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Office of the Secretary of Health and Human Services
| DEPARTMENT | FY 2009 Budgetary Recommendations |
FY 2009 Federal, Trust, and ISF |
FY 2009 Total Spending |
FY 2009 Budgetary Non-Tax Revenue |
|---|---|---|---|---|
| Office of the Secretary of Health and Human Services | 6,186,065 | 1,628,953 | 7,815,018 | 4,318,846 |
| account | description | amount | ||||
|---|---|---|---|---|---|---|
| OFFICE OF THE SECRETARY OF HEALTH AND HUMAN SERVICES | 7,815,017,979 | |||||
| Budgetary Direct Appropriations | 6,186,064,833 | |||||
| Direct Appropriations | ||||||
| 4000-0050 | Personal Care Attendant Council
For the personal care attendant quality home care workforce council established under section 29 of chapter 118G of the General Laws |
728,073 | ||||
| 4000-0117 | Human Services Purchase of Service Reform Initiative
For a reserve to adjust the wages, compensation or salary and associated employee-related costs to personnel earning less than $25,000 in annual compensation who are employed by private human service providers that deliver human and social services under contracts with departments within the executive office of health and human services, the executive office of elder affairs and the department of early education and care and to take initial steps toward implementing reform of purchase of service reimbursement mechanisms |
23,000,000 | ||||
| 4000-0265 | Primary Care Workforce
For a primary care workforce development and loan forgiveness grant program at community health centers and community hospitals, for the purpose of enhancing recruitment and retention of primary care physicians and other clinicians at community health centers and community hospitals throughout the commonwealth; provided, that the grant shall be administered by the Massachusetts League of Community Health Centers in consultation with the secretary of health and human services and relevant member agencies; provided further, that the funds shall be matched by other public and private funds; and provided further, that the League shall work with the secretary and the agencies to maximize all sources of public and private funds |
1,700,000 | ||||
| 4000-0300 | Executive Office of Health and Human Services and Medicaid Administration
For the operation of the office of the secretary of health and human services, including the operation of the managed care oversight board and the office of the child advocate established under Executive Order 494; 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 these systems compatible with one another for enhanced interagency interaction; provided further, that the executive office shall continue to develop and implement the common client identifier; provided further, that funds appropriated in this item shall be expended for the administrative, contracted services and non-personnel systems costs related to the implementation and operation of programs authorized by sections 9A, 9B, 9C and 16C of chapter 118E of the General Laws; provided further, that in consultation with the division of health care finance and policy, 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 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 expenditures for the purposes of each item appropriated for programs authorized by chapter 118E shall be accounted for according to the purpose on the Massachusetts management accounting and reporting system not more than 10 days after the expenditures have been made by the Medicaid management information system; 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 approved under section 1115(a) of the act or the Community First section 1115 demonstration waiver, whether made by the executive office or another commonwealth entity, except as explicitly authorized in this item, or unless made for 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 executive office 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 the executive office may collect directly from a liable third party any amounts paid to contracted providers under 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 the purpose of funding 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 the federal financial participation received from claims filed based on in-kind administrative services related to outreach and eligibility activities performed by certain community organizations, under the "covering kids initiative", and in accordance with the federal revenue criteria in 45 CFR 74.23 or any other federal regulation which provides a basis for federal financial participation, shall be credited to this item and may be expended, without further appropriation, on administrative services including those covered under an agreement with the organizations participating in the initiative; and provided further, that notwithstanding any general or special law to the contrary, the executive office shall require the commissioner of mental health to 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 |
145,635,110 | ||||
| 4000-0301 | MassHealth Auditing and Utilization Reviews
For the costs of MassHealth provider and member audit and utilization review activities, including, but not limited to, eligibility verification, disability evaluations, provider financial and clinical audits, and other initiatives intended to enhance program integrity |
2,225,904 | ||||
| 4000-0352 | MassHealth Enrollment Outreach Grants
For MassHealth enrollment outreach grants to public and private non-profit groups to encourage and stimulate enrollment in publicly subsidized health care programs and to strengthen connections between new enrollees and primary care providers to be administered by the executive office in consultation with the health care reform outreach and education unit; provided, that funds shall be awarded as grants to community and consumer-focused public and non-profit groups to provide enrollment assistance, education, outreach and coverage maintenance activities directly to consumers eligible for publicly administered and subsidized options |
