Health Coverage Related Services

Government Function: Health Coverage Related Services

Program Category: Health Market Oversight

Program: Drug Control and Prescription Monitoring

For the purpose of protecting consumers against fraud, deception and unsafe practices in the distribution, handling and use of pharmaceuticals by licensing pharmacies and monitoring the prescription of controlled substances.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Department of Public Health

$1,295,175

$1,295,175

Budgetary Appropriations

$1,295,175

$1,295,175

Totals

$1,295,175

$1,295,175


Government Function: Health Coverage Related Services

Program Category: Health Market Oversight

Program: Health Care Access

For the purpose of providing regulatory oversight of the small group and individual health insurance markets in order to ensure the provision of affordable health plans including the dissemination of information to consumers relative to health insurance coverage and access to affordable insurance products.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Division of Insurance

$1,100,000

$1,100,000

Budgetary Appropriations

$1,100,000

$1,100,000

Office of the Secretary for Administration and Finance

$990,000

$0

Budgetary Appropriations

$990,000

$0

Totals

$2,090,000

$1,100,000


Government Function: Health Coverage Related Services

Program Category: Health Market Oversight

Program: Health Connector Administration and Operations

For the purpose of administering and operating  the Commonwealth Health Insurance Connector Authority to support cost-containment of health insurance for students, individuals and small businesses and to support other state and federal health reform efforts aimed at decreasing the rate of uninsured persons in Massachusetts.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary for Administration and Finance

$38,641,966

$25,965,282

Budgetary Appropriations

$16,012,060

$11,354,194

Trust Spending

$22,629,906

$14,611,088

Totals

$38,641,966

$25,965,282


Government Function: Health Coverage Related Services

Program Category: Health Market Oversight

Program: Health Market Analysis

For the purpose of monitoring the Massachusetts health care system and providing reliable information and analysis to improve health care quality, affordability, access, and outcomes.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Center for Health Information and Analysis

$31,909,221

$28,800,000

Budgetary Appropriations

$31,909,221

$28,800,000

Health Policy Commission

$0

$16,406,250

Trust Spending

$0

$16,406,250

Office of the Secretary for Administration and Finance

$2,644,509

$0

Budgetary Appropriations

$2,644,509

$0

Office of the State Auditor

$0

$862,500

Budgetary Appropriations

$0

$862,500

Totals

$34,553,730

$46,068,751


Government Function: Health Coverage Related Services

Program Category: Health Market Oversight

Program: Pharmaceutical / Medical Device Regulation

For the purpose of supporting the Pharmaceutical and Medical Device Code of Conduct which establishes standards for certain interactions between the pharmaceutical/medical device industry and health care providers/health plan administrators.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Department of Public Health

$432,188

$432,188

Budgetary Appropriations

$432,188

$432,188

Totals

$432,188

$432,188


Government Function: Health Coverage Related Services

Program Category: Public Employees Health Coverage

Program: Dental and Vision Insurance for Current Commonwealth Employees

For the purpose of providing dental and vision insurance for current Commonwealth employees, including processing dental and vision insurance payments pursuant to collective bargaining agreements.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Group Insurance Commission

$8,183,370

$8,510,936

Budgetary Appropriations

$8,183,370

$8,510,936

Human Resources Division

$27,758,500

$28,737,519

Budgetary Appropriations

$27,758,500

$28,737,519

Totals

$35,941,870

$37,248,455


Government Function: Health Coverage Related Services

Program Category: Public Employees Health Coverage

Program: Health Insurance for Commonwealth Employees

For the purpose of providing health insurance for Commonwealth employees, their spouses, and dependents


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Group Insurance Commission

$700,150,114

$675,342,829

Budgetary Appropriations

$654,150,114

$673,721,769

Trust Spending

$46,000,000

$1,621,060

Totals

$700,150,114

$675,342,829


Government Function: Health Coverage Related Services

Program Category: Public Employees Health Coverage

Program: Health Insurance for Commonwealth Retirees and Survivors

For the purpose of providing health insurance for Commonwealth retirees, survivors, and their dependents.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Group Insurance Commission

$822,613,714

$850,089,510

Budgetary Appropriations

$411,306,857

$425,044,755

Trust Spending

$411,306,857

$425,044,755

Totals

$822,613,714

$850,089,510


Government Function: Health Coverage Related Services

Program Category: Public Employees Health Coverage

Program: Health Insurance for Municipal Employees, Retirees, and Survivors

For the purpose of providing health insurance for participating municipal employees, retirees, survivors, and their dependents, including those who entered through municipal health reform as well as those who are in the retired municipal teachers program.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Group Insurance Commission

$511,262,011

$548,427,621

Budgetary Appropriations

$503,762,011

$542,927,621

Trust Spending

$7,500,000

$5,500,000

Totals

$511,262,011

$548,427,621


Government Function: Health Coverage Related Services

Program Category: Public Employees Health Coverage

Program: Health Insurance for Other Public Employees, Retirees, and Survivors

For the purpose of providing health insurance for employees, retirees, survivors, and their dependents for public entities such as housing and redevelopment authorities.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Group Insurance Commission

$122,822,435

$125,229,962

Budgetary Appropriations

$122,822,435

$125,229,962

Totals

$122,822,435

$125,229,962


Government Function: Health Coverage Related Services

Program Category: Public Employees Health Coverage

Program: Public Employee Insurance Administration and Operations

For the purpose of providing administration of insurance benefits to state, municipal, and other public agency employees, retirees, survivors, and their dependents.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Group Insurance Commission

$4,230,066

$4,807,191

Budgetary Appropriations

$4,230,066

$4,807,191

Office of the Secretary for Administration and Finance

$902,872

$1,061,218

Budgetary Appropriations

$902,872

$1,061,218

Totals

$5,132,938

$5,868,409


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Affordable Care Act Expansion Populations

For the purpose of providing affordable health insurance coverage for low-income individuals and families who will become newly eligible for State Plan coverage in 2014 due to the implementation of the Affordable Care Act (ACA).


