 |
| Health and Human Services |
| |
FISCAL YEAR 2006 RESOURCE SUMMARY ($000)
| DEPARTMENT |
FY 2006
Budgetary
Recommendations |
FY 2006
Federal, Trust,
and ISF |
FY 2006
Total
Spending |
FY 2006
Budgetary
Non-Tax Revenue |
|
| Executive Office of Health and Human Services |
4,769,610 |
83,641 |
4,853,251 |
2,766,918 |
|
| TOTAL |
4,769,610 |
83,641 |
4,853,251 |
2,766,918 |
| | | | Executive Office of Health and Human Services |
4,853,251,268 |
| |
|
Click here for outside sections related to: Executive Office of Health and Human Services |
| |
| Budgetary Direct Appropriations |
4,769,610,404 |
| Direct Appropriations |
|
| |
| Executive Office of Health and Human Services and Medicaid Administration |
| | | 4000-0300 |
For the operation of the executive office, including the operation of the managed care oversight board; provided, that the executive office shall provide technical and administrative assistance to agencies under the purview of the secretariat receiving federal funds; provided further, that the executive office shall monitor the expenditures and completion timetables for systems development projects and enhancements undertaken by all agencies under the purview of the secretariat and shall ensure that all measures are taken to make such systems compatible with one another for enhanced interagency interaction; provided further, that the executive office shall continue to develop and implement the common client identifier; provided further, that funds appropriated herein shall be expended for the administrative, contracted services, and non-personnel systems 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 further, that in consultation with the division of health care finance and policy, no rate increase shall be provided to 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 for the purpose of programs authorized by chapter 118E of the General Laws shall be accounted for according to such purpose on the Massachusetts management accounting and reporting system not more than 10 days after such expenditures have been made by the Medicaid management information system; provided further, that no expenditures shall be made for the purpose of such programs authorized by said chapter 118E 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 executive office may collect directly from a liable third party any amounts paid to contracted providers under said chapter 118E for which the executive office later discovers another third party is liable if no other course of recoupment is possible; provided further, that no funds shall be expended for the purpose of funding interpretive services directly or indirectly related to a settlement or resolution agreement with the office of civil rights or any other office, group, or entity; provided further, that interpretive services currently provided shall not give rise to enforceable legal rights for any party or to an enforceable entitlement to interpretive services; provided further, that the federal financial participation received from claims filed for the costs of outreach and eligibility activities performed at certain hospitals or by community health centers which are funded in whole or in part by federally permissible in-kind services or provider donations from the hospitals or health centers, shall be credited to this item and may be expended without further appropriation in an amount specified in the agreement with each donating provider hospital or health center; provided further, that the federal financial participation received from claims filed based on in-kind administrative services related to outreach and eligibility activities performed by certain community organizations, under the so-called "covering kids initiative" and in accordance with the federal revenue criteria 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 with the organizations participating in the initiative; provided further, that notwithstanding the provisions of any general or special law to the contrary, the executive office shall require the commissioner of mental health to approve any prior authorization or other restriction on medication used to treat mental illness in accordance with written policies, procedures, and regulations of the department of mental health; provided further, that the secretary of the executive office of health and human services may authorize transfers among items 4000-0430, 4000-0500, 4000-0600, 4000-0620, 4000-0700, 4000-0860, 4000-0870, 4000-0875, 4000-0880, 4000-0890, 4000-0891, 4000-0895, 4000-0990, 4000-1400, and 4000-1405; provided further, that the amount transferred from any of the items stated herein shall not exceed 10 per cent of the total amount appropriated for that item; and provided further, that any such transfer shall take place no later than June 30, 2006 |
123,723,502 |
| |
| MassHealth - Auditing and Utilization Review |
| | | 4000-0301 |
For the costs of MassHealth provider and member audit and utilization review activities, including, but not limited to, eligibility verification, disability evaluations, provider financial and clinical audits, and other initiatives intended to enhance program integrity; provided, that $150,000 shall be expended for the operation of the Medicaid fraud control unit within the office of the attorney general; and provided further, that $150,000 shall be expended for MassHealth auditing within the office of the state auditor |
1,500,000 |
| |
| Office of Residential and Placement Licensure |
| | | 4000-0351 |
For the licensing of residential and group care facilities and foster and adoption placement agencies |
737,593 |
| |
| MassHealth - Enrollment Outreach Grants |
| | | 4000-0352 |
For MassHealth enrollment outreach grants to public and private non-profit groups to be administered by the executive office |
250,000 |
| |
