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Floor Number: 751 Clerk Number: 106
TO PROTECT THE HOME OF NURSING HOME RESIDENTS
Mr. Montigny moves to amend the bill, in section 281 in subsection (a)(1) by striking out the words:- "ten bed hold days," and inserting in place thereof the following:- "20 bed hold days."
Floor Number: 752 Clerk Number: 664
NURSING FACILITY ASSESSMENT
Mr. Berry moves to amend the bill in Section 281, subsection
(4), by adding the following words:-
",and to the extent that an annual amount of $17 million in this
subsection is not fully allocated, the division shall first fund capital rate
adjustments for nursing homes in urban or geographically remote underbedded areas;
and provided further that in fiscal year 2005 the division shall continue to make
supplemental rate payments in accordance with the regulation 114.2 CMR 6.06 (10)(a)
in effect September 1, 2003."
Floor Number: 753 Clerk Number: 13
ASSISTED LIVING CONVERSION
Ms. Tucker moves to amend the bill by inserting, after Section____, the following new
Section:-
"Section____. Section 4 of Chapter 19D of the General
Laws, as so appearing, is hereby amended by inserting after the second paragraph
the following paragraph:-
Notwithstanding the provisions
of the previous paragraph, no fees, including minimum fees, for initial certification
or certification renewal shall be due from any provider for assisted living units
created under the HUD Assisted Living Conversion Program.
Floor Number: 754 Clerk Number: 130
NURSING FACILITY BED HOLD:
Mr. Tisei moves to amend the bill by inserting, after Section
362, the following new section:-
"SECTION____. Section 14A of chapter
118E of the General Laws is hereby amended by adding the following paragraph:-
" In the event that a nursing facility resident who is 22 years or under
and is a MassHealth recipient leaves the nursing facility for non-medical reasons,
the facility shall preserve his or her bed for a period up to 10 calendar days
per year and the division shall pay to preserve his or her bed in the facility
for a period of up to 10 calendar days per year. The division shall reimburse
the nursing facility for the non-medical leave of absence at the recipient's pre-absence
rate during the non-medical leave and upon the resident's return."
Floor Number: 755 Clerk Number: 619
MASSHEALTH BENEFITS
Messrs. Lees, Tisei, Tarr, Knapik and Brown and Mrs. Sprague
move to amend the bill by inserting at the end thereof the following section:-
"SECTION ____.
The secretary of the executive office of health and human services shall conduct
a study to determine the costs of allowing MassHealth participants who care for
elderly parents to obtain additional benefits to offset the expenses paid for
caring for elderly parents. The secretary shall submit this report no later than
March 1, 2004 and shall submit said report to the senate president, senate minority
leader, chairman of senate ways and means committee, speaker of the house of representatives,
house minority leader and chairman of the house ways and means committee."
Floor Number: 756 Clerk Number: 34
ELIMINATING THE MASSHEALTH REIMBURSEMENT PENALTY FOR STUCK KIDS
Mr. Moore moves to amend the bill, in section 2, in line item 4000-0500, by inserting at the end thereof the following:- " provided further, that notwithstanding the provisions of any general or special law or regulation to the contrary, inpatient behavioral health contractors under contract with MassHealth's managed care contractors for mental health/substance abuse carve-outs, shall receive their full contracted inpatient per diem rate for patients aged eighteen and under who are classified as on administrative necessary day (AND) status".
Floor Number: 757 Redraft Clerk
Number: 112
HAMPDEN MEDICAID
Ms. Melconian and Mr. Lees move to amend the bill, in section
2, in item 4000-0600, by inserting after the words "house and senate committees
on ways and means prior to any transfer" the following:-
"provided further, that notwithstanding
any general or special law to the contrary, all licensed chronic care hospitals
located in Hampden county shall be paid under the same Medicaid reimbursement
methodology as applied to all other similarly situate chronic care hospitals;
and provided further, that in calculation the Medicaid reimbursement, such reimbursement
shall exclude any costs associated with any beds licensed by the department of
mental health"
Floor Number: 758 Clerk Number: 403
RESIDENTIAL CARE FACILITIES - RATES
Ms. Wilkerson moves to amend the bill in section 2, in item
4405-2000 by inserting after the words "foster care benefit" the following:
--
"; provided further, that effective July 1, 2004 through
June 30, 2005, the division of health care finance and policy shall establish
rates for residential care facilities (rest homes) using calendar year 2002 base
year costs; provided further that such rates utilize a limitation for the variable
cost allowance at the 85th percentile of 2002 base year costs; and provided further,
that the scope of the variable cost allowance include those accounts allowed under
regulations 114.2 CMR 4.05 as of July 1, 2003;"
and by striking the figure
"$203,272,025" of said item and replacing it with the following figure:
"$205,878,031"
Ms. Wilkerson further moves to amend the bill in Section
2, in item 4408-1000 by inserting after the words "made available herein;"
the following: --
"provided further that effective July
1, 2004 through June 30, 2005, the division of health care finance and policy
shall establish rates for residential care facilities (rest homes) using calendar
year 2002 base year costs; provided further that such rates utilize a limitation
for the variable cost allowance at the 85th percentile of 2002 base year costs;
and, provided further that the scope of the variable cost allowance include those
accounts allowed under regulations 114.2 CMR 4.05 as of July 1, 2003"
Floor Number: 759 Clerk Number: 97
NURSING HOME MEDICAID RATES:
Mr. Tisei, Mr. Lees, Mr. Knapik, Mr. Tarr, Ms. Sprague,
and Mr. Brown move to amend the bill in section 281 by adding at the end thereof
the following new paragraph:-
(b) Notwithstanding any general or special law or regulation
to the contrary, the division of health care finance and policy shall in calculating
Medicaid occupancy rates include Massachusetts Commission for the Blind patients.
