CTION 1.
SECTION 2.
SECTION 3.
SECTION
4. Section 51 of chapter 7 of the General
Laws, as so appearing in the 2002 Official Edition, is hereby repealed.
SECTION 5.
Section 9 of chapter 15A of the
General Laws, as most recently amended by section 52 of chapter 26 of the acts
of 2003, is hereby further amended by adding the following paragraph:— Notwithstanding
any general or special law to the contrary, for the purpose of determining
eligibility for in-state tuition rates and fees at public institutions of
higher education, except the University of Massachusetts Medical School, an
individual, other than a non-immigrant alien within the meaning of paragraph 15
of subsection (a) of Section 1101 of Title 8 of the United States Code, who has
attended high school in the commonwealth for 3 or more years and has achieved
graduation from a high school in the commonwealth or attained the equivalent
thereof, shall be eligible for in-state tuition rates and fees at the
University of Massachusetts, or any state or community college in the
commonwealth. No person qualified for in-state tuition rates and fees under
this chapter shall be denied such in-state tuition and fees upon the granting
of eligibility under this paragraph; but, in the case of an individual who is
not a citizen or permanent resident of the United States, the individual shall
provide the University of Massachusetts, or the state or community college with
an affidavit stating that the individual has filed an application to become a
citizen or permanent resident of the United States, or shall file an
application at the earliest opportunity the individual is eligible to do so.
SECTION
6. Chapter 75 of the
General Laws, as so appearing, is hereby amended by inserting after section 45
the following section:—
Section 46. There shall be at the
Said office of dispute resolution shall be
available to assist agencies and offices of the executive, legislative, and
judicial branches of the commonwealth, as well as any political subdivision or
public instrumentality created by the commonwealth or any county, city, or
town, hereafter referred to as public agencies, to improve the resolution of
disputes that arise within their respective jurisdictions. Said office is
authorized to (a) facilitate the resolution of disputes through provision of
impartial mediation and other dispute resolution services; (b) establish
standards for the selection, assignment, and conduct of persons acting on behalf
of said office in the resolution of disputes; (c) conduct educational programs
and provide other services designed to reduce the occurrence, scope,
complexity, or cost of disputes; (d) design, develop, or operate dispute
resolution programs or to assist public agencies to improve or extend their
existing dispute resolution programs; and (e) take such other action as will
promote and facilitate dispute resolution by public agencies in the
commonwealth. The director may establish
reasonable fees to be charged to parties, litigants, or public agencies for the
provision of the educational, consultation, dispute resolution, or other
services authorized herein and may apply for and accept on behalf of the
commonwealth any federal, local, or private grants, bequests, gifts, or
contributions to aid in the financing of any of the programs or activities of
the office. Such fees, grants, bequests, gifts, or contributions shall be
received by the University of Massachusetts at Boston and deposited in a separate
account and shall be expended, without further appropriation, at the direction
of the director, with the approval of the provost, for the cost of operation of
the office, including personnel. The office
may make agreements with public agencies and officers and may contract with
other persons, including private agencies, corporations, or associations, to
carry out any of the functions and purposes of this section.
The office shall prepare annually a report on the
activities of the office, including all income and expenditures, and shall file
said report with the house and senate committees on ways and means on or before
December 31 of each year.
SECTION
7. Section 47 of chapter 94C of the General
Laws, as appearing in the 2002 Official Edition, is hereby amended by striking
out the paragraph starting at line 116 through and including line 122, and
inserting in place thereof the following:—
The final order of the court shall
provide that said moneys and the proceeds of any such sale shall be distributed
to the commonwealth. The office of the
state treasurer shall direct thirty-three percent of said moneys and proceeds
to the prosecuting district attorney or attorney general, thirty-three percent
of said moneys and proceedings to the city, town or state police department
involved in the seizure and the remaining portion of said moneys and proceeds
shall be deposited into the general fund.
SECTION 8. Section 39C of chapter
112 of the General Laws, as inserted by section 306 of chapter 26 of the acts
of 2003, is hereby amended by inserting after the first sentence the following
sentence:—Such entities shall be deemed retail pharmacies and not providers of
institutional, residential, or long-term care services.
SECTION 9. Section 18 of chapter
118G, as appearing in the 2002 Official Edition, is hereby amended by striking
out subsection (o), and inserting in place thereof the following subsection:—
(o) Within the Uncompensated Care Trust Fund,
there shall be established a medical assistance account, administered by the
secretary of the executive office of health and human services, consisting of
any funds directed to the commonwealth from public entities, and federal
reimbursements related to medical assistance payments funded by this account.
