This is not the official budget document.

Budget Summary FY2016

40000300 - EOHHS and MassHealth Administration
Data Current as of:  8/19/2015





Account Description FY2015
Spending
FY2016
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 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 the executive office 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 and housing on said islands; provided further, that the executive office shall contract with Martha's Vineyard Community Services, Inc. for no less than $75,000 to increase access to health and human services on Martha's Vineyard and Nantucket, and such funds shall be used to cover feasible travel costs associated with arranging access to health and human services; provided further that on or before December 31, 2015, not less than $150,000 shall be provided to Noble Hospital, a federal and state disproportionate share hospital that is geographically isolated, to improve the access entry way for all patients, especially those challenged with disabilities; provided further, that those funds are matched by an equal or greater amount by Noble Hospital; 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 to ensure that rates of payment to providers shall not exceed the rates that are necessary to meet only those costs which shall be incurred by efficiently and economically operated providers in order to provide services of adequate quality; 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 or the MassHealth demonstration waiver pursuant to section 1115(a) of said Social Security Act or the community first demonstration waiver pursuant to section 1115 of said Social Security Act, whether made by the executive office or another commonwealth entity, except as required for: (i) 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; (ii) dental benefits provided to clients of the department of developmental services who are age 21 or over; or (iii) 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 the office of Medicaid shall apply an add-on to reimburse the managed care organizations and senior care organizations under contract with the commonwealth for the full costs associated with the Affordable Care Act's annual insurer fee, as specified in section 9010(a) of the Affordable Care Act, Public Law 111-148; provided further, that the add-on shall be exclusive of any additional rate increase currently being proposed for the fiscal year 2016; provided further, that subject to the availability of federal financial participation, the add-on shall include the related tax liability for the annual insurer fee; provided further, that MassHealth shall provide a report not later than March 1, 2016 to the house and senate committees on ways and means and the joint committee on health care financing on the amount of reimbursement of the Affordable Care Act's insurer fee and the related tax liability and the methodology for calculating the reimbursement to the managed care organizations and senior care organizations; 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 these recoveries shall be considered current fiscal year expenditure refunds; provided further, that the executive office may collect directly from a liable third party any amounts paid to contracted providers under said chapter 118E for which the executive office later discovers another third party is liable if no other course of recoupment is possible; 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, 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 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 5, 2015 a report detailing utilization of the Health Safety Net Trust Fund established in section 66 of said chapter 118E; 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 2015; (b) the total dollar amount billed to the Health Safety Net Trust Fund in fiscal year 2015; (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 2015; provided further, that the office of Medicaid shall coordinate with the health policy commission in the development of care delivery and payment models in the MassHealth program, including patient centered medical homes and accountable care organizations, in order to ensure alignment of such models with the commission's certification programs under sections 14 and 15 of chapter 6D; provided further, that the secretary of health and human services, in consultation with the secretary of administration and finance, shall file an implementation plan with the clerks of the house of representatives and senate not later than October 1, 2015, detailing how the executive office of health and human services will implement modern, digital integrated eligibility determination processes as required by section 16 of chapter 6A in order to achieve maximum federal reimbursement before December 2018; provided further, that MassHealth shall provide a report, no later than October 1, 2015, to the house and senate committees on ways and means on the feasibility of federal reimbursement for transitional support services; provided further, that not less than $200,000 shall be expended for the Maris Center for Women in the town of Salisbury; 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 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 make a supplemental payment to any acute care pediatric hospital and pediatric specialty unit in the commonwealth, above base rates, to compensate for high-complexity pediatric care in an amount not less than 50 per cent of the amount appropriated in this item in chapter 165 of the acts of 2014; provided further, that any projection of deficiency in item 4000-0430, 4000-0500, 4000-0600, 4000-0640, 4000-0700, 4000-0875, 4000-0880, 4000-0885, 4000-0940, 4000-0950, 4000-0990, 4000-1400, 4000-1420 or 4000-1425 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, 2016; provided further, that $50,000 shall be expended for the direct payroll costs of a MassHealth liaison to the trial court responsible for the administration of health insurance benefits for participants in the specialty courts; provided further, that the executive office of health and human services shall expend not less than $100,000 to develop a pilot program in Norfolk county to incentivize independent home health care nurses to work with patients with rare diseases and disorders including, but not limited to, Rett Syndrome and mitochondrial diseases; provided further, that in the development of the program, the executive office shall review the reimbursement rates for independent home care nurses and consider restructuring the rate system so that independent home care nurses who agree to treat patients with more severe needs are compensated at a higher rate; 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 not less than $25,000 shall be expended for the Harvard Street Neighborhood Health Center for purposes including, but not limited to, addressing adult mental health and support services, including the opiate addiction epidemic through the implementation of substance abuse treatment programs and other programs to ensure access to healthcare for anyone regardless of their ability to pay for services rendered; 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; and provided further, that not later than January 18, 2016, the executive office of health and human services shall submit a report to the house and senate committees on ways and means detailing the methodology used to project caseload and utilization in fiscal year 2015 and fiscal year 2016

88,223,229 92,240,452

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