Floor Number: 760 Clerk Number: 54
INTERGOVERNMENT TRANSFER-MILFORD AND OTHER PUBLIC NURSING FACILITIES
Mr. Moore moves to amend the bill by striking out section
290 and inserting in place thereof the following section:
"SECTION 290. Notwithstanding the provisions of any
general or special law to the contrary, the division of medical assistance may
expend an amount not to exceed $16,000,000 from the medical assistance intergovernmental
transfer account within the Uncompensated Care Trust Fund for Title XIX payments
to certain publicly owned or publicly operated providers. The payments shall be
established in accordance with Title XIX of the federal Social Security Act, or
any successor federal statute, any regulations promulgated thereunder, the Commonwealth's
Title XIX state plan and the terms and conditions of agreements reached with the
division for such payments. No funds shall be expended unless a public entity
is legally obligated to make an intergovernmental funds transfer in an amount
specified in an agreement with such entity, which amount shall not be less than
50 per cent of the Title XIX payment. All revenues generated pursuant to the provisions
of this section shall be credited to the medical assistance intergovernmental
transfer account and administered in accordance with the provisions of subsection
(o) of section 18 of chapter 118G of the General Laws."
Floor Number: 761 Clerk Number: 8
THE COMMUNITY HEALTH CENTER IN CAPE COD
Mr. O'Leary moves to amend the bill by inserting in Section 295, at the end of the second sentence after the words "Massachusetts Hospital Association" the following:-
"; provided that the secretary shall provide a $200,000 one-time grant from said fund to a community health center serving the full range of the underserved population in the town of Barnstable and further serving the dental needs of all the underserved population throughout the mid-cape area."
Floor Number: 762 Clerk Number: 16
ESSENTIAL COMMUNITY PROVIDER EXPENDABLE TRUST FUND
Mr. O'Leary moves to amend the bill by inserting, in Section 295 at the end of the second sentence after the words "Massachusetts Hospital Association" the following:-
"; provided that said secretary shall provide a $750,000 one-time grant from said fund for a sole community hospital under the Medicare program located in Barnstable county."
Floor Number: 763 Clerk Number: 84
ESSENTIAL COMMUNITY PROVIDER FUND:
Mr. Tisei moves to amend the bill in Section 295 by inserting
after the words "Massachusetts Hospital Association" the following:-
", provided that said secretary shall provide a $250,000 one-time grant from
said fund for an acute care hospital serving the Melrose and Wakefield communities
that operates a family health service clinic."
Floor Number: 764 Clerk Number: 104
RELATIVE TO THE ESSENTIAL COMMUNITY PROVIDER TRUST FUND
Mr. Montigny moves to amend the bill, S 2400, in section
295, by inserting at the end of the second sentence, after the words Massachusetts
Hospital Association, the following:-
; provided that,
the secretary of shall make available from said fund, $750,000 for a non-teaching,
community, disproportionate share, acute care hospital located in Southeastern
Massachusetts, which provides impatient care to over 5,000 Mass Health or Mass
Health HMO patients per year.
FLOOR NUMBER: 765 CLERK NUMBER: 165
ESSENTIAL COMMUNITY PROVIDER EXPENDABLE TRUST FUND
Senator Hart of Boston moves to amend the bill, in Section 295 by inserting after the first sentence the following sentence: "Furthermore, the secretary of health and human services shall make available from said fund $5,500,000 in a one-time grant for a disproportionate share financially distressed community hospital located in Suffolk County with a locked inpatient adolescent psychiatric unit that participates in the MassHealth program."
