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Health & Human Services - Related Outside Sections Detail

Health and Human Services

Medicaid - Maximization of Third Party and Federal Revenue SECTION 4. Section 16 of chapter 6A of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by adding at the end the following paragraph:- Notwithstanding any general or special law to the contrary, state agencies and direct and subcontracted providers of health-related services, including purchase-of-service providers financed from appropriation items for any state agency, shall maximize Title XIX and all other federal, state and private health insurance coverage available to offset costs to the commonwealth in compliance with the requirements herein. The agencies or providers shall collect information from clients, or from the parent or guardian of a minor receiving services, necessary to determine the extent to which clients may be eligible for medical assistance benefits under chapter 118E or are beneficiaries of any health insurance policy. The agency or provider shall forward client information collected under this section to the executive office of health and human services and such data shall only be used to match against available databases for the purpose of identifying all sources of potential payment for health services or health insurance coverage. As required or permitted by federal law, the executive office of health and human services shall return the results of any such data matches to the originating agency, which shall take the appropriate action to ensure that costs to the commonwealth are minimized. Such actions shall include, but not be limited to, the agency or provider billing or re-billing all verified third-party sources. The executive office for administration and finance may grant an agency or provider an exemption from this section for good cause. The executive office of health and human services and the operational services division within the executive office for administration and finance shall review regulations, contracting forms, service delivery reports and uniform financial reporting requirements to determine what changes are necessary for the successful implementation of this section.


TAFDC Reform #1 SECTION 13. Section 18A of chapter 18 of the General Laws, as so appearing, is hereby amended by striking out, in line 1, the words "shall impose the sanction required", and inserting in place thereof the words "is authorized to impose the sanctions permitted".


Repeal of Fund SECTION 17. Section 2FF of chapter 29 of the General Laws, as so appearing, is hereby repealed. As of the effective date of this section, the comptroller shall transfer any remaining balance in the fund to the General Fund.


Establishment of the Medical Assistance Trust Fund SECTION 18. Said chapter 29, as so appearing, is hereby amended by adding the following:- Section 2OOO. There shall be established on the books of the commonwealth the Medical Assistance Trust Fund, which shall be administered by the secretary of health and human services. Funds from this account may be expended for supplemental Medicaid payments to qualifying providers pursuant to an approved state plan or federal waiver. Amounts credited to the fund shall not be subject to further appropriation.


Ancillary Costs Mass Hospital School #1 SECTION 48. Section 12 of chapter 71B of the General Laws, as amended by section 8 of chapter 6 of the Acts of 2005, is hereby further amended by striking the last paragraph and inserting in place thereof the following paragraph:- The city, town or regional school district in which each school-age child in any institution described in this section would normally be eligible to attend school and the city, town or regional school district in which each day student admitted to an institution under the control of the department of public health and receiving educational services from the department of education would normally be eligible to attend school shall pay to the commonwealth the costs of the education of that child in the school department of that institution in an amount determined according to the regulations issued under section 10. The payment for each such child shall not be less than its average per pupil cost for pupils of comparable age within the city, town or regional school district, and for each such day student, shall include any charges for related medical, educational or other service provided by the department of public health authorized by section 62T of chapter 111. The amount due the commonwealth each year shall be deducted from the annual distribution to said city, town or school district pursuant to section 20 of chapter 59.


Ancillary Costs Massachusetts Hospital School #2 SECTION 51. Chapter 111 of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by inserting the following section:- Section 62T. The Massachusetts Hospital School may charge for the expense of all services, including but not limited to, related medical or other educational services that it provides to any school-age child with a disability admitted to its day program. Said charges shall be in additional to any educational expenses charged by the department of education pursuant to section 12 of chapter 71B.