| MassHealth - CommonHealth Plan |
| | | 4000-0430 |
For the commonhealth program to provide primary and supplemental medical care and assistance to disabled adults and children pursuant to the provisions of 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 recipients in prior fiscal years; provided further, that the executive office shall maximize federal reimbursement for state expenditures made on behalf of such adults and children; and provided further, that children shall be determined eligible for the medical care and assistance if they meet the disability standards as defined by the executive office, which standards shall be no more restrictive than the standards in effect on July 1, 1996 |
75,246,379 |
| |
| MassHealth - Managed Care Plans |
| | | 4000-0500 |
For health care services provided to medical assistance recipients under the executive office's primary care clinician, mental health, and substance abuse plan or through a managed care organization under contract with the executive office; provided, 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; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
1,977,150,989 |
| |
| MassHealth - Indemnity and Third Party Liability Plans |
| | | 4000-0700 |
For health care services provided to medical assistance recipients under the executive office's health care indemnity, third party liability plan and medical assistance recipients who are not seniors nor otherwise covered under the executive office's managed care plans; provided, 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 funds may be expended from this item for health care services provided to recipients in prior fiscal years; and provided further, that notwithstanding the foregoing, funds may be expended from this item for the purchase of third party insurance including, but not limited to, Medicare for any medical assistance recipient including, but not limited to, seniors |
1,498,059,398 |
| |
| MassHealth - 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 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 executive office, exceed 150 per cent of the federal poverty level; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
389,892,223 |
| |
| MassHealth - Basic Coverage |
| | | 4000-0870 |
For health care services provided to adults participating in the medical assistance program pursuant to the provisions of 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 recipients in prior fiscal years |
56,372,203 |
| |
| MassHealth - Breast and Cervical Cancer Treatment |
| | | 4000-0875 |
For the provision of benefits to eligible women who require medical treatment for either breast or cervical cancer in accordance with 1902(a)(10)(A)(ii)(XVIII) of the Social Security Act, and in accordance with section 10D of chapter 118E of the General Laws; provided, that the executive office shall provide said benefits to women whose income, as determined by the executive office, does not exceed 250 per cent of the federal poverty level, subject to continued federal approval; provided further, that eligibility for such benefits shall be extended solely for the duration of such cancerous condition; provided further, that prior to the provision of any benefits covered by this item, said division shall require screening for either breast or cervical cancer at the comprehensive breast and cervical cancer early detection program operated by the department of public health, in accordance with item 4570-1512; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
5,022,572 |
| |
| MassHealth - Family Assistance Plan |
| | | 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 executive office exceed 150 per cent of the federal poverty level; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
26,416,411 |
| |
| MassHealth - Premium Assistance and Insurance Partnership Program |
| | | 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 |
35,953,008 |
| |
| MassHealth - Insurance Partnership for Employers |
| | | 4000-0891 |
For the cost of health insurance subsidies paid to employers participating in the insurance reimbursement program pursuant to the provisions of section 9C of chapter 118E of the General Laws |
6,326,879 |
| |
| Healthy Start Program |
| | | 4000-0895 |
For the healthy start program to provide medical care and assistance to pregnant women and infants residing in the commonwealth pursuant to the provisions of section 10E of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
15,447,686 |
| |
| Children's Medical Security Plan |
| | | 4000-0990 |
For the children's medical security plan to provide primary and preventive health services for uninsured children from birth through age 18 pursuant to the provisions of section 10F of chapter 118E of the General Laws; provided, that the executive office shall pre-screen enrollees and applicants for Medicaid eligibility; provided further, that no applicant shall be enrolled in said program until said applicant has been denied eligibility for the MassHealth program; provided further, that the MassHealth benefit request shall be used as a joint application to determine the eligibility for both MassHealth and the children's medical security plan; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
20,207,603 |
| |
| MassHealth - HIV Plan |
| | | 4000-1400 |
For the purposes of providing MassHealth benefits to persons with a diagnosis of human immunodeficiency virus whose incomes, as determined by the executive office, do not exceed 200 per cent of the federal poverty level; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
6,926,068 |
| |
| MassHealth - Essential Plan |
| | | 4000-1405 |