Floor Number: 766 Clerk Number: 197
VISITING NURSE ASSOCIATION SERVING SUFFOLK COUNTY
Mr. Hart of Boston moves that the bill be amended in section 295 by inserting at the end of the second sentence after the words "Massachusetts Hospital Association" the following:
", provided that a non-profit visiting nurse association located in Boston, that delivers at least 30 per cent of all MassHealth reimbursed skilled nursing visits and at least 50 per cent of all MassHealth reimbursed home health aide services in Suffolk county, shall receive $750,000 from said fund."
Floor Number: 767 Clerk Number: 206
COMMUNITY HEALTH CENTERS
Mr. Hart of Boston moves to amend the bill in Section 295, by inserting after the word "fund", in line 15, the words: "Not withstanding the provisions of any general or special law to the contrary, said secretary shall make available from said fund $400,000 in a one time grant for a community health center located in South Boston which operates an urgent care center and which is affiliated with the disproportionate share teaching hospital in Suffolk County with the highest volume of free care, $350,000 in a one time grant for a community health center located in the Codman Square neighborhood of Dorchester providing health care to medically underserved patients in Dorchester, who has formed an integrated health services network to provide access to primary and preventive public health services; $350,000 in a one time grant for a community health center located near the Fields Corner neighborhood of Dorchester, on Dorchester Avenue, providing health care to medically underserved patients in Dorchester, who has formed an integrated health services network to provide access to primary and preventive public health services; and $400,000 in a one time grant for a community health center with at least three sites serving the medically undeserved areas of Dorchester and South Boston, including at least one public housing project.
Floor Number: 768 Clerk Number: 208
ESSEX COUNTY FAMILY PRACTICE RESIDENCY
Ms. Tucker moves to amend the bill in Section 295, in line 9, by adding after the words "Massachusetts Hospital Association" the following words;- "Said Secretary shall make available from said fund $750,000 for a one-time payment to a disproportionate share hospital provider in the county formerly known as Essex County who has a family practice residency in partnership with a federally qualified community health center."
Floor Number: 769 Clerk Number: 226
ESSENTIAL COMMUNITY PROVIDER EXPENDABLE TRUST FUND
Mr. Nuciforo moves to amend the bill (S.2400) in section
295 by inserting after the words "care sites in the community." the
following:-
"Notwithstanding the provisions of any general or special
law to the contrary, the secretary of health and human services shall make available
from said fund $750,000 in one-time grant for a teaching hospital located in central
Berkshire county."
Floor Number: 770 Clerk Number: 310
ESSENTIAL COMMUNITY PROVIDER
Mr. Knapik of Westfield moves to amend the bill in Section 295 by adding the following words:- " Notwithstanding the provisions of any general or special law to the contrary, said Secretary shall make available from said fund $500,000 in a one-time grant for a hospital located in Hampden County , west of the Connecticut River with under 100 beds that participates in MassHealth."
Floor Number: 771 Clerk Number: 331
COMMUNITY HEALTH CENTERS
Mrs. Chandler moves to amend the bill, in Section 295, by
inserting at the end of the first sentence the following wording:-
", provided that $500,000 shall
be expended for a one-time grant for a community health center that serves as
a family practice residency training site for a commonwealth funded medical school
and that assumed the primary care services of the former Worcester City Hospital".
Floor Number: 772 Clerk Number: 387
ESSENTIAL COMMUNITY PROVIDER EXPENDABLE TRUST FUND AND LONG TERM ACUTE CARE HOSPITALS
Ms. Wilkerson moves to amend the bill in Section 295 by inserting after the words "Massachusetts Hospital Association" the following: --
"; provided that a not-for-profit long term acute care hospital located in Roxbury shall receive $250,000 from said Fund."
Amendment to Section 295
Rationale: Allocation from Essential Community Provider Expendable Trust Fund for Long Term Acute Care Hospital Located in Roxbury
The purpose of this section is to ensure that Jewish Memorial Hospital and Rehabilitation Center ("JMH"), an urban, non-profit long term acute care hospital serving primarily Medicaid and Medicare recipients, receives sufficient funding to enable them to continue providing services to their vulnerable patients, including a significant number of ventilator dependent persons. JMH provided more than $675,000 in unreimbursed free care in FY03 and already has provided approximately $300,000 in unreimbursed free care in FY2004.
Floor Number: 773 Clerk Number: 604
PROVIDENCE BEHAVIORAL HEALTH HOSPITAL
Mr. Lees moves to amend the bill in section 295 by adding
the following words:-
"Not less than $4,000,000 of available funds,
from said Fund, shall be made available for payment to statewide providers with
the service area of the Sisters of Providence Health System and Providence Behavioral
Health Hospital."
Floor Number: 774 Clerk Number: 738
ESSENTIAL COMMUNITY PROVIDER FUND
Mr. Berry moves to amend the bill in Section 295 by adding
at the end of the second sentence after the words "Massachusetts Hospital
Association" the following words:-
", provided that said secretary shall provide a
$500,000 one-time grant from said fund for an acute care hospital located in Gloucester
that is part of a health care system."
