This is not the official budget document.

Budget Summary FY2016

40000700 - MassHealth Fee for Service Payments
Data Current as of:  8/19/2015





Account Description FY2015
Spending
FY2016
GAA
4000-0700 MassHealth Fee for Service Payments
For health care services provided to medical assistance recipients under the executive office's health care indemnity or third party liability plan, to medical assistance recipients not otherwise covered under the executive office's managed care or senior care plans and for MassHealth benefits provided to children, adolescents and adults under section 9 of chapter 118E of the General Laws and clauses (a) to (d), inclusive, and clause (h) of subsection (2) of section 9A of said chapter 118E and section 16C of said chapter 118E; provided, that no payments for special provider costs shall be made from this item without the prior written approval of the secretary of administration and finance; provided further, 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 children who have aged out of the custody of the department of children and families shall be eligible for benefits through the age limit specified in MassHealth's approved state plan; provided further, that funds shall be expended from this item for members who qualify for early intervention services; provided further, that funds may be expended from this item for health care services provided to the recipients in prior fiscal years; provided further, the funds appropriated in item 4000-0265 of section 2A of chapter 142 of the acts of 2011 shall again be appropriated for the same dollar amount as in said item 4000-0265 and shall be distributed in and managed in the same manner as designated in section 60 of chapter 118 of the acts of 2012; provided further, that the executive office shall not, in fiscal year 2016, fund programs relating to case management with the intention of reducing length of stay for neonatal intensive care unit cases; provided further, that notwithstanding this item, funds may be expended from this item for the purchase of third party insurance including, but not limited to, Medicare for any medical assistance recipient; provided further, that the executive office may reduce MassHealth premiums or copayments or offer other incentives to encourage enrollees to comply with wellness goals; provided further, that funds may be expended from this item for activities relating to disability determinations or utilization management and review, including patient screenings and evaluations, regardless of whether such activities are performed by a state agency, contractor, agent, or provider; provided further, that not later than March 1, 2016, the executive office shall report to the house and senate committees on ways and means on the dental coverage available to MassHealth recipients as of January 1, 2016 as it compares to dental coverage available to MassHealth recipients on January 1, 2010; and provided further, that the executive office shall maintain full-year coverage for adult dental fillings and adult denture coverage
2,438,166,429 2,478,152,092

Veto Explanation:   I am reducing this item to the amount projected to be necessary.