This is not the official budget document.

Budget Summary FY2018

40000300 - EOHHS and MassHealth Administration
Data Current as of:  7/20/2017





Account Description FY2017
Spending
FY2018
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 funds appropriated in this item shall be expended for administrative and contracted services related to the implementation and operation of programs under 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 to ensure that rates of payment to providers shall not exceed the rates necessary to meet only the cost of 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; provided further, that no expenditures, whether made by the executive office or another commonwealth entity, shall be made that are not federally reimbursable, including those related to Titles XIX or XXI of the Social Security Act, the MassHealth demonstration waiver under section 1115(a) of the Social Security Act or the community first demonstration waiver under section 1115 of the Social Security Act, 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; (iii) managed care capitation payments for MassHealth members who are residents of Institutions for Mental Disease for more than 15 days in any calendar month, and otherwise as explicitly authorized; or (iv) cost-containment efforts, the purposes and amounts of which shall be submitted to the executive office for administration and finance and the house and senate committees on ways and means 30 days before 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 said chapter 118E, the executive office shall make a supplemental payment not less than $7,400,000 to any acute care pediatric hospital and pediatric specialty unit in the commonwealth, above base rates, to compensate for high-complexity pediatric care; provided further, that the executive office 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 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 commissioner of mental health shall approve any prior authorization or other restriction on medication used to treat mental illness under written policies, procedures and regulations of the department of mental health; provided further, that the executive office shall report to the house and senate committees on ways and means not later than January 13, 2018 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 a report not later than December 1, 2017 to the house and senate committees on ways and means and the joint committee on health care financing detailing utilization in fiscal year 2017 of the Health Safety Net Trust Fund established in section 66 of said chapter 118E, including: (a) the number of persons whose medical expenses were billed to the Health Safety Net Trust Fund; (b) the total dollar amount billed to the Health Safety Net Trust Fund; (c) the age, income level and insurance status of recipients using the Health Safety Net Trust Fund; (d) the types of services paid for out of the Health Safety Net Trust Fund; and (e) the amount disbursed from the Health Safety Net Trust Fund to each hospital and community health center; 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 of the General Laws; provided further, that the executive office shall report to the house and senate committees on ways and means not later than January 1, 2018 on the feasibility of offering all applications, application information, service information and guidelines in electronic form, paper form and on the MassHealth website for MassHealth and MassHealth-related programs in both classical and traditional Chinese translations; provided further, that any unexpended balance in these accounts shall revert to the General Fund on June 30, 2018; provided further, that not later than January 18, 2018, the executive office 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 2017 and fiscal year 2018; provided further, that the executive office of health and human services, in consultation with the department of transitional assistance, shall report to the joint committee on ways and means, the joint committee on health care financing, and the joint committee on children, families and persons with disabilities, no later than January 1, 2018, on the feasibility of offering MassHealth applicants or recipients the opportunity to complete a common application for MassHealth and for programs administered by the department of transitional assistance, including the federal Supplemental Nutrition Assistance Program, the program for emergency aid to elders, disabled and children pursuant to chapter 117A and the program for transitional assistance to families with dependent children pursuant to chapter 118; provided further, that the executive office shall submit monthly MassHealth caseload reports in a searchable electronic format to the executive office for administration and finance and the house and senate committees on ways and means by the 15th day of the subsequent month; provided further, that not later than December 1, 2017, the executive office, in coordination with the department of public health and the office of Medicaid, shall report to the house and senate committees on ways and means on a plan to expand lead testing and follow-up services including, but not limited to: (1) a review of all services currently offered for lead poisoning-related services; (2) a plan of implementation for expanded lead poisoning-related services, including steps required to increase reimbursement opportunities for services such as lead poisoning testing, prevention, follow-up, investigation and treatment; (3) spending and revenue cost estimates for implementing such expanded services; (4) revenue maximization opportunities associated with pursuing such services; and (5) an analysis of the short- and long-term cost effectiveness associated with providing such services; provided further, that not less than $250,000 shall be expended for the Brookline Community Mental Health Center, Inc. to expand the Healthy Lives program; provided further, that $75,000 shall be expended for The MetroWest Free Medical Program, Inc.; provided further, that the executive office shall expend not less than $100,000, of which not less than $25,000 of said funds shall be expended to contract with Martha's Vineyard Community Services, Inc., to increase access to health and human services on the islands of 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

99,496,881 102,257,373

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.