3,500,000 | ||||
| 4000-0355 | Health Care Quality and Cost Council
For the operation of a health care quality and cost council to promote high-quality, cost-effective patient-centered care |
1,888,616 | ||||
| 4000-0430 | MassHealth CommonHealth Plan
For the commonhealth program to provide primary and supplemental medical care and assistance to disabled adults and children under sections 9A, 16 and 16A of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years; provided further, that the executive office shall maximize federal reimbursement for state expenditures made on behalf of these adults and children; and provided further, that children shall be determined eligible for this medical care and assistance if they meet the disability standards as defined by the executive office, which standards shall be no more restrictive than the standards in effect on July 1, 1996 |
111,900,000 | ||||
| 4000-0500 | MassHealth Managed Care
For health care services provided to medical assistance recipients under the executive office's primary care clinician, mental health and substance abuse plan, or through a managed care organization under contract with the executive office, and for MassHealth benefits provided to children, adolescents and adults under clauses (a), (b), (c), (d) and (h) of subsection (2) of section 9A and section 16C of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
3,117,519,323 | ||||
| 4000-0622 | Health Disparities Initiative
For the operation of the office of health equity |
1,000,000 | ||||
| 4000-0650 | Community First Initiative
For community-based services for elderly and disabled individuals under 65 provided under the Community First section 1115 demonstration waiver or for costs necessary to prepare for or implement the waiver |
45,800,000 | ||||
| 4000-0700 | MassHealth Indemnity
For health care services provided to medical assistance recipients under the executive office's health care indemnity, third party liability plan and medical assistance recipients who are neither seniors nor otherwise covered under the executive office's managed care plans, and for MassHealth benefits provided to children, adolescents and adults under clauses (a), (b), (c), (d), and (h) of subsection (2) of section 9A and section 16C of chapter 118E of the General Laws; provided, that no payment 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 funds may be expended from this item for health care services provided to recipients in prior fiscal years; provided further, that notwithstanding the foregoing, 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 including, but not limited to, seniors; and 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 these activities are performed by a state agency, contractor, agent or provider |
1,525,376,319 | ||||
| 4000-0870 | MassHealth Basic Coverage
For health care services provided to adults participating in the medical assistance program under clause (g) of subsection (2) of section 9A of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
122,700,000 | ||||
| 4000-0875 | MassHealth Breast and Cervical Cancer Treatment
For the provision of benefits to eligible women who require medical treatment for either breast or cervical cancer under 1902(a)(10)(A)(ii)(XVIII) of the Social Security Act, and under section 10D of chapter 118E of the General Laws; provided, that the executive office shall provide benefits to women whose income, as determined by the executive office, does not exceed 250 per cent of the federal poverty level, subject to continued federal approval; provided further, that eligibility for these benefits shall be extended solely for the duration of the cancerous condition; provided further, that prior to the provision of any benefits covered by this item, the division shall require screening for either breast or cervical cancer at the comprehensive breast and cervical cancer early detection program operated by the department of public health, in accordance with item 4570-1512; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
5,500,000 | ||||
| 4000-0880 | MassHealth Family Assistance Plan
For MassHealth benefits under clause (c) of subsection (2) of section 9A and section 16C of chapter 118E of the General Laws for children and adolescents whose family income as determined by the executive office exceeds 150 per cent of the federal poverty level; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
211,100,000 | ||||
| 4000-0890 | MassHealth Premium Assistance and Insurance Partnership Program
For the cost of health insurance premium subsidies paid to employees of small businesses participating in the insurance reimbursement program under section 9C of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
40,300,000 | ||||
| 4000-0891 | MassHealth Insurance Partnership for Employers
For the cost of health insurance subsidies paid to employers participating in the insurance reimbursement program under section 9C of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
5,200,000 | ||||
| 4000-0895 | Healthy Start Program
For the healthy start program to provide medical care and assistance to pregnant women and infants residing in the commonwealth under section 10E of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
19,400,000 | ||||
| 4000-0990 | Children's Medical Security Plan
For the children's medical security plan to provide primary and preventive health services for uninsured children from birth through age 18 under section 10F of chapter 118E of the General Laws; provided, that the executive office shall pre-screen enrollees and applicants for Medicaid eligibility; provided further, that no applicant shall be enrolled in the program until the applicant has been denied eligibility for the MassHealth program; provided further, that the MassHealth benefit request shall be used as a joint application to determine the eligibility for both MassHealth and the children's medical security plan; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