Floor Number: 775 Clerk Number: 747
ESSENTIAL COMMUNITY PROVIDER 2
Mr. Knapik moves that the bill be amended in Section 295 by inserting at the end of the second sentence after the words "Massachusetts Hospital Association" the following:
", provided that said secretary shall provide a $2,500,000 one-time grant from said fund for an acute care hospital located in Holyoke that is affiliated with a commonwealth-owned university medical school and that provides clinical training programs for nurses, allied health professionals and technicians through affiliations with community colleges and private universities."
Floor Number: 776 Clerk Number: 42
UNCOMPENSATED CARE TRUST FUND CREDIT
Mr. Moore moves to amend the bill, Section 296, by striking the fourth paragraph and replacing therein the following:-
"In hospital fiscal year 2005, the total surcharge liability of surcharge payers to the uncompensated care trust fund shall be $160,000,000. The surcharge amount for each surcharge payer shall be equal to the product of (a) the surcharge percentage and (b) amounts paid for services of an acute hospital or ambulatory surgical center by each surcharge payer, minus (c) any net loss incurred during the previous calendar year on operations as a MassHealth managed care organization contracted with the division of medical assistance pursuant to section 12 of chapter 118E. The division of health care finance and policy shall calculate the surcharge percentage by dividing $160,000,000 by the projected annual aggregate "payments subject to surcharge", as that phrase is defined in section 1 of chapter 118G of the General Laws. Net loss incurred during the previous calendar year on operations as a MassHealth managed care organization contracted with the division of medical assistance shall be determined based on the results of the annual financial reports submitted to the division of insurance by managed care organizations under section 10 of chapter 176G."
Floor Number: 777 Clerk Number: 70
UNCOMPENSATED CARE POOL
Mr. Moore moves to amend the bill by inserting, in Section 296, after "In addition to those 12 disproportionate share hospitals, a teaching hospital located in Hampden county with high Medicaid utilization" the following:- "and a non-profit acute care regional teaching hospital in Worcester county that is affiliated with a commonwealth-owned medical school"
Floor Number: 778 Clerk Number: 114
UNCOMPENSATED CARE POOL
Ms. Melconian and Mr. Knapik move to amend the bill by striking
out Section 296 and replacing it with the following new Section:_
"SECTION 296. Notwithstanding
any general or special law to the contrary, in hospital fiscal year 2005, the
division of health care finance and policy is authorized to administer, as provided
in this section, the Uncompensated Care Trust Fund established by section 18 of
chapter 118G of the general laws, to collect assessments as specified in section
1 of said chapter 118G for deposit to the fund, and make certain payments to acute
hospitals and community health centers from the uncompensated care pool to offset
the costs of services provided to uninsured residents. The division and the division
of medical assistance may promulgate regulations to implement any of the provisions
in this section.
The division, in consultation with the division of medical
assistance and the executive office of health and human services, shall ensure
that assessment liability to the fund and payments from the uncompensated care
pool are structured in a manner that would secure for the General Fund the maximum
allowable federal reimbursement under Title XIX, XXI or any successor federal
statute.
In hospital fiscal year 2005, the total liability of all acute care
hospitals to the fund shall be $160,000,000 and the division of health care finance
and policy shall calculate an assessment percentage rate by dividing $160,000,000
by the projected annual aggregate private sector charges in the fiscal year for
all acute care hospitals. Each acute care hospital's liability to the fund shall
be equal to the product of the percentage rate and its "private sector charges".
In hospital fiscal year 2005, the total surcharge liability of surcharge
payers to the uncompensated care trust fund shall be $160,000,000. The surcharge
amount for each surcharge payer shall be equal to the product of (a) the surcharge
percentage and (b) amounts paid for services of an acute hospital or ambulatory
surgical center by each surcharge payer. The division of health care finance and
policy shall calculate the surcharge percentage by dividing $160,000,000 by the
projected annual aggregate "payments subject to surcharge", as that
phrase is defined in section 1 of chapter 118G of the General Laws.
All title
XIX federal financial participation revenue generated by hospital payments funded
by the Uncompensated Care Trust Fund, whether the payments are made by the division
of health care finance and policy or the division of medical assistance, shall
be credited to the General Fund; provided however, that for fiscal year 2005,
the comptroller shall transfer to the Uncompensated Care Trust Fund $218,000,000
of the federal financial participation credited to the General Fund.
All
hospital payments made pursuant to this section are subject to federal approval
and conditioned on the receipt of full federal financial participation. All such
payments shall be established in accordance with Title XIX of the Social Security
Act, or any successor federal statute, any regulations promulgated thereunder
and the Commonwealth's Title XIX state plan; provided, that the division, in consultation
with the division of medical assistance, the executive office of health and human
services, the Massachusetts Hospital Association, and representatives of acute
care hospitals, shall ensure that all funding for hospital payments made pursuant
to this section through disproportionate share payments or Title XIX service rate
adjustment payments, shall qualify for federal financial participation.