All amounts credited to this account shall be held in trust and shall be
available for expenditure by the secretary of the executive office of health
and human services to be used for medical assistance payments to entities
authorized by the general court, and for which a public entity has
contractually agreed to direct funds to said account; provided, however, that
any amount in excess of such medical assistance payments may be credited to the
General Fund; provided, further, that the amount of all such expenditures shall
be subject to annual approval by the general court. The maximum payments from
said account shall not exceed those permissible for federal reimbursement under
Title XIX or Title XXI of the Social Security Act or any successor federal
statute. The comptroller may make payments, including payments during the
accounts payable period, in anticipation of revenues, including receivables due
and collectibles during the months of July and August, and shall establish
procedures for reconciling overpayments or underpayments from said account;
provided, that said procedures shall include, but not be limited to,
appropriate mechanisms for refunding public funds directed to this account and
federal reimbursements upon recoupment of any such overpayments. The executive
office of health and human services shall ensure that the division of health
care finance and policy is informed regarding revenue and expenditure activity
within said account and submit to the secretary of administration and finance
and the house and senate committees on ways and means a schedule of said
payments ten days prior to any expenditures, and no funds shall be expended
without an enforceable agreement with or legal obligation imposed upon a public
entity to make an intergovernmental transfer in an appropriate amount to said
account.
SECTION
10. Chapter 175 of the acts of 1998 is hereby
amended by striking out section 25 and inserting in place thereof the following
section:—
Section
25. Sections 3A, 20A, and 21A of this act shall take effect on December 31,
2008.
SECTION
11. Chapter 141 of the acts of 2003 is hereby
amended by striking out section 79 and inserting in place thereof the following
section:—
Section
79. Section 11 of this act shall take effect on December 31, 2008.
SECTION 12. Notwithstanding any
general or special law to the contrary, the office of the secretary of the
commonwealth shall assign title 130 of the code of Massachusetts regulations to
the executive office of health and human services in recognition of the
designation of such executive office, under section 16 of chapter 6A of the
General Laws, as the single state agency authorized to supervise and administer
the state programs under Titles XIX and XXI of the Social Security Act.
SECTION 13. Notwithstanding the
provisions of any general or special law to the contrary, the executive office
of health and human services, pursuant to section 16 of chapter 6A of the General
Laws, acting in its capacity as the single state agency under Title XIX of the
Social Security Act, and other federally assisted programs administered by said
secretariat, and as the principal agency for all of the agencies within the
secretariat, is authorized to enter into interdepartmental services agreements
with the University of Massachusetts medical school to perform such activities
as the secretary, in consultation with the comptroller, determines are
appropriate and within the scope of the proper administration of said Title XIX
and other federal funding provisions to otherwise support the programs and
activities of the executive office. Such activities shall include: (1)
provision of administrative services, including, but not limited to, activities
such as providing the medical expertise to support or administer utilization
management activities, determining eligibility based on disability, supporting
case management activities, and similar initiatives; (2) consulting services
related to quality assurance, program evaluation and development, integrity and
soundness, and project management; and (3) activities and services for the
purpose of pursuing federal reimbursement or avoiding costs, third party
liability, and recouping payments to third parties. Federal reimbursement for
any expenditures made by the
SECTION 14. Notwithstanding any
general or special law to the contrary, state agencies and direct and
subcontracted providers of health-related services, including
purchase-of-service providers financed from appropriation items for any state
agency, shall maximize Title XIX and all other federal, state, and private
health insurance coverage available to offset costs to the commonwealth. The
agencies or providers shall collect information from clients, or from the
parent or guardian of a minor receiving services, necessary to determine the
extent to which clients may be eligible for medical assistance benefits under
chapter 118E of the General Laws or are beneficiaries of any health insurance
policy. The agencies or providers shall forward client information collected
under this section to the executive office of health and human services and
such data shall only be used to match against available databases for the
purpose of identifying all sources of potential payment for health services or
health insurance coverage. As required or permitted by federal law, the
executive office of health and human services shall return the results of any
such data matches to the originating agency, which shall take the appropriate
action to ensure that costs to the commonwealth are minimized. Such actions
shall include, but not be limited to, the agency or provider billing or
re-billing all verified third-party sources. The executive office of
administration and finance may grant an agency or provider an exemption from
this section for good cause. The executive office of health and human services
and the division of procurement within the executive office of administration
and finance shall review regulations, contracting forms, service delivery
reports, and uniform financial reporting requirements to determine what changes
are necessary for the successful implementation of this section.
SECTION 15. Notwithstanding any
special or general law to the contrary, the executive office of health and
human services may promulgate regulations allowing any dentist participating in
the MassHealth program to limit the number of MassHealth patients in his or her
practice in accordance with standards or procedures to be established by the
executive office of health and human services.