Chelsea Soldiers' Home Licensed Practical Nurse Work Commitment SECTION 57. Chapter 115A of the General Laws is hereby amended by inserting the following section:- Section 10A. (a) The commandant of the Soldiers' Home in Massachusetts may establish a program for the education and training of practical nurses and promulgate regulations pursuant thereto. The commonwealth may provide said education and training at no cost to the program participant, apart from fees and uniforms; provided, that a participant completing such education and training program and licensed as a practical nurse by the board of registration in nursing shall be required to obtain employment as a practical nurse at a state-operated facility for 2,080 hours on either a full time or part time basis as specified by the commandant, or as determined by the appointing authority of the state facility where the person becomes employed. Participants of said program shall be required to sign an agreement acknowledging their work commitment to the commonwealth, or in lieu of completing said work commitment, shall acknowledge their obligation to repay the cost of such education and training program to said Soldiers' Home in Massachusetts. (b) In the event that a participant who has completed such education and training program, and who is licensed by said board as a practical nurse, fails to complete said employment requirement or any portion thereof, or fails to repay any or all of the costs thereof, the remaining contractual obligation between said Soldiers' Home and the participant shall be charged against the participant. The commandant shall, within his discretion, determine the names of those defaulting on their obligations in said training and education program and shall report those names, addresses, and license numbers to the board of registration in nursing. The commandant shall notify those he has determined to be in default, that he has notified the board of registration in nursing that he has begun proceedings to suspend, cancel or revoke their licenses. The commandant shall also notify said division of administrative law appeals of the names, addresses, and license numbers of those in default. Said division shall schedule an adjudicatory hearing under section 10 of chapter 30A within 15 days of receipt of the commandant's notice and shall notify the commandant and the licensee, the those named participants that they have the right to a full and fair hearing on the matter. For purposes of such hearings, the commandant's written representation, with supporting documentation, to said division that a participant is in default of his or her obligation shall be prima facie evidence to that effect. The commandant shall notify the board of registration in nursing of the final written decision of the division of administrative law appeals. If said division finds the license should be suspended, cancelled, or revoked, the board of registration in nursing shall, within 15 days of receipt of such finding, suspend, cancel or revoke any license. Within 30 days of receipt of notice of the final decision of said division, or if a petition for rehearing has been timely filed with said division, within thirty days after receipt of notice of said division's denial of such petition for rehearing, an aggrieved party may file for judicial review in superior court pursuant to section 14 of said chapter 30A. (c) Any license suspended, cancelled or revoked by this section shall not be reinstated or renewed until the commandant notifies said board that the licensee is in good standing with respect to any and all costs or employment commitments to the commonwealth. Upon such notice, said board may reissue or renew the individual's license. (d) Notwithstanding the foregoing, said board of registration may take any additional actions or sanctions against the individual as provided by said law and regulation.


