for special provider costs shall be made from this item without the prior written approval of the secretary of administration and finance; provided further, that not less than $8,600,000 shall be made available from this item for home and community-based health waiver services provided to elderly MassHealth members enrolled in the section 2176 waiver, so called; provided further, that expenditures from this item shall be made only for the purposes expressly stated herein; and provided further, that the commissioner of medical assistance may, with the approval of the secretary of administration and finance, transfer a total amount not to exceed 10 per cent of the sum appropriated herein to items 4000-0430, 4000-0500, and 4000-0700	1,740,070,000

HEALTH CARE INDEMNITY/THIRD PARTY LIABILITY PLANS
4000-0700	For health care services provided to MassHealth members under the division of medical assistance's health care indemnity/third party liability plan and MassHealth members not otherwise covered under the division's commonhealth, managed care, or senior care plans; provided, that not more than $150,000,000 shall be expended from this item for health care services provided to said members in prior fiscal years; provided further, that no payment for special provider costs shall be made from this item without the prior written approval of the secretary of administration and finance; provided further, that expenditures from this item shall be made only for the purposes expressly stated herein; and provided further, that the commissioner of medical assistance may, with the approval of the secretary of administration and finance, transfer a total amount not to exceed 10 per cent of the sum appropriated herein to items 4000-0430, 4000-0500, and 4000-0600	891,100,000

MASSHEALTH EXPANSION - STANDARD COVERAGE
4000-0860	For MassHealth benefits provided to children and adults pursuant to the provisions of clauses (a), (b), (c), (d), and (h) of subsection (2) of section 9A of chapter 118E of the General Laws; provided, that not more than $35,000,000 shall be expended from this item for health care services provided to said children and adults in prior fiscal years; provided further, that no funds shall be expended from this item for children and adolescents pursuant to the provisions of said clause (c) of said subsection (2) whose family incomes, as determined by the division of medical assistance, exceed 150 per cent of the federal poverty level; provided further, that all federal reimbursements received for expenditures from this item pursuant to the provisions of Title XIX and Title XXI of the Social Security Act shall be credited to the Children's and Seniors' Health Care Assistance Fund; and provided further, that the commissioner of medical assistance may, with the approval of the secretary of administration and finance, transfer a total amount not to exceed 10 per cent of the sum appropriated herein to items 4000-0870, 4000-0880, 4000-0890, and 4000-0891	265,900,000
	Children's and Seniors' Health Care Assistance Fund 100%

MASSHEALTH BASIC - PROGRAM EXPANSION
4000-0866	For the expansion of the MassHealth Basic program to provide health insurance benefits to certain homeless individuals as defined by section 103 of the McKinney Act, 42 U.S.C. 11302, including persons with intermittent work histories, whether or not they are employed when they are homeless; provided, that funds shall only be expended and such expansion implemented, subject to federal approval of an amendment to the Medicaid section 1115 waiver, so called, and the availability of federal financial participation	3,700,000
	Tobacco Settlement Fund 100%

MASSHEALTH EXPANSION - BASIC COVERAGE
4000-0870	For health care services provided to MassHealth members pursuant to clause (g) of subsection (2) of section 9A of chapter 118E of the General Laws; provided, that not more than $20,000,000 shall be expended from this item for health care services provided to said members in prior fiscal years; and provided further, that the commissioner of medical assistance may, with the approval of the secretary of administration and finance, transfer a total amount not to exceed 10 per cent of the sum appropriated herein to items 4000-0860, 4000-0880, 4000-0890, and 4000-0891	208,280,000
	Children's and Seniors' Health Care Assistance Fund 100%

FAMILY ASSISTANCE - DIRECT COVERAGE AND PREMIUM ASSISTANCE
4000-0880	For MassHealth benefits pursuant to the provisions of clause (c) of subsection (2) of section 9A and section 16C of chapter 118E of the General Laws for children and adolescents whose family incomes, as determined by the division of medical assistance, exceed 150 per cent of the federal poverty level; provided, that not more than $5,000,000 shall be expended from this item for health care services provided to said children and adolescents in prior fiscal years; and provided further, that the commissioner of medical assistance may, with the approval of the secretary of administration and finance, transfer a total amount not to exceed 10 per cent of the sum appropriated herein to items 4000-0860, 4000-0870, 4000-0890, and 4000-0891	54,140,000
	Children's and Seniors' Health Care Assistance Fund 100%