The
division of health care finance and policy shall calculate an annual payment liability
from the uncompensated care pool to each acute hospital for fiscal year 2005.
In determining the liability amount, the division shall (a) ascertain each hospital's
reported unreimbursed free care costs from fiscal year 2004 and project the remaining
months of hospital fiscal year 2004 using the most recent reliable data available,
and shall also take into account such factors as available funding in the pool,
the financial burden of hospitals that provide proportionately the largest volume
of free care, medical inflation and the situation of any free-standing pediatric
hospital with a disproportionately low volume of Title XVIII payments; provided
further, that the division shall project every acute hospital's cost growth for
hospital fiscal year 2005 using a uniform growth factor determined from the prior
twelve months and projecting forwards; and (b) allocate the available funds in
a manner that pays to each hospital a fixed percentage of its projected free care
costs for hospital fiscal year 2005, as determined by the division using prior
year data and considering the total funds available for the purpose; provided
further, that the fixed percentage shall not be less than 85 per cent of free
care costs as defined in section 1 of chapter 118G of the General Laws for the
2 disproportionate share hospitals with the highest relative volume of free care
costs in hospital fiscal year 2002, and not less than 88 per cent of free care
costs, as defined under section 1 of chapter 118G of the General Laws, for the
14 acute hospitals with the next highest relative volume of free care costs in
said year. In addition to those 16 disproportionate share hospitals, a teaching
hospital located in Hampden county with high Medicaid utilization shall receive
not less than 88 per cent of its free care costs reimbursed. All other acute hospitals
shall receive the highest possible percentage of free care costs given available
remaining funds. The hospital fiscal year 2005 annual liability amount to each
hospital shall be funded by the trust fund; provided, that the liability may be
satisfied through either a disproportionate share payment or adjustment to Title
XIX service rate adjustment payment, or combination thereof, in accordance with
the terms provided for in an agreement entered into by any acute hospital and
the division of medical assistance. The comptroller shall transfer without further
appropriation funds to the division of medical assistance for the purpose of the
Title XIX service rate adjustment payments.
The division shall maximize the
use of other federally permissible funding mechanisms available for publicly-operated
hospitals and hospitals with an affiliation with a publicly-operated health care
entity to reimburse up to $70,000,000 of uncompensated care costs at the hospitals
using sources distinct from the funding made available to the trust fund under
this section.
The division shall make payments from the uncompensated care
pool for services provided by community health centers to uninsured residents
in accordance with the relevant provisions of chapter 118G, and regulations promulgated
under chapter 118G, in effect at the end of fiscal year 2004. Said division, in
consultation with the division of medical assistance, the executive office of
health and human services, and interested parties representing community health
centers, shall develop a plan and take whatever steps necessary to adjust any
or all payments made to community health centers for uncompensated care to be
paid as Title XIX service rate adjustment payments, in accordance with Title XIX
of the Social Security Act, or any successor federal statute, any regulations
promulgated thereunder. The comptroller shall transfer without further appropriation
funds determined by the division of health care finance and policy to the division
of medical assistance for the purpose of the Title XIX service rate adjustment
payments under this section. The division of health care finance and policy shall
submit a report by March 30, 2005, specifying the payments made to community health
centers for uncompensated care paid as Title XIX service rate adjustment payments
and the amount of federal reimbursement obtained and anticipated in hospital fiscal
year 2005 from such payments. Said federal reimbursement shall be deposited to
Uncompensated Care Trust Fund and be appropriated by September 30, 2005, to be
used by community health centers as provided by this paragraph and any other provider
of free care.
In hospital fiscal year 2005, $5,000,000 shall be transferred
from the uncompensated care trust fund to the division of medical assistance,
in collaboration with the division of health care finance and policy, to fund
the start-up costs associated with the design and implementation of a cost-neutral
pilot program of primary and preventive care and disease management of chronic
conditions that will reduce the costs of federally mandated emergency care and
the costs otherwise charged to the uncompensated care pool. Individuals eligible
for said pilot program shall include but not be limited to recipients of emergency
assistance for the elderly, disabled and children, elderly residents aged 65 or
older and adults under age 65 who are disabled, blind or chronically ill. The
division shall report back to the house and senate committees on ways and means
on the cost neutrality of the pilot program and data on anticipated savings to
the Uncompensated Care Pool by December 1, 2004.