TAFDC Reform #2 SECTION 58. The General Laws are hereby amended by inserting after chapter 118A the following chapter:- CHAPTER 118B TRANSITIONAL AID TO FAMILIES WITH DEPENDENT CHILDREN Section 1. The program of aid to families with dependent children established by chapter 118 is hereby modified for the purposes of promoting the principles of family unity, individual responsibility, full engagement and self-reliance; structuring financial and economic incentives and disincentives that promote such principles in the administration of said program; and maximizing the Commonwealth's federal work participation rate to avoid federal sanction. Section 2. For purposes of this chapter the following words shall, unless the context clearly requires otherwise, have the following meanings:- "Assistance", cash grants, special needs assistance, and other benefits funded from the program. "Child of record", the youngest child of a recipient on July 1, 1995 or at the time a family first applies for assistance after July 1, 1995; provided, however, that a child born to a woman who was pregnant on July 1, 1995 or at the time of first applying for assistance shall be the child of record; provided, further that the commissioner shall establish exemptions to allow a later-born child to be the child of record if such child was born as a result of rape, incest, or other extraordinary circumstances as determined by the commissioner which may include, at the commissioner's discretion, renewed eligibility for assistance after a 36-month period of ineligibility. Unless the commissioner grants an exemption, the designation of child of record shall not change, even if said child no longer lives in the household, or subsequent children are born to the parent. "Commissioner", the commissioner of the department. "Department", the department of transitional assistance known previously as the department of public welfare established by chapter 18. "Dependent child", "dependent children", "child" or "children", the children of recipients eligible to receive assistance from the program. "Family", the household unit consisting of dependent children and a recipient or recipients determined eligible for assistance from the program. "Program", the program of transitional aid to families with dependent children established by this chapter. "Recipient", parents receiving or otherwise eligible to receive assistance from the program who are responsible for the care of dependent children. Notwithstanding any language to the contrary, for purposes of eligibility for support services or any other related program benefits, the term, "recipient", shall not include parents or other caretakers who are not receiving assistance from the program on their own behalf and whose income and assets are not counted in determining the eligibility of the household unit. Section 3. A family shall be eligible for assistance provided its maximum allowable countable resources do not exceed $2,500 and upon meeting all other eligibility criteria; provided, however, that the department shall disregard the fair market value of a licensed motor vehicle of such family from the family's countable resources up to an amount determined by the department. Section 4. The department shall not provide any increment in assistance because of the addition to a family of any child born after the "child of record." A caretaker or guardian who is not eligible for assistance but is caring for dependent children shall not be affected by the limit on additional assistance imposed by this section, until said caretaker or guardian gives birth to a child that makes the caretaker or guardian initially eligible for assistance. In cases in which payments for child support are received for a child born after the child of record, the parent shall assign the rights to such payments to the commonwealth. A monthly amount equal to the standard increment of assistance shall be paid to the parent from any payments received, and shall not be counted in determining eligibility and benefit level. Section 5. The department shall establish levels of assistance subject to the provisions of the general appropriations act. An earnings disregard of $30 and one-half of the remaining gross earned income shall be established for recipients subject to the provisions of section 8. Section 6. Recipients meeting the following eligibility criteria shall be exempt from the provisions of sections 7, 9 and 11 until such time as their eligibility status has been determined by the department to have changed and they no longer conform to the criteria that define the following exempt categories of assistance: (a) recipients with a child of record under the age of one year or any child other than the child of record who is under the age of three months, except that section 7(f) shall apply; (b) caretakers of children in their care, provided, however, that the department shall provide assistance for only the children; or (c) parents who receive supplemental security income and have children in their care provided, however, that the department shall provide assistance for only the children. Section 7. (a) A family in which the recipient does not qualify for the exempt categories of assistance established by section 6 shall receive assistance for not more than a maximum and cumulative 24 months during a continuous 60-month period, unless an extension is granted by the commissioner. Said continuous period of 60 months shall commence from the date a recipient first becomes eligible for assistance. (b) In the event the eligibility status of a recipient changes to an exempt category of assistance during the 60-month period, the calculation of the maximum assistance period of 24 months within the 60-month period shall be suspended and not resume until such time as the recipient is no longer eligible for an exempt status, at which time the calculation shall resume. (c) The calculation of the 24-month period of eligibility for assistance shall be suspended when a recipient or a family unenrolls from said program. The calculation of the 24-month period shall resume when said recipient or family is determined upon reapplication to be eligible for assistance. Reapplication for assistance within the continuous 60-month period shall not be considered a new case for purposes of calculating the periods of eligibility and ineligibility for assistance under this section. Determinations of the exempt category status of a recipient under this section shall be subject to a fair hearing; provided, however, that the time during which any appeal is pending shallbe calculated toward the period of maximum assistance eligibility. The commissioner shall establish a procedure by which a recipient may request an extension of benefits. (d) The commissioner shall establish criteria to be considered in making a determination that the benefits of a recipient should be extended. The criteria shall include, but not be limited to: (1) whether the recipient has received and or rejected offers of employment, has quit a job without good cause or has been fired for cause; and (2) the degree to which the recipient has cooperated, and is cooperating, with the agency in work-related activities. In making the determination, the commissioner shall further consider whether appropriate job opportunities actually exist locally at a given point in time for recipients. The commissioner may review and revise such determinations as the commissioner deems appropriate. (e) A recipient who, in order to remain eligible for benefits changes eligibility status, and the change in status is proven in a court of competent jurisdiction to be the result of fraud or deceit, shall not be eligible for any program of assistance provided by the commonwealth including, but not limited to, programs of assistance administered by the department, including programs administered jointly with the federal government or solely on the part of the commonwealth, or programs administered by the department of public health, the department of social services, the department of early education and care, or under chapter 118E, and shall be required to pay full restitution and any fine levied and shall not be eligible to receive assistance until such amounts have been paid. Any recipient who participates in or assists in procuring payments from the department by falsely depicting himself as exempt as defined herein, shall be punished by a fine of not less than $200 nor more than $5,000 or by imprisonment for not less than one year nor more than five years and in all cases repayment of the amount of any such payments procured in addition to and not in lieu of any penalties imposed pursuant to this section shall be ordered. (f) The department shall promulgate regulations to implement the provisions of federal law concerning a life-time limit on receipt of benefits. A recipient who has received state or federal benefits prior to the effective date of this chapter shall have the receipt of such benefits counted against the life-time limit, provided that no more than 24 months of benefits shall be counted. Section 8. A