This is not the official budget document.

Budget Summary FY2014

40000300 - EOHHS and MassHealth Administration
Data Current as of:  9/11/2013





Account Description FY2013
Spending
FY2014
GAA
4000-0300 EOHHS and MassHealth Administration
For the operation of the executive office of health and human services, 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 ensure that any collaborative assessments for children receiving services from multiple agencies within the secretariat shall be performed within existing resources; provided further, that the executive office of health and human services and its agencies, when contracting for services on the islands of Martha's Vineyard and Nantucket, shall take into consideration the increased costs associated with the provision of goods, services, housing, and travel costs and shall provide no more than $30,000 for the increased costs associated with travelling to and from said islands; provided further, that funds appropriated in this item shall be expended for administrative and contracted services related to the implementation and operation of programs authorized by chapter 118E of the General Laws; provided further, that in consultation with the center for health information and analysis, no rate increase shall be provided to existing Medicaid provider rates without taking all measures possible under Title XIX of the Social Security Act, as codified at 42 U.S.C. chapter 7, subchapter XIX, to ensure that rates of payment to providers do not exceed the rates that 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 funds may be expended for the operation of the office of health equity within the executive office of health and human services; provided further, that no expenditures shall be made that are not federally reimbursable, including those related to Titles XIX or XXI of the Social Security Act, as codified at 42 U.S.C. chapter 7, subchapters XIX or XXI or the MassHealth demonstration waiver pursuant to section 1115(a) of said Social Security Act, as codified at 42 U.S.C. section 1315(a) or the community first demonstration waiver pursuant to section 1115 of the Social Security Act, as codified at 42 U.S.C. section 1315, whether made by the executive office or another commonwealth entity, except as required for: (a) the equivalent of MassHealth Standard benefits for children under age 21 who are in the care or custody of the department of youth services or the department of children and families; (b) dental benefits provided to clients of the department of developmental services who are age 21 or over; or (c) cost containment efforts the purposes and amounts of which have been submitted to the executive office for administration and finance and the house and senate committees on ways and means 30 days prior to making these expenditures; provided further, that in calculating rates of payment for children enrolled in MassHealth receiving inpatient and outpatient services at acute care pediatric hospitals and pediatric specialty units as defined in section 8A of Chapter 118E of the General Laws, the executive office shall provide additional reimbursement to the pediatric acute hospital in the Commonwealth, above the base rates, to compensate for high-complexity pediatric care in an amount no less than $11,800,000 and to the pediatric specialty unit in the Commonwealth in an amount no less than $3,000,000; provided further, that the executive office of health and human services may continue to recover provider overpayments made in the current and prior fiscal years through the Medicaid management information system, and that these recoveries shall be considered current fiscal year expenditure refunds; provided further, that funds shall be provided in an amount not less than the total appropriated in item 1599-2009 in section 2 of chapter 182 of the acts of 2008; provided further, that the executive office may collect directly from a liable third party any amounts paid to contracted providers under chapter 118E of the General Laws for which the executive office later discovers another third party is liable if no other course of recoupment is possible; provided further, that in calculating rates of inpatient and outpatient services for neonatal intensive care units, also known as NICU, with at least 55 licensed NICU beds within an acute hospital that has at least 109 pediatric intensive NICU licensed beds, the executive office shall make a supplemental payment of no more than $200,000; provided further, that no funds shall be expended for 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, $150,000 shall be expended for the work of the Massachusetts Unaccompanied Homeless Youth Commission to determine the scope of need among unaccompanied youth and young adults ages 24 and younger who are experiencing homelessness, and to identify and implement potential models for appropriate service delivery to unaccompanied homeless youth in urban, suburban, and rural areas of the commonwealth; provided further, that notwithstanding any general or special law to the contrary, the commissioner of mental health shall 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 not less than $1,500,000 shall be provided to the town of Webster to support emergency department capacity for a regional Medicare eligible disproportionate share, geographically isolated, community healthcare provider affiliated with the University of Massachusetts Medical School; provided further, that such funds shall be provided only if they will be matched by an equal or greater amount of private funds; provided further, that these funds shall be made available to said provider not later than December 31, 2013; provided further, that the executive office of health and human services shall report to the house and senate committees on ways and means not later than December 16, 2013 on the number of members that received case management services in fiscal year 2013, the scope of services provided and the spending impact of these services in both the primary care clinician and managed care organization populations; provided further, that the executive office of health and human services shall report to the house and senate committees on ways and means not later than January 13, 2014 on the number of members served in the dual eligible initiative, the average expenditure per member, the average expenditure per member prior to the demonstration project and the number of clients that receive care at skilled nursing facilities; provided further, that the executive office shall submit to the house and senate committees on ways and means and the joint committee on health care financing not later than December 6, 2013 a report detailing utilization of the Health Safety Net Trust Fund, established pursuant to section 66 of chapter 118E of the General Laws; provided further, that the report shall include: (a) the number of persons whose medical expenses were billed to the Health Safety Net Trust Fund in fiscal year 2013; (b) the total dollar amount billed to the Health Safety Net Trust Fund in fiscal year 2013; (c) the demographics of the population using the Health Safety Net Trust Fund; and (d) the types of services paid for out of the Health Safety Net Trust Fund in fiscal year 2013; provided further, that the executive office 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 any projection of deficiency in item 4000-0430, 4000-0500, 4000-0600, 4000-0700, 4000-0870, 4000-0875, 4000-0880, 4000-0890, 4000-0895, 4000-0940, 4000-0950, 4000-0990, 4000-1400 or 4000-1405 shall be reported to the house and senate committees on ways and means not less than 90 days before the projected exhaustion of funding; provided further, that any unexpended balance in these accounts shall revert to the General Fund on June 30, 2014; provided further, that for purposes of long-term health care cost savings and enhanced patient care, the commonwealth shall recognize telehealth remote patient monitoring provided by home health agencies as a service to clients otherwise reimbursable through Medicaid; and provided further, that the funds authorized in this item for telehealth reimbursement shall be short-term reimbursement made through MassHealth

87,844,889 91,785,813

Veto Explanation:   I am striking language which earmarks funding for programs not recommended. The reduction in this item and 4000-0700 incorporates the amount of the stricken earmarked funds.