SECTION
16. Notwithstanding any general or special law
to the contrary, expenditures from the Distressed Provider Expendable Trust
Fund shall be dedicated to efforts that are designed to improve and enhance the
ability of distressed community providers to serve populations in need more
efficiently and effectively, including, but not limited to, the ability to provide
community-based care, clinical support and care coordination services, pharmacy
management services or other efforts to create effective coordination between
hospital care and ambulatory care sites in the community. The secretary of the executive office of
health and human services shall file a report not later than November 1, 2005
to the speaker of the house of representatives, the president of the senate and
the house and senate committees on ways and means describing the providers
funded or to be funded during fiscal year 2006, the amount expended or to be
expended for each provider pursuant to this section, and the extent to which
any portion of such expenditures are eligible for federal reimbursement. Any federal reimbursements received by the commonwealth
for expenditures made from the fund shall be deposited into said fund.
SECTION 17. Notwithstanding any
general or special law to the contrary, the department of mental health, the
department of public health, the executive office of health and human services,
as the single state agency responsible for administering the Medicaid program
under Title XIX of the Social Security Act, and the division of health care
finance and policy shall take appropriate action to obtain the maximum amount
of federal financial participation available for amounts paid for low-income
care costs at those mental health and public health facilities determined to be
disproportionate share hospitals in accordance with requirements of Title XIX
of the Social Security Act. Such appropriate action may include, but shall not
be limited to, the establishment of a separate account within the Uncompensated
Care Trust Fund, established by section 18 of chapter 118G of the General Laws,
for the purpose of making disproportionate share payment adjustments to such
qualifying mental health and public health facilities under relevant division
of health care finance and policy regulations and the Title XIX state plan on
file with the Centers for Medicare and Medicaid Services. The executive office
of health and human services, the department of public health, and the
department of mental health may expend amounts transferred to them from such
separate account within the Uncompensated Care Trust Fund without further
appropriation. Any federal funds obtained as a result of actions taken pursuant
to this section shall be deposited in the General Fund. The state treasurer and
the comptroller shall establish such procedures as may be necessary to
accomplish the purpose of this section, including procedures for the proper
accounting and expenditure of funds under this section.
SECTION 18. Notwithstanding any
general or special law to the contrary, during fiscal year 2006 the executive
office of health and human services may expend from the medical assistance
intergovernmental transfer account within the Uncompensated Care Trust Fund an
amount not to exceed the actual amount paid for fiscal year 2005 for a program
of MassHealth supplemental payments to certain publicly operated entities
providing Title XIX reimbursable services, directly or through contracts with
hospitals under an agreement with the executive office of health and human
services, relating to such payments and transfers as established in accordance
with Title XIX of the Social Security Act or federal waivers thereof, federal
regulations promulgated thereunder, the terms of the waiver under section 1115
of the Social Security Act, state law, and the Medicaid state plan. The funds
may be expended only for payment obligations arising during fiscal year 2006.
Such expenditures shall reduce payments from the Uncompensated Care Trust Fund
to such entities by an amount comparable to the net revenues received by such
entities under this section. The executive office of health and human services
shall notify the house and senate committees on ways and means if such
expenditures are rendered ineligible for federal reimbursement. All
expenditures made pursuant to this section shall be reported quarterly to the
house and senate committees on ways and means. Amounts so authorized for said
expenditure shall be funded in part through intergovernmental transfers to the
commonwealth of municipal or other non-federal public funds. The Boston public
health commission and the Cambridge public health commission shall transfer to
said medical assistance intergovernmental transfer account an amount not less
than 55 per cent of the gross amounts of supplemental payments made by the
executive office of health and human services under managed care contracts with
the commissions. An amount equal to 9.09 per cent of the total amount that the
Boston and Cambridge public health commissions transfer to the medical
assistance intergovernmental transfer account pursuant to this section shall be
transferred from the medical assistance intergovernmental transfer account and
credited to the Distressed Provider Expendable Trust Fund, established
pursuant to chapter 241 of the acts of 2004.