recipient, or an applicant who has received transitional aid to families with dependent children within the last four calendar months, shall be eligible to have $30 and one-half of the remaining gross earned income, after work-related expenses but before dependent care deductions, disregarded, subject to the provisions of 106 CMR 204.285, for the entire period that the recipient is eligible for assistance. Section 9. (a) Subject to appropriation, the department shall develop for each recipient an employment development plan designed to enable the recipient to attain economic self-sufficiency. The plan shall be prepared by the case manager with the involvement of the recipient. The plan shall include an assessment of the current employability of the recipient and development of a strategy for the recipient to attain economic self-sufficiency. Hourly requirements for the plan of each recipient may differ based on standards, established by the department through regulation, designed to maximize the federal work participation rate for the commonwealth. Each employment development plan can be made up of one or more components, subject to availability and program slots, including work, the full employment program, job search, specified education and training, community service and barrier removal as defined by the department. Component choices will also be designed to maximize the federal work participation rate of the commonwealth, provided that department-approved vocational education and training programs may count for the participation requirement for up to 12 months. A teen parent meeting the requirements of section 10 shall have such activities considered as satisfying the requirements of an employment development plan. A recipient caring for a disabled child, spouse or other immediate relative may use such hours of care considered as meeting comparable hourly requirements of the employment development plan. The department shall determine program availability levels for each of the program components after considering the appropriations for said components, for assistance, and for day care services related to the program. Volunteers shall be given first priority for participation in all such program components. No recipient shall be allowed to enroll in a program component if the number of participants already in the program component meets or exceeds the number established as the program availability level for the program component. The department shall consider the availability of transportation in developing said employment development plans; provided, however, that the department shall develop a proposal for an alternative transportation plan. (b) It shall be the responsibility of the recipient to fulfill the obligations of the employment development plan, contingent upon the provision of needed services or supports as indicated in the plan. Recipients who fail to adhere to the obligations set forth in their employment development plan and experience a reduction of family income due to a reduction or termination of benefits which, in turn, places their children at risk, shall be required to meet with their caseworker for reassessment. Recipients not qualifying as exempt under the provision of section 6 and whose child of record is under the age at which full-time school attendance is mandatory may, without penalty, choose not to participate in the full engagement program established by section 11 if they need child care services and the office of child care services or its successor agency determines that there will not be sufficient funding or space to provide child care services to the recipient's child while the recipient is participating in said full engagement program. Section 10. (a) In determining the amount of a cash payment to be made to a teen recipient living with her parent(s), the department shall disregard income of the household up to 200 per cent of the poverty level for a family of comparable size unless the income is earned by the recipient living with her parent(s). In situations where no abuse, neglect or addiction is present, the department shall not provide benefits to a family headed by a recipient under the age of 20, hereinafter referred to as "teen recipients," unless the recipient resides with a parent, grandparent, uncle, aunt, adult sibling, spouse, other family member as determined by regulations, or guardian, or lives in structured housing; provided, however, that the department may determine that a teen recipient who achieved necessary educational and vocational goals and acquired sufficient independent living skills and parenting skills may live on her own. (b) In situations where a teen recipient asserts that she cannot stay at home because abuse, neglect or addiction is present, or because of other extraordinary circumstance which the commissioner determines should exempt the teen from this requirement, the home shall be evaluated by a professional, experienced in the field of adolescent development and young parenting, chosen by the department. The department shall establish standards and procedures to govern determinations of abuse, neglect and addiction as required by the section. Whenever it is determined that abuse, neglect or addiction is present or such other extraordinary circumstance requires, the teen shall reside in a structured setting in order to receive benefits from the department. If a structured setting is not available at the time the determination is made, the teen shall be exempt from the provisions requiring the teen recipient to live at home pursuant to this section until such time as a placement in a structured setting shall be made available (c) The department shall not provide benefits to a teen recipient unless the teen has graduated from or is enrolled in a program for a high school diploma or a general education development certificate. The department shall authorize child care for all teen recipients who are unable to find suitable alternative child care arrangements; provided that the department shall promote the use of informal child care for teen recipients subject to the provisions of this section. (d) Teen recipients residing in structured residential settings shall be required to pay a portion of their income, as determined by their residential program, as a program fee. (e) For the purposes of this section, a structured setting shall: (1) require teen recipients to enroll and make acceptable progress in a program for a high school diploma or a general education development certificate; (2) require teenage recipients to participate in basic parenting classes, basic life skills classes and pregnancy prevention classes; (3) provide necessary rules to promote stability; and (4) provide regular counseling sessions to enhance the self-esteem of the recipient. (f) Transitional housing programs serving teenage parents 16 years of age or older shall not be considered to fall within the definition of "group care facility" as appearing in section 9 of chapter 28A. Section 11. The department shall administer a program, to be known as the full engagement program, for families that are not exempt under section 6. The full engagement program shall require that the head of household in each such family or both parents in a two-parent family meet the terms of their employment development plan developed by the department as described in section 9 within 60 days of the receipt of assistance by the family. The department shall promulgate regulations establishing exceptions for good cause for not meeting the employment development plan. The exceptions shall include, but need not be limited to, domestic violence, medical reasons, and emergency circumstances. At the discretion of the commissioner, recipients subject to the full engagement requirement who fail to meet the requirements shall be subject to sanction up to and including the termination of all assistance for their family. Section 12. (a) The full employment program is hereby established as a program in which recipients, subject to criteria and eligibility rules established by the department, in lieu of receiving food stamp benefits under the food stamp program and cash benefits under the program of transitional aid to families with dependent children, shall be provided with employment in a manner which promotes self-sufficiency and which provides work experience to improve the competitive position of the recipient in the work force. The department may require participation in this program pursuant to an employment development plan as described in section 9; provided, however, that volunteers shall be given first priority for participation. (b)(1) An eligible individual who participates in the program shall work 40 hours per week in a program job, as available, and shall be paid not less than the applicable minimum wage. If the net wage amount is less than the grant for which the participant would be eligible, the commonwealth shall supplement the amount necessary to equal the eligible grant. (2) In addition to the participant wage, as defined in paragraph (1) of this subsection, the employer