16,500,000 | ||||
| 4000-1400 | MassHealth HIV Plan
For the purposes of providing MassHealth benefits to persons with a diagnosis of human immunodeficiency virus whose incomes, as determined by the executive office, do not exceed 200 per cent of the federal poverty level; provided, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
16,591,488 | ||||
| 4000-1405 | MassHealth Essential
For the operation of the essential program under section 9A of chapter 118E of the General Laws |
304,600,000 | ||||
| 4000-1420 | Medicare Part D Phased Down Contribution
For the purposes of making payment to the federal Centers for Medicare and Medicaid Services in compliance with Title XIX of the Social Security Act, as amended by the Medicare Prescription Drug Improvement and Modernization Act of 2003 |
238,900,000 | ||||
| account | description | amount | ||||
|---|---|---|---|---|---|---|
| Retained Revenues | ||||||
| 4000-0320 | MassHealth Recoveries from Current and Prior Fiscal Years Retained Revenue
The executive office may expend an amount not to exceed $225,000,000 from recoveries of any current or prior year expenditures and collections from liens, estate recoveries, third party recoveries, drug rebates, accident and trauma recoveries, case mix recoveries, computer audits, insurance recoveries, provider overpayment recoveries, bankruptcy settlements, Medicaid fraud returns, data match returns, Medicare appeals, and program and utilization review audits; provided, that any revenues collected by the executive office that are not attributable to the aforementioned categories shall be deposited in the General Fund and shall be tracked separately; provided further, that no funds from this item shall be used for the purposes of item 4000-0300; provided further, that expenditures from this item shall be limited solely to payment obligations arising in the current fiscal year for the provision of medical care and assistance; and provided further, that additional categories of recoveries and collections, including the balance of any personal needs accounts collected from nursing and other medical institutions after a recipient's death and held by the executive office for more than 3 years may, notwithstanding any general or special law to the contrary, be credited to this item |
225,000,000 | ||||
| account | description | amount | ||||
|---|---|---|---|---|---|---|
| Intragovernmental Service Spending | 35,100,876 | |||||
| 4000-0102 | Chargeback for Human Services Transportation
For the cost of transportation services for health and human services clients and the operation of the health and human services transportation office
|
7,475,343 | ||||
| 4000-0103 | Chargeback for Human Services Administration
For the costs of core administrative functions performed within the executive office of health and human services; provided, that the secretary of health and human services may, notwithstanding any general or special law to the contrary, identify administrative activities and functions common to the separate agencies, departments, offices, divisions and commissions within the executive office and designate them "core administrative functions" in order to improve administrative efficiency and preserve fiscal resources; provided further, that common functions that may be designated core administrative functions include, without limitation, human resources, financial management, information technology, and leasing and facility management; provided further, that all employees performing functions so designated may be employed by the executive office and the executive office shall charge the agencies, departments, offices, divisions and commissions for these services; provided further, that upon the designation of a function as a core administrative function, the employees of each agency, department, office or commission who perform these core administrative functions may be transferred to the executive office of health and human services; provided further, that the reorganization shall not impair the civil service status of any transferred employee who immediately before the effective date of this act either holds a permanent appointment in a position classified under chapter 31 of the General Laws or has tenure in a position by reason of section 9A of chapter 30 of the General Laws; and provided further, that nothing in this section shall be construed to impair or change an employee's status, rights, or benefits under chapter 150E of the General Laws
|
27,625,533 | ||||
| account | description | amount |
|---|---|---|
| Federal Grant Spending | 9,020,611 | |
| 4000-0713 | Youth Development State Collaboration
For the purposes of a federally funded grant entitled, Youth Development State Collaboration |
120,000 |
| 4000-7570 | Medicaid Transformation Grant
For the purposes of a federally funded grant entitled, Medicaid Transformation Grant |
814,370 |
| 4000-9401 | Community Mental Health Services
For the purposes of a federally funded grant entitled, Community Mental Health Services |
8,086,241 |
| account | description | amount |
|---|---|---|
| Trust and Other Spending | 1,584,831,659 | |
| 4000-0330 | Connector Administration Expendable Trust | 5,200,000 |
| 4000-1068 | Medical Assistance Trust Fund | 251,000,000 |
| 4000-3005 | Essential Community Provider Payments Trust | 28,000,000 |
| 4000-4000 | Health Insurance Portability and Accountability Act Fund | 8,070,203 |
| 4000-5819 | Commonwealth Care Trust Fund | 1,292,561,456 |
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