INSURANCE PARTNERSHIP FOR EMPLOYEES OF SMALL EMPLOYERS AND THE SELF EMPLOYED
4000-0890	For the cost of health insurance premium subsidies paid to employees of small businesses participating in the insurance reimbursement program pursuant to the provisions of section 9C of chapter 118E of the General Laws; provided, that the commissioner of medical assistance may, with the approval of the secretary of administration and finance, transfer a total amount not to exceed 10 per cent of the sum appropriated herein to items 4000-0860, 4000-0870, 4000-0880, and 4000-0891	19,050,000
	Children's and Seniors' Health Care Assistance Fund 100%

INSURANCE PARTNERSHIP FOR SMALL EMPLOYERS
4000-0891	For the cost of health insurance subsidies paid to employers participating in the employer insurance partnership program pursuant to the provisions of section 9C of chapter 118E of the General Laws; provided, that the division of medical assistance shall seek federal reimbursement for said payments to employers; and provided further, that the commissioner of medical assistance may, with the approval of the secretary of administration and finance, transfer a total amount not to exceed 10 per cent of the sum appropriated herein to items 4000-0860, 4000-0870, 4000-0880, and 4000-0890	5,210,000
	Children's and Seniors' Health Care Assistance Fund 100%

ACUTE CARE HOSPITAL RATE ENHANCEMENT
4000-1007	For the purpose of funding non-recurring rate enhancements for acute care hospitals for inpatient and outpatient medical services; provided, that the division of medical assistance shall collaborate with the division of health care finance and policy to determine the methodology by which to enhance existing rates; provided further, that the division of medical assistance shall make payments in a manner designed to maximize federal financial participation; provided further, that said enhancements shall commence for the hospital fiscal year beginning October 1, 2001; and provided further, that the division of medical assistance shall file a report not later than September 15, 2001 with the secretary of administration and finance and the house and senate committees on ways and means detailing the methodology used to determine such payments and the amount projected to be paid to each such acute care hospital in hospital fiscal year 2002	10,000,000

MASSHEALTH EXPANSION FOR INDIVIDUALS WITH HIV
4000-1400	For the purposes of expanding MassHealth benefits to persons with a diagnosis of human immuno-deficiency virus, so called, whose incomes are up to 200 per cent of the federal poverty level, subject to federal approval of an amendment to the Medicaid state plan and section 1115 waiver, so called	13,840,000
	Tobacco Settlement Fund 100%

Budgetary Retained Revenues

DMA ADMINISTRATION RETAINED REVENUE
4000-0306	The division of medical assistance is hereby authorized to expend for costs associated with administrative activities designed to increase federal reimbursements or reduce program costs an amount not to exceed $2,000,000 from federal reimbursement collected for services rendered by the division; provided, that notwithstanding the provisions of any general or special law to the contrary, for the purpose of accommodating timing discrepancies between the receipt of retained revenues and related expenditures, the division may incur expenses and the comptroller may certify for payment amounts not to exceed the lower of this authorization or the most recent revenue estimate therefor as reported in the state accounting system	2,000,000

PRIOR-YEAR SPENDING RECOVERIES AND COLLECTIONS RETAINED REVENUE
4000-0320	The division of medical assistance is hereby authorized to expend solely for the provision of medical care and assistance rendered in the current fiscal year an amount not to exceed $70,000,000 from the monies received from recoveries of any prior fiscal year expenditures, and collections from liens, estate recoveries, third party recoveries, drug rebates, accident and trauma recoveries, case mix recoveries, computer audits, insurance recoveries, provider overpayment recoveries, bankruptcy settlements, Masspro and Healthpro refunds, Medicaid fraud returns, data match returns, Medicare appeals, and program and utilization review audits; provided, that any revenues collected by the division that are not attributable to the aforementioned categories shall be deposited in the General Fund and shall be tracked separately therein; provided further, that additional categories of recoveries and collections, including the balance of any personal needs accounts collected from nursing and other medical institutions after a recipient's death and held by the division for more than three years, may, notwithstanding the provisions of any general or special law to the contrary, be credited to this item after providing written notice to the house and senate committees on ways and means, and the secretary of administration and finance; and provided further, that no funds from this item shall be used for the purposes of items 4000-0300, 4000-0310, or 4000-0325	70,000,000

Federal Grant Spending

WELFARE REFORM ADMINISTRATION
4000-0314	For the purposes of a federally funded grant entitled, Welfare Reform Administration	1,200,000

HRSA STATE PLANNING GRANT
4000-0319	For the purposes of a federally funded grant entitled, HRSA State Planning Grant	321,195