For the operation of a program of preventive and primary care for chronically unemployed persons who are not receiving unemployment insurance benefits and who are not eligible for medical assistance but who are determined by the executive office of health and human services to be long-term unemployed; provided, that such persons meet the eligibility requirements established under the MassHealth program as established in section 9A of chapter 118E of the General Laws; provided further, that the income of such persons shall not exceed 100 per cent of the federal poverty level; provided further, that said eligibility requirements shall not exclude from eligibility persons who are employed intermittently or on a non-regular basis; provided further, that the provision of care to such persons under this program may, taking into account capacity, continuity of care, and geographic considerations, be restricted to certain providers; provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years; provided further, that the secretary of health and human services is hereby authorized to limit or close enrollment if necessary in order to ensure that expenditures from this item do not exceed the amount appropriated herein; and provided further, that no funds may be expended from this item prior to October 1, 2005 |
119,377,890 |
| |
| Medicare Part D Phased Down Contribution |
| | | 4000-1420 |
For the purposes of making payment to the federal centers for Medicare and Medicaid services in compliance with 42 USC 1396u-5 |
120,000,000 |
| |
| Retained Revenues | |
| |
| MassHealth Recoveries from Current and Prior Fiscal Years Retained Revenue |
| | | 4000-0320 |
The executive office may expend an amount not to exceed $291,000,000 from the monies received from recoveries of any current or prior 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, Medicaid fraud returns, data match returns, Medicare appeals, and program and utilization review audits; provided, that any revenues collected by the executive office that are not attributable to the aforementioned categories shall be deposited in the General Fund and shall be tracked separately; provided further, that no funds from this item shall be used for the purposes of item 4000-0300; provided further, that expenditures from this item shall be limited solely to payment obligations arising in the current fiscal year for the provision of medical care and assistance; provided further, that the executive office shall file quarterly with the house and senate committees on ways and means and the executive office for administration and finance, a report delineating the amount of current year rebates received from pharmaceutical companies or other current year collections; and 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 executive office for more than three years may, notwithstanding 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 |
291,000,000 |
| |
| Intragovernmental Service Spending |
31,862,083 |
| |
| Chargeback for Human Services Transportation Services |
| | | 4000-0102 |
For the cost of transportation services for health and human services clients and the operation of the health and human services transportation office |
6,869,957 |
| |
| Intragovernmental Service Fund |
100% |
| |
| |
| Chargeback for Human Services Core Administrative Functions |
| | | 4000-0103 |
The secretary of the executive office of health and human services is hereby authorized, notwithstanding the provisions of any general or special law to the contrary, to identify administrative activities and functions common to the separate agencies, departments, offices, divisions, and commissions within the executive office and to designate such functions "core administrative functions" in order to improve administrative efficiency and preserve fiscal resources; provided, that common functions that may be designated core administrative functions include, without limitation, human resources, financial management, information technology, and human services transportation; provided further, that all employees performing functions so designated may be employed by the executive office, and the executive office shall charge said agencies, departments, offices, divisions, and commissions for such services, subject to appropriation; provided further, that upon the designation of a function as a core administrative function, the employees of each agency, department, office, or commission who perform such core administrative functions may be transferred to the executive office of health and human services; provided further, that the reorganization shall not impair the civil service status of any such transferred employee who immediately before the effective date of this act either holds a permanent appointment in a position classified under chapter 31 of the General Laws or has tenure in a position by reason of section 9A of chapter 30 of the General Laws; and provided further, that nothing in this section shall be construed to impair or change an employee's status, rights, or benefits under chapter 150E of the General Laws |
24,992,126 |
| |
| Intragovernmental Service Fund |
100% |
| |
| |
| Federal Grant Spending |
44,278,781 |
| |
| Head Start Demonstration |
| | | 4000-0708 |
For the purposes of a federally funded grant entitled, Head Start Demonstration |
175,000 |
| |
| Youth Development State Collaboration |
| | | 4000-0713 |
For the purposes of a federally funded grant entitled, Youth Development State Collaboration |
84,779 |
| |
| Community Mental Health Services |
| | | 4000-9401 |
For the purposes of a federally funded grant entitled, Community Mental Health Services |
8,898,380 |
| |
| Substance Abuse Prevention and Treatment Block Grant |
| | | 4000-9402 |
For the purposes of a federally funded grant entitled, Substance Abuse Prevention and Treatment Block Grant |
35,120,622 |
| |
| Trust and Other Spending |
7,500,000 |
| |
| 4000-4000 |
Health Insurance Portability and Accountability Act Fund |
7,500,000 |
|
|