may be required to pay a set amount for each participant hour worked into a qualified Individual Asset Account, hereinafter called the "IAA". The IAA shall be owned by the participant and access shall be restricted until such time as the participant leaves the program for a job of at least 30 hours per week for which compensation is paid or after twelve months in the program, whichever is sooner. The IAA is established in order to improve the position of program participants by increasing their asset base; however, the amount in the IAA shall not be counted as an asset for the purpose of determining financial eligibility for benefits authorized by this chapter. (c) Upon the acceptance of a program job in compliance with the employment development plan of the participant as set forth herein, transitional aid to families with dependent children and food stamp benefits shall no longer be paid as a grant to the program participant. The commonwealth shall pay to employers a subsidy determined by the department as partial reimbursement for wages paid to program participants. (d) The department shall seek to ensure that jobs made available to program participants shall not: (1) Require work in excess of 40 hours per week; and (2) Be used to displace regular employees nor to fill unfilled positions previously established. (e) (1) Program employers shall pay all participants a wage rate of not less than the applicable minimum wage per hour. (2) Sick leave, holiday and vacation absences shall conform to the rules of the employer for new employees. (3) All persons participating in the program shall be considered to be employees of the employer providing the employment and shall be entitled to all benefits required by state and federal law. (4) Employers shall provide workers' compensation coverage for each program participant. (f) Program participants who are eligible for federal- and state-funded medical assistance at the time they enter the program shall remain eligible for as long as they shall continue to participate in such program. (g) For the purposes of determining the one-year transitional day care and MassHealth provided to certain former recipients of assistance who have left the program for employment, the transitional year, so-called, shall commence on the day a participant is hired into non-subsidized employment. Section 13. (a) A taxpayer required to file a return under the provision of chapter 62 shall be allowed a credit against the excise due under said chapter for employing persons that had been employed by such taxpayer through the full employment program defined in section 12. The credit shall be calculated by multiplying the number of full months after cessation of state subsidies a qualifying program participant was employed by the taxpayer by $100. The maximum credit allowed for all years for the employment of each qualifying program participant shall be $1,200. A taxpayer entitled to a credit under this section for a taxable year may carry over and apply to its excise for any one or more of the next succeeding five taxable years, the portion, reduced from year to year, of its credit which exceeds its excise for the taxable year. (b) The department shall report to the department of revenue and to the employer the name and social security number of the program participant, the name and identification number of the employer and the number of complete months of eligible employment for each participant of the program for whom an employer would be eligible to claim the credit provided by this section within 31 days of the end of each calendar year. The department of revenue shall consult with the house and senate committees on ways and means to determine non-confidential data which shall annually be published to determine the effectiveness of the credit provided by this section. The department of revenue shall promulgate rules and regulations necessary to implement the provisions of this section. (c) A taxpayer required to file a return under the provisions of chapter 63 shall be allowed a credit against the excise due under said chapter for employing persons that had been employed by the taxpayer through the full employment program defined in section 12. The credit shall be calculated by multiplying the number of full months after cessation of state subsidies a qualifying program participant was employed by the taxpayer by $100. The maximum credit allowed for all years for the employment of each qualifying program participant shall be $1,200. A taxpayer entitled to a credit under this section for a taxable year may carry over and apply to its excise for any one or more of the next succeeding five taxable years, the portion, reduced from year to year, of its credit which exceeds its excise for the taxable year. (d) The department shall report to the department of revenue and to the employer the name and social security number of the program participant, the name and identification number of the employer and the number of complete months of eligible employment for each participant of the program for whom an employer would be eligible to claim the credit provided by this section within 31 days of the end of each calendar year. The department of revenue shall consult with the house and senate committee on ways and means to determine the effectiveness of the credit provided by this section. The department of revenue shall also promulgate rules and regulations to implement the provisions of this section. Section 14. (a) No aid shall be paid under the program to, or on behalf of, any child under the age of mandatory school attendance whose school attendance does not meet the requirements of subsection (b), with respect to that period during which the child does not meet these requirements. (b) Each recipient shall provide documentation to the department, not less than quarterly, that any school age child under the age of mandatory school attendance receiving assistance has missed not more than eight school days during the previous quarter; provided, however, that absences due to the following reasons shall be considered excused absences: (1) illness, as certified by a physician or by other proof that the department determines is adequate; (2) hospitalization; (3) disability, as defined by the department; (4) death of a family member; or (5) crisis situations as defined by the commissioner. (c) A recipient who does not, without good cause, provide the documentation required by this section within the reasonable time established by the department, or the documentation so provided indicates that the child has had more than eight unexcused absences from school during the prior quarter as defined in subsection (b), the department may determine that no aid shall be paid to, or on behalf of, that child until the recipient provides documentation that the school attendance of the child meets the requirements of this section. The department shall develop standards for making this determination in regulation. (d) Notwithstanding the provisions of section 27C of chapter 29, and without regard to any acceptance of appropriation by a city, town or regional school district, and without regard to any appropriation by the general court, any school attended by a child to which this section applies shall provide the documentation required by this section upon the request of the recipient. Section 15. No recipient shall be eligible to receive the recipient's portion of assistance payable under the program without presenting a certificate of immunization from a medical provider for each child to the department. The certificate shall state that the child has been immunized for diseases outlined by section 15 of chapter 76. A recipient shall not be denied assistance until having been provided 60 days to meet the requirements established by this section. The department, in consultation with the executive office of health and human services, shall inform each such recipient about health care providers available in the community of the recipient who are capable of assisting with such immunizations. Section 16. Notwithstanding the provisions of section 27A of chapter 18, any recipient receiving assistance in the form of cash benefits under the program with an active account at a banking or financial institution shall have such assistance directly transferred to the account, commonly known as direct deposit or electronic funds transfer. A recipient who is employed and receiving assistance shall be encouraged by the department to establish an account with a banking or financial institution in order to receive the assistance. The commissioner may waive the requirements of this section in the event such institutions are not readily accessible to the recipient; provided, however, that locations where public transportation is available within one mile of the residence of the recipient shall not be eligible for such a waiver. A disabled recipient shall be provided with the opportunity to seek a waiver from this requirement upon a showing that such recipient would be unable to access his or her cash assistance due to the disability.