SECTION 19. Notwithstanding the
provisions of any general or special law to the contrary, the executive office
of health and human services and the division of health care finance and policy
shall take any appropriate action to obtain the maximum amount of federal
financial participation available for amounts paid to hospitals, determined by
the division to be disproportionate share hospitals in accordance with Title
XIX requirements, for low income care costs of such hospitals. Such appropriate
action may include, but shall not be limited to, the assessment on hospitals
for their liability to the uncompensated care pool pursuant to chapter 118G of
the General Laws. Such appropriate action shall include the establishment or
renewal of an interdepartmental services agreement between the executive office
and the division which may authorize the division to make deposits into and
payments from an account established for the purposes of this section within
the Uncompensated Care Trust Fund, established by section 18 of said chapter
118G, or authorize the division to transfer uncompensated care fee revenue
collected from hospitals pursuant to said chapter 118G or funds otherwise made
available to said trust fund by the general court, to the executive office for
the purposes of making disproportionate share adjustment payments to hospitals
qualifying for such payments in accordance with the commonwealth's Title XIX
state plan and relevant provisions of Title XIX. The executive office may
expend amounts transferred to it from the Uncompensated Care Trust Fund by the
division under such interdepartmental services agreement without further
appropriation. In no event shall the amount of money assessed upon each
hospital exceed the hospital's gross liability to the uncompensated care trust
fund as determined by the division of health care finance and policy pursuant
to said section 18 of said chapter 118G. Any federal funds obtained as a result
of said actions shall be deposited into the General Fund. The offices of the
state treasurer and the comptroller shall establish such procedures as may be
necessary to accomplish the purpose of this section, including procedures to
facilitate the expeditious assessment, collection, and expenditure of funds
pursuant to this section.
SECTION 20. Notwithstanding any
general or special law to the contrary, in hospital fiscal year 2006, the
division of health care finance and policy may 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 or low income residents.
Said division and the executive office of health and human services may
promulgate regulations to implement this section.
The
division, in consultation with the executive office, 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
law.
In
hospital fiscal year 2006, the total liability of all acute care hospitals to
the fund shall be $160,000,000. The
division 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 2006, 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 shall calculate
the surcharge percentage by dividing $160,000,000 by the projected annual
aggregate payments subject to surcharge, as defined in said section 1 of said
chapter 118G.
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 or the executive office, shall be credited to the General
Fund.
All
hospital payments made pursuant to this section shall be 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 law, any regulations
promulgated thereunder, and the commonwealth's Title XIX state plan.
The
division shall calculate an annual payment liability from the uncompensated
care pool to each acute care hospital for fiscal year 2006. In determining the
liability amount, the division shall (a):
(1)
calculate each hospital's actual free care cost for the 12-month period from
October 1, 2003 to September 30, 2004 by using each hospital's actual submitted
free care charges to the division on the UC-04 times its ratio of costs to
charges for pool fiscal year 2004;
(2)
project each hospital's free care costs above for Pool Fiscal Year 2005 by
using a cost growth factor of 7.6 per cent;
(3)
project each hospital's total free care costs for pool fiscal year 2006 by
multiplying each hospital's pool fiscal year 2005 projected free care costs from
subclause (2) by a cost growth factor of 7.6 per cent; and
(4)
take into account such factors as the financial burden of hospitals that
provide proportionately the largest volume of free care and the situation of
any free-standing pediatric hospital with a disproportionately low volume of
Title XVIII payments; 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 2006, as
determined by the division using prior year data and considering the total
funds available for the purpose; provided, however, that the fixed percentage
shall not be less than 85 per cent of free care costs as defined in said
section 1 of said chapter 118G for the two disproportionate share hospitals
with the highest relative volume of free care costs in hospital fiscal year
2003, and not less than 88 per cent of free care costs, as defined in said
section 1 of said chapter 118G, for the 14 acute hospitals with the next
highest relative volume of free care costs in that year; 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. All other acute care
hospitals shall receive the highest possible percentage of free care costs
given available remaining funds. The hospital fiscal year 2006 annual liability
amount to each hospital shall be funded by the trust fund; provided, however,
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 an acute care hospital and the executive office. The
comptroller, in consultation with the division and the executive office, shall
transfer funds from the trust fund to the executive office for the purpose of
the Title XIX service rate adjustment payments.
The
executive office may use 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
executive office shall make payments from the uncompensated care pool for
services provided by community health centers to low income residents. The
executive office shall structure such payments to maximize allowable federal
reimbursement under Title XIX. Pursuant to section 117 of chapter 140 of the
Acts of 2003, all Title XIX federal financial participation revenue generated
by community health center payments funded by the Uncompensated Care Trust
Fund, whether the payments are made by the division or the executive office,
shall be retained in a separate account within the Uncompensated Care Trust
Fund and expended, without further appropriation, for uncompensated care pool
payments to community health centers, in addition to the amount specified in
the following paragraph.
In
hospital fiscal year 2006, $380,000,000 from the trust fund shall be credited
to the uncompensated care pool for payments to acute hospitals provided for
herein. In addition to the federal financial participation to be retained in,
and expended from, the trust fund for community health centers pursuant to the
preceding paragraph of this section, $56,000,000 from the trust fund shall be
credited to the pool for payments to community health centers provided for in
this section; and $4,000,000 shall be credited for administrative expenses,
including demonstration projects pursuant to sections 21 and 22 of chapter 47
of the acts of 1997, as amended by sections 156, 157, and 158 of chapter 184 of
the acts of 2002.
