40000500 - MassHealth Managed Care

Account Description FY2012
Spending
FY2013
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 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 not less than $20,000,000 shall be expended from this item or item 4000-0700, if necessary to achieve maximum federal financial participation, to enhance the ability of hospitals that are not eligible for delivery system transformation initiative grants to serve populations in need more efficiently and effectively; provided further, that $3,000,000 shall be expended for infrastructure and capacity building grants to critical access community hospitals; provided further, that these funds shall be disbursed not later than April 1, 2013; provided further, that not less than $3,000,000 shall be expended from this item or item 4000-0700, if necessary to achieve maximum federal financial participation, to enhance the ability of community health centers and primary care clinicians to serve populations in need more efficiently and effectively; provided further, that these funds shall be disbursed not later than April 1, 2013; 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 MassHealth may, to the extent feasible, contract with payers and providers to provide case management services to high cost and high acuity patients
3,954,095,160 4,167,475,376