MassHealth - Nursing Facility Rate Reviews SECTION 59. Section 7 of chapter 118G of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by striking out in line 2, the word "annually" and inserting in place thereof the following:- biennially.


Nursing Facility Base Rate Adjustment SECTION 60. Said section 7 of said chapter 118G, as so appearing, is hereby further amended by striking out in line 27 the word "four" and inserting in place thereof the following:- five.


MassHealth - Hospital Supplemental Payment #1 SECTION 61. Section 18 of said chapter 118G, as so appearing, is hereby amended by adding the following subsection:- (q) Within the Medical Assistance Trust Fund as established in section 2OOO of chapter 29, there is hereby established a MassHealth provider payment account, administered by the secretary of the executive office of health and human services. Subject to the availability of federal financial participation, funds may be expended from this account for supplemental Medicaid payments to qualifying providers pursuant to an approved state plan or federal waiver. All Title XIX federal financial participation revenue generated by hospital payments funded by the Medical Assistance Trust Fund, whether the payments are made by the division of health care finance and policy or the executive office of health and human services, shall be credited to the General Fund.


TAFDC Reform #3 SECTION 67. Sections 110, 119, 121, 122, 132, 140, 141 and 142 of chapter 5 of the Acts of 1995 are hereby repealed.


Health Care Security Trust Fund Transfer to General Fund SECTION 74. Notwithstanding any general or special law to the contrary, during fiscal year 2007, the comptroller shall transfer $50,000,000 from the Health Care Security Trust Fund, established under chapter 29D of the General Laws, to the General Fund.