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary of Health and Human Services

$0

$460,907,878

Budgetary Appropriations

$0

$460,907,878

Totals

$0

$460,907,878


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Commonwealth Care

For the purpose of maintaining access to affordable health insurance coverage for low-income residents of Massachusetts who are not eligible for Medicaid through a competitively procured health insurance premium assistance program.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary for Administration and Finance

$1,435,309,787

$796,728,846

Budgetary Appropriations

$623,656,448

$348,396,517

Trust Spending

$811,653,339

$448,332,329

Totals

$1,435,309,787

$796,728,846


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Disabled Adults Health Coverage

For the purpose of providing health insurance to low-to-medium-income disabled adults for covered health care services.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary of Health and Human Services

$3,016,383,588

$3,438,558,390

Budgetary Appropriations

$3,016,383,588

$3,438,558,390

Totals

$3,016,383,588

$3,438,558,390


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Disabled Children Health Coverage

For the purpose of providing health insurance to disabled children of low-to-medium-income families for covered health care services.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary of Health and Human Services

$657,215,470

$723,525,233

Budgetary Appropriations

$657,215,470

$723,525,233

Totals

$657,215,470

$723,525,233


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Health Safety Net

For the purpose of reimbursing acute hospitals and community health centers for a portion of the cost of reimbursable health services provided to low-income, uninsured and underinsured residents.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Center for Health Information and Analysis

$396,877,248

$0

Trust Spending

$396,877,248

$0

Office of the Secretary for Administration and Finance

$51,226,858

$52,579,206

Budgetary Appropriations

$21,226,858

$22,992,028

Trust Spending

$30,000,000

$29,587,178

Office of the Secretary of Health and Human Services

$0

$-11,000,000

Trust Spending

$0

$-11,000,000

Totals

$448,104,106

$41,579,206


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Insurance Premium Payments and Subsidies

For the purpose of reducing the amount of out-of-pocket money paid for prescriptions and medical care for low- to medium-income individuals, families, and disabled persons.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary of Health and Human Services

$285,913,499

$284,153,027

Budgetary Appropriations

$285,913,499

$284,153,027

Totals

$285,913,499

$284,153,027


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Long Term Unemployed Health Coverage

For the purpose of providing health insurance to long term unemployed adults for covered health care services.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Department of Workforce Development

$133,611,618

$48,345,536

Trust Spending

$133,611,618

$48,345,536

Office of the Secretary of Health and Human Services

$677,286,971

$711,678,431

Budgetary Appropriations

$677,286,971

$711,678,431

Totals

$810,898,589

$760,023,967


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: MassHealth Administration and Operations

For the purpose of operating the MassHealth (Medicaid) insurance program providing health care for low- to medium-income and disabled persons.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary of Health and Human Services

$117,167,197

$126,815,915

Budgetary Appropriations

$112,167,197

$121,815,915

Trust Spending

$5,000,000

$5,000,000

Totals

$117,167,197

$126,815,915


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Medical Assistance and Delivery System Incentive Hospital Payments

For the purpose of providing hospitals and health networks with supplemental payments for costs incurred for serving low-income populations with serious medical needs in order to promote integrated delivery systems, innovative care methods, alternative payment models, and population-level healthcare services.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary of Health and Human Services

$1,855,930,379

$1,202,512,273

Budgetary Appropriations

$751,914,223

$485,449,470

Trust Spending

$1,104,016,156

$717,062,803

Totals

$1,855,930,379

$1,202,512,273


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Non-Disabled Adults Health Coverage

For the purpose of providing health insurance to low-to-medium-income non-disabled adults for covered health care services.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Department of Elder Affairs

$11,833

$12,497

Budgetary Appropriations

$11,833

$12,497

Department of Workforce Development

$1,597,843

$0

Trust Spending

$1,597,843

$0

Office of the Secretary of Health and Human Services

$1,215,168,827

$1,332,982,027

Budgetary Appropriations

$1,215,168,827

$1,332,982,027

Totals

$1,216,778,503

$1,332,994,523


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Non-Disabled Children Health Coverage

For the purpose of providing health insurance to non-disabled children of low-to-medium-income families for covered health care services.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary of Health and Human Services

$1,943,289,740

$2,107,336,355

Budgetary Appropriations

$1,943,289,740

$2,107,336,355

Totals

$1,943,289,740

$2,107,336,355


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: Seniors Health Coverage

For the purpose of providing health insurance to low- to medium-income seniors. Services are designed to provide comprehensive medical and social services to frail elders so that they are able to live in their communities instead of in nursing homes.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Department of Elder Affairs

$3,060,675,095

$3,209,923,010

Budgetary Appropriations

$3,060,675,095

$3,209,923,010

Totals

$3,060,675,095

$3,209,923,010


Government Function: Health Coverage Related Services

Program Category: Subsidized Health Coverage

Program: State-Subsidized Wrap-around Program

For the purpose of reducing health insurance premiums for individuals and small businesses in Massachusetts by offering competitive subsidies through eligible health insurance carriers to reduce the cost of health insurance coverage for low-income residents who are not eligible for Medicaid.


Department

FY 2013

Projected Spending

FY 2014

Recommended Spending

Office of the Secretary for Administration and Finance

$0

$190,812,062

Budgetary Appropriations

$0

$83,438,999

Trust Spending

$0

$107,373,062

Totals

$0

$190,812,062