In hospital fiscal year
2005, $525,000,000 from the trust fund shall be credited to the uncompensated
care pool for payments to acute hospitals provided for herein; provided, that
an amount up to $56,000,000 from the trust fund shall be credited to the pool
for payments to community health centers provided for in this section; provided
further, that $28,000,000 of said $56,000,000 payment for said community health
centers, shall come from federal financial participation monies received from
said $28,000,000 expenditure. The comptroller shall transfer, without further
appropriation, $160,000,000 from the trust fund to the division of medical assistance
for the purposes of meeting payment obligations for services provided pursuant
to section 292 of this act."
Floor Number: 779 Clerk Number: 279
PSYCHIATRIC AND SUBSTANCE ABUSE FREE CARE SERVICES
Mr. Knapik, Mr. Lees and Ms. Melconian moves to amend the
bill in Section 296 by inserting after the words "Title XIX service rate
adjustment payments" the following words:-
"In hospital fiscal year 2005, the
division of health care finance and policy shall expend $35,000,000 to reimburse
acute hospitals for psychiatric and substance abuse related free care services
rendered in emergency situations. Not less than $4,000,000 of said amount shall
be made available for a one-time payment to the Sisters of Providence Health System
Behavioral Health Network to address costs associated with the provision of mental
health services."
Floor Number: 780 Clerk Number: 418
PRIORITY ALLOCATION OF UNCOMPENSATED CARE POOL PAYMENTS TO SAFETY NET HOSPITALS
Mr. O'Leary, Mr. Knapik and Mr. Nuciforo move to amend the
bill in Section 296, clause (b) of the sixth paragraph, by striking the figure
"10" and inserting in place thereof the following figure:-
"14"
And, further in said Section 296 by inserting after the
words "with the next highest relative volume of free care costs in said
year" the following:-
"; provided further that in order to identify said 16
hospitals, the division shall rank all hospitals based on the percentage of each
hospital's free care costs divided by the total free care costs of all hospitals
in the commonwealth."
and further in said Section 296 by striking the figure "12" and inserting in place thereof the following figure:-"16".
Floor Number: 781 Clerk Number: 765
COMMUNITY HOSPITAL IN LYNN
Mr. McGee moves to amend the bill, in section 296, in paragraph
seven, by inserting after the words "a teaching hospital located in Hampden
County with high Medicaid utilization" the following words: -
"
and a community hospital located in the city of Lynn."
Floor Number: 782 Clerk Number: 55
INTERGOVERNMENTAL TRANSFER TO NEIGHBORHOOD HEALTH PLAN
Mr. Moore moves to amend the bill by adding at the end thereof
the following new Section:- SECTION________.
Notwithstanding
the provisions of any general or special law or regulation to the contrary, the
division of medical assistance may expend, subject to federal approval, an amount
not to exceed $16,000,000 from the medical assistance intergovernmental transfer
account within the medical assistance intergovernmental uncompensated care trust
fund for Title XIX payments to Neighborhood Health Plan. The payments shall be
established in accordance with Title XIX of the federal Social Security Act, or
any successor federal statute, any regulations promulgated thereunder, the Commonwealth's
Title XIX state plan, and the terms and conditions of agreements reached with
the division for such payments. No such funds shall be expended unless Neighborhood
Health Plan has executed a managed care contract with the division of medical
assistance and makes an intergovernmental funds transfer in an amount specified
in an agreement, which amount shall be not less than 50 per cent of the Title
XIX payment. All revenues generated pursuant to the provisions of this section
shall be credited to the medical assistance intergovernmental transfer account
and administered in accordance with the provisions of paragraph (o) of section
18 of chapter 118G of the General Laws.
Floor Number: 783 Clerk Number: 58
MEDICAID PROSPECTIVE PAYMENT DEMONSTRATION PROJECT
Mr. Moore moves to amend the bill by adding at the end thereof
the following new Section:- SECTION________.
Notwithstanding
the provisions of any general or special law to the contrary, the division of
medical assistance may enter into contracts with certain home health agencies
to provide home health services to medical assistance recipients. The division
may enter into such contracts with only those home health agencies that: (i) are
organized as not-for-profit entities; (2) according to the most recent agency-specific
utilization data collected from the division, delivered twenty five per cent of
MassHealth reimbursed skilled nursing visits within a county designation, and
more than 15 per cent of all MassHealth reimbursed home health aide services within
a county designation and (3) in the determination of the division, provide services
that are essential to ensure access to home health services for medical assistance
recipients. The division shall ensure that any home health agency that is a party
to any such contract shall comply with any performance measures, outcome goals,
cost effectiveness standards and other terms and conditions established by the
division. In defining a prospective payment amount under this subsection the division
shall consider each agency's specific data to determine an appropriate unit of
service and the number, type and duration of visits provided within that unit
and a general system design that provides for continued access to quality services
through appropriate adjustments based upon a clinical assessment of each patient's
needs. In addition, the department of public health shall establish procedures
to ensure appropriate access and quality of services provided under this system.
The department shall conduct an assessment of this demonstration after six months
and shall report the findings to the house and senate committees on ways and means.