UMass/Health and Human Services Interagency Service Agreements SECTION 83. Notwithstanding the provisions of any general or special law to the contrary, the executive office of health and human services pursuant to section 16 of chapter 6A of the general laws, acting in its capacity as the single state agency under Title XIX of the Social Security Act, and other federally assisted programs administered by said secretariat, and as the principal agency for all of the agencies within the secretariat, is authorized to enter into interdepartmental services agreements with the university of Massachusetts medical school to perform such activities as the secretary, in consultation with the comptroller, determines are appropriate and within the scope of the proper administration of said Title XIX and other federal funding provisions to otherwise support the programs and activities of the executive office. Such activities shall include: (1) provision of administrative services, including, but not limited to, activities such as providing the medical expertise to support or administer utilization management activities, determining eligibility based on disability, supporting case management activities and similar initiatives; (2) consulting services related to quality assurance, program evaluation and development, integrity and soundness and project management; and (3) activities and services for the purpose of pursuing federal reimbursement or avoiding costs, third party liability and recouping payments to third parties. Federal reimbursement for any expenditures made by the university of Massachusetts medical school relative to federally-reimbursable services the university provides under said interdepartmental service agreements or other contracts with the executive office of health and human services shall be distributed to the university. The secretary may negotiate contingency fees for activities and services related to the purpose of pursuing federal reimbursement or avoiding costs, and the comptroller shall be directed to certify said fees and pay upon the receipt of such revenue, reimbursement or demonstration of costs avoided; provided however that the secretary shall not pay contingency fees in excess of $40,000,000 for state fiscal year 2007. The secretary of health and human services shall submit to the secretary of administration and finance and the senate and house committees on ways and means a quarterly report detailing the amounts of the agreements, the ongoing and new projects undertaken by the university, the amounts spent on personnel and the amount of federal reimbursement and recoupment payments that the university was able to collect.


MassHealth - Spending Authorization for Nursing Facility Assessment SECTION 84. (a) Notwithstanding any general or special law to the contrary, in fiscal year 2007, the division of health care finance and policy, hereinafter referred to as the division, shall establish nursing facility Medicaid rates, payable out of the Health Care Quality Improvement Trust Fund established under section 2EEE of chapter 29, effective July 1, 2006 through June 30, 2007 that cumulatively total $288,500,000 more than the annual payment rates established by the division under the rates in effect as of June 30, 2002, as mandated under section 1 of chapter 42 of the acts of 2003. Payments from the fund shall be allocated in the following manner in fiscal year 2007: (1) $287,950,000 for the purposes of Medicaid per diem rate payments to nursing homes participating in the MassHealth program for services provided to MassHealth members during fiscal year 2007, provided that as a condition for such funds, the division shall require that each nursing home document to the division that at least $50,000,000 of such funds are spent only on direct care staff by increasing the wages, hours and benefits of direct care staff, increasing the facility's staff-to-patient ratio, or by demonstrably improving the facility's recruitment and retention of nursing staff to provide quality care, which shall include expenditure of funds for nursing facilities which document actual nursing spending that is higher than the median nursing cost per management minute in the base year used to calculate Medicaid nursing facility rates. A facility's direct care staff shall include any and all nursing personnel including registered nurses, licensed practical nurses, and certified nurses' aides hired by the facility from any temporary nursing agency or nursing pool registered with the department of public health. The division shall credit wage increases that are over and above any previously collectively bargained for wage increases. In monitoring compliance under this clause, the division's regulations shall adjust any spending compliance test to reflect any Medicaid nursing facility payment reductions, including, but not limited to, rate reductions imposed on or after October 1, 2002. The expenditure of these funds shall be subject to audit by the division in consultation with the department of public health and the executive office of health and human services; (2) $300,000 for the purposes of an audit of funds distributed pursuant to subsection (1). The division of health care finance and policy, in consultation with the department of public health and with the assistance of the executive office of health and human services, shall establish penalties sufficient to deter noncompliance to be imposed against any facility that expends any or all monies in violation of subsection (1), including but not limited to recoupment, assessment of fines or interest; and (3) $250,000 to fund expenses at the division of health care finance and policy related to the implementation and administration of section 25 of chapter 118G of the General Laws. (b) The comptroller shall transfer from the Health Care Security Trust Fund to the Health Care Quality Improvement Trust Fund on the first business day of each quarter, the amount indicated by the division of health care finance and policy to fund the expenditures described herein.


