This is not the official budget document.

Budget Summary FY2013

Division of Health Care Finance and Policy
Data Current as of:  7/7/2012





FISCAL YEAR 2013 BUDGET SUMMARY ($000)
ACCOUNT FY2013
Conference
FY2013
Vetoes
FY2013
GAA
Division of Health Care Finance and Policy 22,030 0 22,030
All Payer Claims Database RR 4,000 0 4,000
Health Safety Net Claims Migration Retained Revenue 2,000 0 2,000
Health Care Quality and Cost Council Retained Revenue 100 0 100
TOTAL    28,130 0 28,130

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account description amount
DIVISION OF HEALTH CARE FINANCE AND POLICY 28,129,516
 
Direct Appropriations
4100-0060 Division of Health Care Finance and Policy
For the operation of the division of health care finance and policy and the administration of the Health Safety Net Trust Fund established in section 36 of chapter 118G of the General Laws; provided, that notwithstanding any general or special law to the contrary, the assessment to acute hospitals authorized in section 5 of said chapter 118G for the estimated expenses of the division shall include, in fiscal year 2013, the estimated expenses, including indirect costs, of the division and shall be equal to the amount appropriated in this item less the amounts projected to be collected in fiscal year 2013 from: (i) filing fees; (ii) fees and charges generated by the division's publication or dissemination of reports and information; and (iii) federal financial participation received as reimbursement for the division's administrative costs; provided further, that the assessed amount shall be no less than 55 per cent of the total expenses appropriated for the division and the health safety net office; provided further, that for the purposes of supporting the division's expanded role in developing health care policies that benefit government entities, providers, purchasers and consumers, the division shall assess surcharge payors, as defined in section 34 of said chapter 118G, not less than 10 per cent of the total estimated expenses appropriated for the division and the health safety net office, including indirect costs, in fiscal year 2013 less the amounts projected to be collected in fiscal year 2013 from: (a) filing fees; (b) fees and charges generated by the division's publication or dissemination of reports and information; and (c) federal financial participation received as reimbursement for the division's administrative costs; provided further, that the assessment on surcharge payors shall be calculated in a manner similar to the assessment authorized in section 38 of said chapter 118G, and shall be collected in a manner consistent with said chapter 118G and deposited in the General Fund; provided further, that the division shall require all hospitals receiving payments from the Health Safety Net Trust Fund to report to the division the number of inpatient admissions and outpatient visits by age category, income category, diagnostic category and average charge per admission; provided further, that the division shall submit quarterly reports to the house and senate committees on ways and means compiling this data; provided further, that the division, in consultation with the executive office of health and human services, shall not promulgate any increase in Medicaid provider rates without taking all measures possible under Title XIX of the Social Security Act or any successor federal law to ensure that rates of payment to providers do not exceed such rates as are necessary to meet only those costs incurred by efficiently and economically operated providers in order to provide services of adequate quality; provided further, that the division shall meet the reporting requirements of section 25 of chapter 203 of the acts of 1996; provided further, that funds may be expended for a survey and study of the uninsured and underinsured in the commonwealth, including the health insurance needs of the residents of the commonwealth; provided further, that this study shall examine the overall impact of programs administered by the executive office of health and human services on the uninsured, the underinsured and the role of employers in assisting their employees in affording health insurance pursuant to section 23 of said chapter 118G; provided further, that the division shall publish a report on the financial condition of hospitals and other health care providers through the Health Benchmarks project website, in collaboration with the executive office of health and human services, the office of the attorney general and the University of Massachusetts; provided further, that the division shall submit to the house and senate committees on ways and means and the joint committee on health care financing not later than December 7, 2012 a report detailing utilization of the Health Safety Net Trust Fund; provided further, that the report shall include: (1) the number of persons in the commonwealth whose medical expenses were billed to the Health Safety Net Trust Fund in fiscal year 2012; (2) the total dollar amount billed to the Health Safety Net Trust Fund in fiscal year 2012; (3) the demographics of the population using the Health Safety Net Trust Fund; and (4) the types of services paid for out of the Health Safety Net Trust Fund in fiscal year 2012; provided further, that the division shall include in the report an analysis on hospitals' responsiveness to enrolling eligible individuals into the MassHealth program upon the date of service rather than charging those individuals to the Health Safety Net Trust Fund; provided further, that the division of health care finance and policy shall allocate $2,400,000 for the Catastrophic Illness in Children Relief Fund, established in section 2ZZ of chapter 29 of the General Laws, from funds previously allocated for a demonstration project under section 22 of chapter 47 of the acts of 1997; and provided further, that funds shall be expended for the operation of the health care quality and cost council established in section 16K of chapter 6A of the General Laws to promote high-quality, cost-effective, patient-centered care
22,029,516

account description amount
Retained Revenues
4100-0061 All Payer Claims Database RR
For the division of health care finance and policy, which may expend for the development, operation and maintenance of an all payer claims database an amount not to exceed $4,000,000 from amounts paid to the division for all fees paid for health data information and from any federal financial participation associated with the collection and administration of health care claims data; provided, that for the purpose of accommodating discrepancies between the receipt of retained revenues and related expenditures, the division may incur expenses and the comptroller may certify for payment amounts not to exceed the lower of this authorization or the most recent revenue estimate, as reported in the state accounting system
4,000,000
4100-0082 Health Safety Net Claims Migration Retained Revenue
For the division of health care finance and policy, which may expend for the migration of health safety net claims adjudication to the executive office of health and human services through its MMIS system and for the maintenance of claims adjudication an amount equal to the amount of federal financial participation received by the state for such activities, not to exceed $2,000,000; provided, that such federal revenue shall be deposited into the General Fund and such amount shall be transferred into this account; and provided further, that notwithstanding any general or special law to the contrary, for the purpose of accommodating timing discrepancies between the receipt of retained revenues and related expenditures, the division may incur expenses, in anticipation of revenue, after written approval from the secretary of administration and finance and the comptroller may certify for payment, amounts not to exceed the lower of this authorization or the most recent revenue estimate, as reported in the state accounting system
2,000,000
4100-0360 Health Care Quality and Cost Council Retained Revenue
For the health care quality and cost council established in section 16K of chapter 6A of the General Laws; provided, that the council may expend an amount not to exceed $100,000 from the monies received from the sale of data reports
100,000

account description amount