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 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; provided further, that the division shall report quarterly to the house and senate committees on ways and means the amounts of said expenditure refunds credited to each item of appropriation; provided further, that the division shall report quarterly to the house and senate committees on ways and means the amount of hand-generated payments, so called, to providers by item of appropriation from which said payments were made; provided further, that the division shall submit a report to the house and senate committees on ways and means detailing projected expenditures for fiscal years 2003 and 2004 for this item and all other division items; provided further, that in identifying said projected expenditures, said report shall account for any and all assumptions used to forecast expenditures; provided further, that said report shall include monthly caseload, date-of-service, and date-of-payment expenditure data by provider type and benefit plan; provided further, that said report shall detail by item of appropriation any updates or budgetary revisions made subsequent to the governor`s budget submission for fiscal year 2004, including, but not limited to, any assumptions used to develop said recommendations; provided further, that said report shall be submitted not later than February 28, 2003; 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	47,789,102
	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 used to fund administrative personnel at the division; 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	48,941,694
	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 funds may be expended from this item for health care services provided to said recipients 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	58,600,000

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 funds may be expended from this item for health care services provided to said recipients 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, 4000-0600, and 4000-0700	1,973,700,000

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 funds may be expended from this item for health care services provided to said recipients 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 4000-0700	1,808,500,000

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 funds may be expended from this item for health care services provided to said recipients 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	1,163,200,000

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 funds may be expended from this item for health care services provided to said recipients 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	341,000,000
	Children`s and Seniors` Health Care Assistance 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 funds may be expended from this item for health care services provided to said recipients 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	281,000,000
	Children`s and Seniors` Health Care Assistance Fund 100%

MASSHEALTH EXPANSION - INDIVIDUALS WITH BREAST AND CERVICAL CANCER
4000-0875	For health care benefits provided to eligible women who require medical treatment for either breast or cervical cancer pursuant to section 10D of chapter 118E of the General Laws; provided, that the division limit the provision of said benefits to women whose income, as determined by the division, does not exceed 250 per cent of the federal poverty level; provided further, that funds may be expended from this item for health care services provided to said recipients in prior fiscal years; provided further, that funds shall only be expended and such program implemented, subject to federal approval and the availability of federal financial participation; and provided further, that all federal reimbursements received for expenditures from this item pursuant to the provisions of Title XIX of the federal Social Security Act shall be credited to the General Fund	2,824,552

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 funds may be expended from this item for health care services provided to said recipients 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	63,300,000
	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 funds may be expended from this item for health care services provided to said recipients 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, 4000-0880, and 4000-0891	33,500,000
	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; provided further, that funds may be expended from this item for health care services provided to said recipients 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, 4000-0880, and 4000-0890	8,000,000
	Children`s and Seniors` Health Care Assistance Fund 100%

MASSHEALTH EXPANSION - 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; provided, that funds may be expended from this item for health care services provided to said recipients in prior fiscal years	17,900,000
	Tobacco Settlement Fund 100%

Budgetary Retained Revenues

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, 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