Floor Number: 784 Clerk Number: 71
EMERGENCY MENTAL HEALTH DISPROPORTIONATE SHARE PAYMENTS
Mr. Moore, Ms Chandler and Ms. Resor moves to amend the bill in section _____ by adding at the end of the sixth paragraph, the following:--
, provided further that not less than $3,100,000 shall be expended for a disproportionate share teaching hospital in Worcester County for emergency mental health services.
Floor Number: 785 Clerk Number: 168
INTERGOVERNMENTAL TRANSFER
Mr. Hart of Boston moves to amend the bill by inserting,
after Section_________ the following new Section: -
"SECTION____. Notwithstanding the provisions
of any general or special law or regulation to the contrary, the division of medical
assistance may expend, subject to federal approval, an amount not to exceed $10,000,000
from the medical assistance intergovernmental transfer account within the Uncompensated
Care Trust Fund for Title XIX payments to qualifying hospitals located in the
Dorchester section of the city of Boston. The payments shall be established in
accordance with Title XIX of the federal Social Security Act, or any successor
federal statute, any regulations promulgated thereunder, the Commonwealth's Title
XIX state plan, and the terms and conditions of agreements reached with the division
for such payments. No such funds shall be expended unless said qualifying hospitals
have executed the division of medical assistance's current Acute Hospital Request
for Applications and Contract, and the Boston Public Health Commission makes an
intergovernmental funds transfer in an amount specified in an agreement, which
amount shall be not less than 50 per cent of the Title XIX payment. All revenues
generated pursuant to the provisions of this section shall be credited to the
medical assistance intergovernmental transfer account and administered in accordance
with the provisions of paragraph (o) of section 18 of chapter 118G of the General
Laws."
Floor Number: 786 Clerk Number: 261
AN AMENDMENT TO MAKE PERMANENT THE STATUTORY REVIEW OF NEW HEALTH CARE MANDATES
Mr. Tarr moves to amend the bill (Senate bill 2400) by adding,
at the end thereof, the following new section: -
"SECTION___. Chapter 300 of the acts of
2002 is hereby amended by striking sections 61 and 62.
Floor Number: 787 Clerk Number: 271
AN AMENDMENT RELATIVE TO THE UNCOMPENSATED CARE POOL
Mr. Tarr moves to amend the bill (Senate bill 2400) by adding,
at the end thereof, the following new section: -
"SECTION __. Notwithstanding the provisions of any general
or special law or regulation to the contrary, the division of health care finance
and policy shall allow Medicaid managed care organizations, and the division of
insurance shall require all non-profit entities licensed pursuant to G.L. c. 176
G, to submit one or more proposals to the division of health care finance and
policy for the management of health care services for up to 100,000 individuals
eligible for free care whom the division of health care finance and policy determines
to be higher cost users of the uncompensated care pool. The secretary of health
and human services shall first make a recommendation to the house and senate committees
on ways and means, by not later than November 1, 2004, as to the payment mechanism
and methodology for said managed care organizations and for hospitals treating
patients under such pilot program, including without limitation the use of the
Center Care program, risk based contracts, negotiated fee for service arrangements,
case management fees, pharmacy benefits management, prior authorization services,
or combination thereof. Said committees shall have thirty days to approve such
recommendation after which time final details of the payment structure shall be
disseminated to the managed care organizations for use in developing their proposals
for the management of said free care population. Said proposals shall be submitted
by to the division of health care finance and policy by no later than January
1, 2005. The division shall review all proposals and by no later than February
1, 2005, shall issue a competitive procurement for one or more contracts for the
pilot, to be effective April 1, 2005. Hospitals providing services to persons
whose care is being managed under a contract hereunder shall be required to report
data on such persons, including service and billing information, to the division
and to the contractor managing their care. The division shall collect and analyze
data concerning the quality and cost-effectiveness of managed free care under
contracts hereunder and the effect on utilization of the uncompensated care pool.
The results of this evaluation shall be reported by the division to the house
and senate committees on ways and means and the executive office of administration
and finance, with an initial report due no later than December 1, 2005."
Floor Number: 788 Clerk Number: 274
AN AMENDMENT RELATIVE TO THE UNCOMPENSATED CARE POOL SHORTFALL
Mr. Tarr moves to amend the bill (Senate bill 2400) by adding,
at the end thereof, the following new section: -
"Notwithstanding the provisions of any general
or special law or regulation to the contrary, the division of health care finance
and policy, in consultation with the division of insurance and the office of the
attorney general, shall promulgate regulations requiring surcharge payers to set
aside a percentage, not to exceed 5%, of their net revenues to be used as a dedicated
reserve for the purpose of reducing shortfalls in the uncompensated care trust
fund, said percentage to be determined annually by said division."