In hospital
fiscal year 2006, the office of the inspector general is hereby authorized to
continue to expend funds appropriated in chapter 240 of the acts of 2004 from
the Uncompensated Care Trust Fund for the costs associated with maintaining a
pool audit unit within said office. The unit shall continue to oversee and
examine the practices in emergency rooms of all
SECTION 21. Notwithstanding any general or
special law to the contrary, in fiscal year 2006, the division of health care
finance and policy, herein after referred to as the division, shall establish
nursing facility Medicaid rates, payable out of the Health Care Quality
Improvement Trust Fund, established under section 2EEE of chapter 29 of the
General Laws, effective July 1, 2005 through June 30, 2006 that cumulatively
total $288,500,000 more than the annual payment rates established by the
division under the rates in effect as of June 30, 2002, as mandated under
section 1 of chapter 42 of the acts of 2003.
The division shall adjust per diem rates to reflect any reductions in
medicaid utilization. Payments from the
fund shall be allocated in the following manner in fiscal year 2006:
(1) effective
July 1, 2005, an annual amount of $99,000,000 in the aggregate to fund the use
of 2000 base year cost information for rate determination purposes; provided, that $9,000,000 of said amount
shall be expended for purposes of reimbursing nursing facilities for up to ten
bed hold days for patients of the facility on medical leaves of absence;
(2) effective
July 1, 2005, an annual amount of $122,500,000 for enhanced payment rates to
nursing homes;
(3) effective
July 1, 2005, an annual amount of $50,000,000 to fund a rate add-on for wages,
hours and benefits and related employee costs of direct care staff of nursing
homes. As a condition for such rate add-on, the division shall require that
each nursing home document to the division that such funds are spent only on
direct care staff by increasing the wages, hours and benefits of direct care
staff, increasing the facility’s staff-to-patient ratio, or by demonstrably
improving the facility’s recruitment and retention of nursing staff to provide
quality care, which shall include expenditure of funds for nursing facilities
which document actual nursing spending that is higher than the median nursing
cost per management minute in the base year used to calculate Medicaid nursing
facility rates. A facility’s direct care staff shall include any and all
nursing personnel including registered nurses, licensed practical nurses, and
certified nurses’ aides hired by the facility from any temporary nursing agency
or nursing pool registered with the department of public health. The division
shall credit wage increases that are over and above any previously collectively
bargained for wage increases. In monitoring compliance for this rate add-on,
the division’s regulations shall adjust any spending compliance test to reflect
any Medicaid nursing facility payment reductions, including, but not limited
to, rate reductions imposed on or after October 1, 2002. The expenditure of these funds shall be
subject to audit by the division in consultation with the department of public
health and said executive office. In implementing this section, the division shall
consult with the Nursing Home Advisory Council;
(4) effective
July 1, 2005, an annual amount of $17,000,000 to fund rate adjustments for
reasonable capital expenditures by nursing homes, giving priority to nursing
homes located or constructed in under-bedded areas as determined by said
executive office, in consultation with the division of health care finance and
policy, that meet quality standards established by said executive office in
conjunction with the department of public health and the division for the
purposes of encouraging the upgrading and maintenance of quality of care in
nursing homes, and to fund rate adjustments to eligible nursing homes that meet
utilization standards established by said executive office in consultation with
the division for the purpose of reducing unnecessary nursing home admissions
and facilitating the return of nursing home residents to non-institutional
settings;
(5) $300,000 for
the purposes of an audit of funds distributed pursuant to clause (3). The
division, in consultation with the department of public health and with the
assistance of said executive office, shall establish penalties sufficient to
deter noncompliance to be imposed against any facility that expends any or all
monies in violation of clause (3), including but not limited to recoupment,
assessment of fines or interest. The division shall report to the house and
senate committees on ways and means not later than October 1, 2006 a
preliminary analysis of funds expended pursuant to clause (3) in fiscal year
2006 and a description and timeline for auditing of these funds;
(6) $250,000 to
fund expenses at the division related to the implementation and administration
of section 25 of chapter 118G of the General Laws;
(7) an amount
sufficient to implement the provisions of section 622 of chapter 151 of the
acts of 1996;
The comptroller
shall transfer from the Health Care Security Trust Fund to the Health Care
Quality Improvement Trust Fund on the first business day of each quarter, the
amount indicated by the division and said executive office to provide the
appropriate rate increases to nursing homes; and provided further, that any
additional funds that may become available in the Trust due to decreased
Medicaid utilization shall be spent on further enhanced rates, including, but
not limited to, a per-diem rate add-on for large medicaid providers as
specified in 114.2 CMR 6.00 (10) (a) as in effect on September 1, 2003.
