40000500 - MassHealth Managed Care

Account Description FY2011
Spending
FY2012
GAA
4000-0500 MassHealth Managed Care
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 health maintenance organization under contract with the executive office and for MassHealth benefits provided to children, adolescents and adults under clauses (a) to (d), inclusive, and clause (h) of subsection (2) of section 9A of chapter 118E of the General Laws and section 16C of said chapter 118E; provided, that no funds shall be expended from this item for children and adolescents under clause (c) of said subsection (2) of said section 9A of said chapter 118E whose family incomes, as determined by the executive office, exceed 150 per cent of the federal poverty level; provided further, that the executive office shall maintain the fiscal year 2011 overall reimbursement rate for the commonwealth's only medical respite program for the homeless; provided further, that expenditures from this item shall be made only for the purposes expressly stated herein; provided further, that the executive office shall maximize federal reimbursements for state expenditures made to these providers; provided further, that funds shall be expended from this item or item 4000-0700, if necessary, to achieve maximum federal financial participation, to enhance the ability of hospitals, community health centers and primary care clinicians to serve populations in need more efficiently and effectively; provided further, that these funds may be allocated using the standards used in fiscal year 2010; provided further, that these funds shall be disbursed not later than April 1, 2012; provided further, that funds may be expended from this item or item 4000-0700, if necessary, to enhance the ability of hospitals to address emergency room capacity issues due to individuals with mental illness who are awaiting placement in an acute care bed; provided further, that funds may be expended from this item for health care services provided to the recipients in prior fiscal years; and provided further, that for purposes of long-term health care cost savings and enhanced patient care, the commonwealth may recognize telehealth remote patient monitoring provided by home health agencies as a service to clients otherwise reimbursable through Medicaid
3,850,255,987 3,879,010,669