MassHealth - Hospital Supplemental Payment #2 SECTION 85. The Comptroller shall, in consultation with the office of the state treasurer, the executive office for administration and finance, and the executive office of health and human services, develop a schedule and shall make a series of transfers not to exceed $251,000,000 from the General Fund to the MassHealth provider payment account in the Medical Assistance Trust Fund established in section 18 of this act.


Medicare Part D and Prescription Advantage SECTION 86. Notwithstanding any general or special law to the contrary, in order to maintain the fiscal viability of the subsidized catastrophic prescription drug insurance program, hereinafter referred to as the "prescription advantage program", authorized by section 39 of chapter 19A of the General Laws, cost sharing required of enrollees in the form of co-payments, premiums, and deductibles, or any combination thereof, shall be adjusted by the department of elder affairs to reflect price trends for outpatient prescription drugs, as determined by the secretary of elder affairs. In addition to the eligibility requirements set forth in said section 39 of said chapter 19A, to be considered eligible for the prescription advantage program, individuals who receive Medicare and are applying for, or are then enrolled in, the prescription advantage program shall also be enrolled in a Medicare prescription drug plan, a Medicare Advantage prescription drug plan, or in a plan which provides creditable prescription drug coverage as defined by section 104 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003, hereinafter referred to as "MMA," and which provides coverage of the cost of prescription drugs actuarially equal to or better than that provided by Medicare Part D, hereinafter a "creditable coverage" plan. In addition to the eligibility requirements set forth in said section 39 of said chapter 19A, to be considered eligible for the prescription advantage program, individuals who receive Medicare and are applying for, or are then enrolled in, the prescription advantage program, who may qualify for the low-income subsidy, so-called, provided under the MMA Subpart P - Premiums and cost-sharing subsidies for low-income individuals, shall apply for those subsidies. To the extent permitted by MMA and regulations promulgated thereunder, and all other applicable federal law, the prescription advantage program may apply on behalf of a member for enrollment into a Medicare prescription drug plan or for the low-income subsidy provided under MMA and may receive information about the member's eligibility and enrollment status necessary for the operation of the prescription advantage program. For enrollees who qualify for enrollment in a Medicare Part D plan, the prescription advantage program will provide a supplemental source of financial assistance for prescription drug costs, hereinafter referred to as "supplemental assistance" in lieu of the catastrophic prescription drug coverage provided pursuant to said section 39 of said chapter 19A. The prescription advantage program will provide supplemental assistance for premiums, deductibles, payments, and co-payments required by a Medicare prescription drug plan or Medicare Advantage prescription drug plan, and will provide supplemental assistance for deductibles, payments and co-payments required by a creditable coverage plan. The department shall establish the amount of the supplemental assistance it will provide enrollees based on a sliding income scale and the coverage provided by the enrollees' Medicare prescription drug plan, Medicare Advantage prescription drug plan, or creditable coverage plan. In addition to the eligibility requirements set forth in section 39 of chapter 19A, to be considered eligible for the prescription advantage program, an individual must have a household income of less than 500 per cent of the poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. 9902(2). Residents of the commonwealth who are not eligible for Medicare will continue to be eligible for the prescription advantage program pursuant to said section 39 of said chapter 19A.


Emergency Aid to the Elderly, Disabled, and Children Reform SECTION 87. Notwithstanding the provisions of section 2 of this act or of any other general or special law to the contrary, recipients of MassHealth benefits under subclause (i) of clause (g) of subsection (2) of section 9A of chapter 118E of the General Laws shall continue to receive such benefits until such time that said recipients no longer meet the eligibility requirements in place as of June 30, 2006 for the emergency aid to the elderly, disabled, and children program, as established under chapter 117A of the General Laws.


Freeze Special Education Provider Rates SECTION 89. Notwithstanding any general or special law to the contrary, the division of purchased services of the division of procurement which, under section 274 of chapter 110 of the acts of 1993, is responsible for determining prices for programs under chapter 71B of the General Laws, shall set all such prices in fiscal year 2007 at the same level calculated for fiscal year 2006 except the prices for those programs for extraordinary relief, as defined in 808 CMR 1.06(4). Programs for which prices in fiscal year 2006 were lower than the full amount permitted by the division of purchased services shall be permitted to charge in fiscal year 2007 the full price calculated for fiscal year 2006.


Effective Date - Repeal of Fund SECTION 90. Section 17 shall take effect June 30, 2006.

Budget Recommendations

Health & Human Services - Related Outside Sections Detail