SECTION 22. Notwithstanding any general
or special law to the contrary, in order to maintain the fiscal viability of
the subsidized catastrophic prescription drug insurance program, hereinafter
referred to as the "prescription advantage program", authorized by
section 39 of chapter 19A of the General Laws, cost sharing required of enrollees
in the form of co-payments, premiums, and deductibles, or any combination
thereof, shall be adjusted by the department of elder affairs to reflect price
trends for outpatient prescription drugs, as determined by the secretary of
elder affairs. Beginning January 1, 2006, in
addition to the eligibility requirements set forth in said section 39 of
chapter 19A, to be considered eligible for the prescription advantage program,
individuals who receive Medicare and are applying for, or are then enrolled in,
the prescription advantage program shall also be enrolled in a Medicare Part D
plan, or in a Medicare Advantage plan if that plan provides prescription drug
benefits equivalent to or better than Medicare Part D. In addition to the
eligibility requirements set forth in section 39 of chapter 19A, to be
considered eligible for the prescription advantage program, individuals who
receive Medicare and are applying for, or are then enrolled in, the
prescription advantage program, who may qualify for the low-income subsidy,
so-called, provided under the Medicare Prescription Drug, Improvement and
Modernization Act of 2003, hereinafter referred to as "MMA", Subpart
P - Premiums and cost-sharing subsidies for low-income individuals shall apply
for those subsidies. To the extent permitted by MMA and regulations promulgated
thereunder, and all other applicable federal law, the prescription advantage
program may apply on behalf of a member for enrollment into a Medicare Part D
plan or for the low-income subsidy provided under MMA.
Beginning January 1, 2006, for enrollees who qualify for Medicare
Part D, the prescription advantage program will provide a supplemental source
of financial assistance for prescription drug costs, hereinafter referred to as
"supplemental assistance" in lieu, of the catastrophic prescription
drug coverage provided pursuant to said section 39 of chapter 19A. The
prescription advantage program will provide supplemental assistance for
premiums, deductibles, payments, and co-payments required by the Part D plan or
Medicare Advantage plan. The department shall establish the amount of the
supplemental assistance it will provide enrollees based on a sliding income
scale and the coverage provided by the enrollees’ Part D or Medicare Advantage
plan. Residents of the commonwealth who are not eligible for Medicare will
continue to be eligible for the prescription advantage program pursuant to said
section 39 of chapter 19A.
SECTION 23. Notwithstanding any general or special law to the contrary,
the board of trustees for the
Notwithstanding any general
or special law to the contrary, for employees of public higher education
institutions who are paid from tuition retained pursuant to this section,
fringe benefits shall be funded as if those employees’ salaries were supported
by state appropriations. This section shall apply only to fringe benefits
associated with salaries paid from tuition retained by the boards of trustees
of public higher education institutions as a direct result of the implementation
of this section.
SECTION 24. Notwithstanding any
general or special law to the contrary, the comptroller shall, in consultation
with the office of the state treasurer, the executive office for administration
and finance, and the executive office of health and human services, develop a
schedule for making a series of transfers not to exceed $85,900,000 from the
General Fund to the Uncompensated Care Trust Fund for the purpose of making
revenues available for the administration of the uncompensated care pool,
established under subsection (d) of section 18 of chapter 118G of the General
Laws, as appearing in the 2002 Official Edition. Said schedule shall make said
transfers in increments as deemed appropriate to meet the cash flow needs of
the commonwealth and said uncompensated care pool; provided, that said
transfers shall not begin before October 1, 2005 and shall be completed on or
before June 30, 2006.
SECTION 25. Notwithstanding the
provisions of any general or special law to the contrary, the comptroller
shall, in consultation with the office of the state treasurer, the executive
office for administration and finance, and the executive office of health and
human services, develop a schedule for transferring the unexpended balance from
account 4000-0896 in the state accounting system to the Uncompensated Care
Trust Fund for the purpose of making revenues available for the administration
of the uncompensated care pool, established under subsection (d) of section 18
of chapter 118G of the General Laws, and pursuant to the provisions of this
act. Said schedule shall make said transfers in increments as deemed
appropriate to meet the cash flow needs of the commonwealth and said
uncompensated care pool; provided, that said transfers shall not begin before
October 1, 2005 and shall be completed on or before June 30, 2006.