Floor Number: 789 Clerk Number: 284
HOLYOKE MEDICAL CENTER INTERGOVERNMENTAL TRANSFER
Mr. Knapik, Mr. Lees, Mr. Rosenberg and Ms. Melconian moves
to amend the bill after Section _____ by inserting the following new Sections:-
"SECTION . Notwithstanding the provisions of any general
or special law or regulation to the contrary, the division of medical assistance
may expend, subject to federal approval, an amount not to exceed $10,000,000 from
the medical assistance intergovernmental transfer account within the Uncompensated
Care Trust Fund for Title XIX payments to the Holyoke Medical Center. The payments
shall be established in accordance with Title XIX of the federal Social Security
Act, or any successor federal statute, any regulations promulgated thereunder,
the Commonwealth's Title XIX state plan, and the terms and conditions of agreements
reached with the division for such payments. No such funds shall be expended unless
the Holyoke Medical Center has executed the division of medical assistance's current
Acute Hospital Request for Applications and Contract, and the City of Holyoke
makes an intergovernmental funds transfer in an amount specified in an agreement,
which amount shall be not less than 50 per cent of the Title XIX payment. All
revenues generated pursuant to the provisions of this section shall be credited
to the medical assistance intergovernmental transfer account and administered
in accordance with the provisions of paragraph (o) of section 18 of chapter 118G
of the General Laws.
SECTION . Notwithstanding the provisions of any general
or special law or regulation to the contrary, for the purpose of qualification
as an essential MassHealth hospital, teaching hospitals affiliated with a commonwealth-owned
university medical school shall include hospitals with such affiliation that (i)
have at least 25 full time equivalent residents and interns, or (ii) provide clinical
training programs for nurses and allied health professionals and technicians through
affiliations with community colleges and private universities.
Floor Number: 790 Clerk Number: 425
TO INCREASE MASSHEALTH REIMBURSEMENT RATE FOR CRITICAL ACCESS HOSPITALS
Mr. O'Leary and Mr. Nuciforo move to amend the bill by inserting,
after Section 362, the following new Section:-
"Section___. Notwithstanding any general or special law
or regulation to the contrary, MassHealth payments to hospitals designated as
critical access hospitals under the federal Medicare rural hospital flexibility
program and by the massachusetts department of public health shall be funded under
line item 4000-0300, shall be based on the actual cost of provided services, and
shall be calculated utilizing Medicare cost reporting principles."
Floor Number: 791 Clerk Number: 733
INTERGOVERNMENTAL TRANSFER OF FUNDS FOR QUINCY MEDICAL CENTER AND THE CITY OF QUINCY
Mr. Morrissey moves to amend the bill by inserting after section 353 the following new section:-
SECTION ____. Notwithstanding the provisions of any general or special law or regulation to the contrary, the division of medical assistance may expend, subject to federal approval, an amount not to exceed $90,000,000 from the medical assistance intergovernmental transfer account within the Uncompensated Care Trust Fund for title XIX payments to the Quincy Medical Center. The payments shall be established in accordance with Title XIX of the federal Social Security Act, or any successor federal statute, any regulations promulgated thereunder, the commonwealth's Title XIX state plan, and the terms and conditions of agreements reached with the division for such payments. No such funds shall be expended unless the Quincy Medical Center has executed the division of medical assistance's current Acute Hospital Request for Applications and Contract, and the City of Quincy makes an intergovernmental funds transfer in the amount specified in an agreement, which amount shall be not less than 50 per cent of the Title XIX payment. No such funds shall be expended by Quincy Medical Center unless the Quincy Medical Center repays the state loan pursuant to chapter 101 of the acts of 1999. All revenues generated pursuant to the provisions of this section shall be credited to the medical assistance intergovernmental transfer account and administered in accordance with the provisions of paragraph (o) of section 18 of chapter 118G of the General Laws.
Floor Number: 792 Clerk Number: 322
ESSENTIAL COMMUNITY PROVIDER TRUST
Mr. Brewer moves to amend the bill, in Section 295, by adding
the following words:-
"Said secretary shall make available from
said fund $1,000,000 in a one-time grant for a hospital that is a member of the
UMass Memorial Health Care system located in Hampden County with less than 50
licensed beds; and $1,000,000 in a one-time grant for a community hospital located
in Hampshire County with an affiliation with a teaching hospital located in Hampden
County"
Floor Number: 793 Clerk Number: 564
MASSHEALTH ESSENTIAL
Mr. Creedon moves to amend the bill, Senate 2400, in section
295 at the end of the second sentence after the words "Massachusetts Hospital
Association" the following:
"that the Secretary shall provide $750,000 one-time grant from said fund
to a disproportionate shore acute care hospital located in Southeastern Massachusetts
division of the medical assistance psychiatric service area that operates an
impatient psychiatric unit within the City of Brockton."