SECTION 26. Notwithstanding any
general or special law to the contrary, the comptroller shall transfer on or
before October 1, 2005, the greater of $30,000,000 or one-twelfth of the total
expenditures to be made to hospitals and community health centers pursuant to
this Act, from the General Fund to the Uncompensated Care Trust Fund
established pursuant to section 18 of chapter 118G of the General Laws, for the
purpose of making initial gross payments to qualifying acute care hospitals for
the hospital fiscal year beginning October 1, 2005. Said payments shall be
made, without further appropriation, to hospitals prior to, and in anticipation
of, the payment by hospitals of their gross liability to the Uncompensated Care
Trust Fund. The comptroller shall transfer from the Uncompensated Care Trust
Fund to the General Fund not later than June 30, 2006, the amount of the
transfer authorized herein and any allocation thereof as certified by the
commissioner of the division of health care finance and policy.
SECTION 27. Notwithstanding any
general or special law to the contrary, during fiscal year 2006, the
comptroller shall transfer from the Health Care Security Trust, established
under chapter 29D of the General Laws, to the General Fund an amount equal to
100 per cent of the total of all payments received by the commonwealth in
fiscal year 2006 pursuant to the master settlement agreement in the action
known as Commonwealth of Massachusetts v. Phillip Morris, Inc. et. al., Middlesex
Superior Court, No. 95-7378, and 50 per cent of the earnings generated in
fiscal year 2006 from the Health Care Security Trust as certified by the
comptroller pursuant to paragraph (f) of section 3 of chapter 29D of the
General Laws for certain health care expenditures appropriated in section 2.
SECTION
28. Notwithstanding any general or special law
to the contrary, pension benefits formerly funded through item 0612-2000 in
fiscal year 2004 shall be funded from the Pension Reserves Investment Trust
Fund, established pursuant to chapter 661 of the Acts of 1983. The state treasurer shall report to the house
and senate committees on ways and means not later than November 15, 2005 on the
benefits funded pursuant to this section. Said report shall list the amount of
benefit received by each individual through this funding in fiscal year 2005
and the amount of benefit projected to be received by each individual through
this funding in fiscal year 2006.
SECTION
29. Notwithstanding the provisions of any
general or special law to the contrary, the amounts transferred to the Commonwealth's
Pension Liability Fund, pursuant to section 22C of chapter 32 of the General
Laws, as appearing in the 2002 Official Edition, shall be made available to
meet the Commonwealth's obligations pursuant to said section 22C, including
retirement benefits payable by the state employees' and the state teachers'
retirement systems, the costs associated with a three per cent cost-of-living
adjustment pursuant to the provisions of section 102 of said chapter 32, the
reimbursement of local retirement systems for previously authorized
cost-of-living adjustments pursuant to said section 102, and for the costs of
increased survivor benefits pursuant to chapter 389 of the Acts of 1984. Subject to rules and regulations promulgated
by the treasurer, the state retirement board and each city, town, county, or
district shall verify the cost of said obligations and the treasurer may make
payments therefor upon a transfer of funds as hereinafter provided, to
reimburse certain cities and towns for pensions to retired teachers, and
including any other obligations which the commonwealth has assumed on behalf of
any retirement system other than the state employees' or state teachers'
retirement systems, and including the commonwealth's share of the amounts to be
appropriated pursuant to section 22B of said chapter 32 and the amounts to be
appropriated pursuant to clause (a) of the last paragraph of section 21 of
chapter 138 of said General Laws. All
payments for the purposes herein described shall be made only pursuant to distribution
of monies from said fund, and any such distribution and the payments for which
distributions are required shall be detailed in a written report filed
quarterly by the commissioner of administration with the house and senate
committees on ways and means and the joint committee on public service in
advance of such distribution; provided, that such distributions shall not be
made in advance of the date on which any payment is actually to be made. Any
request for distribution from said fund shall not be in excess of the amount
necessary to provide sufficient monies to make all payments for the purposes
herein before described. The state retirement board is authorized to expend an
amount for the purposes of the board of higher education's optional retirement
program pursuant to section 40 of chapter 15A of said General Laws. To the extent that the amount transferred
pursuant to section 5B of said chapter 29 exceeds the amount necessary to
adequately fund the annual pension obligations, the excess amount shall be
credited to the Pension Reserves Investment Trust Fund of the commonwealth for
the purpose of reducing the unfunded pension liability of the commonwealth.
SECTION
30. Notwithstanding any general or special law
to the contrary, on or before June 30, 2006, the comptroller shall transfer
$380,000,000 from the Commonwealth Stabilization Fund, established pursuant to
section 2H of chapter 29 of the General Laws, to the General Fund.
SECTION
31. Notwithstanding any general or special law
to the contrary, for fiscal years 2006 and thereafter, the total amount
allocated for distribution to cities and towns pursuant to section 35 of
chapter 10 of the General Laws shall be the sum of the amount distributed in
fiscal year 2005 and: (i) in fiscal year 2006, 45 per cent of the difference
between the fiscal year 2005 distribution and the amount that would otherwise
be payable; (ii) in fiscal year 2007, 60 per cent of the difference between the
fiscal year 2005 distribution and the amount that would otherwise be payable;
(iii) in fiscal year 2008, 80 per cent of the difference between the 2005
distribution and the amount that would otherwise be payable. For fiscal year 2009 and thereafter the
distribution of lottery proceeds shall be determined pursuant to section 35 of
chapter 10 of the General Laws.
SECTION
32.
(a) Upon the request of the board of
selectmen in a town, the city council in a plan E city or the mayor in any
other city, the department of revenue may recalculate the minimum required
local contribution, as defined in section 2 of chapter 70 of the General Laws, as
appearing in the 2002 Official Edition, in the fiscal year ending June 30,
2006. Based on the criteria in this
section, the department shall recalculate the minimum required local
contribution for a municipality's local and regional schools and shall certify
the amounts calculated to the department of education.
(b) A city or town that used qualifying revenue
amounts in a fiscal year which shall not be available for use in the next
fiscal year or that shall be required to use revenues for extraordinary non
school-related expenses for which it did not have to use revenues in the
preceding fiscal year or that has an excessive certified municipal revenue
growth factor which is also greater than or equal to 1.5 times the state
average municipal revenue growth factor may appeal to the department of revenue
not later than October 1, 2005 for an adjustment of its minimum required local
contribution and net school spending.
(c) If a claim is determined to be valid, the
department of revenue may reduce proportionately the minimum required local
contribution amount based on the amount of shortfall in revenue or based on the
amount of increase in extraordinary expenditures in the current fiscal year,
but no adjustment to the minimum required local contribution on account of an
extraordinary expense in the budget for the fiscal year ending on June 30, 2006
shall affect the calculation of the minimum required local contribution in
subsequent fiscal years. Qualifying
revenue amounts shall include, but not be limited to, extraordinary amounts of
free cash, overlay surplus and other available funds.
(d) If, upon submission of adequate documentation, the department
of revenue determines that the municipality's claim regarding an excessive
municipal revenue growth factor is valid, the department shall recalculate the
municipal revenue growth factor and the department of education shall use the
revised growth factor to calculate the preliminary local contribution, the
minimum required local contribution and any other factor that directly or
indirectly uses the municipal revenue growth factor. Any relief granted as a result of an
excessive municipal revenue growth factor shall be a permanent reduction in the
minimum required local contribution.
(e) Upon the request of the board of selectmen
in a town; the city council in a plan E city or the mayor in any other city; or
in a majority of the member municipalities of a regional school district which
used qualifying revenue amounts in a fiscal year that shall not be available
for use in the next fiscal year shall appeal to the department of revenue not
later than October 1, 2005 for an
adjustment to its net school spending requirement. If the claim is determined to be valid, the
department of revenue shall reduce the net school spending requirement based on
the amount of the shortfall in revenue and reduce the minimum required local
contribution of member municipalities accordingly. Qualifying revenue amounts shall include,
but not be limited to, extraordinary amounts of excess and deficiency, surplus
and uncommitted reserves.
(f) If the regional school budget has already been adopted by
two-thirds of the member municipalities then, upon a majority vote of the
member municipalities, the regional school committee shall adjust the
assessments of the member municipalities in accordance with the reduction in
minimum required local contributions approved by the department of revenue or
the department of education in accordance with this section.
(g) Notwithstanding clause (14) of section 3 of
chapter 214 of the General Laws or any other general or special law to the
contrary, the amounts so determined shall be deemed to be the minimum required
local contribution described in chapter 70 of the General Laws. The house and senate committees on ways and
means and the joint committee on education, arts and humanities shall be
notified by the department of revenue and the department of education of the
amount of any reduction in the minimum required local contribution amount.
(h) If a city or town has an approved budget
that exceeds the recalculated minimum required local contribution and net
school spending amounts for its local school system or its recalculated minimum
required local contribution to its regional school districts as provided by
this section, the local appropriating authority shall determine the extent to
which the community shall avail itself of any relief authorized under this
section.
(i) The amount of financial assistance due from the commonwealth in
fiscal year 2006 under said chapter 70 or any other law shall not be changed on
account of any redetermination of the minimum required local contribution under
this section.
(j) The department of revenue and the department
of education shall issue guidelines for their respective duties under this
section.
SECTION
33. The provisions of section 615 of chapter 26
of the acts of 2003 shall apply in fiscal year 2006.
SECTION
34. Except as otherwise specified, this act
shall take effect on July 1, 2005.