PETITION OF:

SECTION 1. Section 51 of chapter 111 of the General Laws is hereby amended by inserting in line 5 after the word "clinic" the following words:– which term shall include under this section a clinic which as been designated by the department as a community health center pursuant to section 57E of this chapter.

SECTION 2. Said chapter is further amended by inserting after section 57D, the following new section:

Section 57E: Community health centers. The department shall, after a public hearing, promulgate rules and regulations for the licensing and conduct of community health centers. For the purpose of this section, the following

words shall have the following meanings: "community health center under independent licensure", a clinic which is

designated as a community health center by the department for meeting the following requirements: (a) is licensed as a freestanding clinic by the department pursuant to section 51 of chapter 111 of the general laws;

(b) meets the qualifications for certification (or provisional certification) by the division of medical assistance, enters into a provider agreement pursuant to 130 CMR 405.404 or any successor provision thereto and is eligible to

receive payments from the Uncompensated Care Pool Trust Fund; (c) operates in conformance with the requirements of 42 U.S.C., section 254b; (d) files cost reports if so requested by the division of health care finance

and policy; and (e) provides at a minimum the following basic services: (i) primary care services including adult/internal medicine, pediatrics (directly or through formal contractual arrangements) and obstetrics (directly or

through formal contractual arrangements); (ii) ancillary services including social services, case management and nutritional counseling; and (iii) community outreach and public health programming through contracts,

grants or other funding to populations at risk. Notwithstanding the above, organizations which do not meet the requirements of sections (a) or (c)above, but have been designated "community health centers" by both the

division of medical assistance and the division of health care finance and policy prior to January 31, 2002 shall continue to be designated as community health centers under independent licensure, provided that they

continue to meet the requirements of sections (b), (d) and (e) above. "community health center under hospital licensure", a clinic which provides comprehensive ambulatory services and which is designated as a community

health center by the department for meeting the following requirements: (a) is licensed as an outpatient clinic by the Massachusetts department of public health pursuant to section 51 of chapter 111 of the general laws; (b) meets

the qualifications for certification (or provisional certification) by the division of medical assistance, enters into a provider agreement pursuant to 130 CMR 410.404 or any successor provision thereto and is eligible to

receive payments from the Uncompensated Care Pool Trust Fund; (c) is licensed under the license of a parent hospital, which hospital has a formal written relationship with a not-for-profit corporation which operates the

health center, the board of which is comprised of a majority of consumers or which meets the requirements of the subsections (i) and (ii) of section 330(j)(3)(H) of the Public Health Service Act (42 USC section

254(b)(j)(3)(H)) or any successor provision thereto); and (d) provides at a minimum the following basic services: (i) primary care services including adult/internal medicine, pediatrics (directly or through formal contractual

arrangements) and obstetrics (directly or through formal contractual arrangements); (ii) ancillary services including social services, case management and nutritional counseling; and (iii) community outreach and public health programming through contracts, grants or other funding to populations at risk. Notwithstanding the above, clinics which do not meet the requirements of section (c) above, but which were designated as "community health centers" by both the division of medical assistance and the department of public health prior to January 31, 2002, shall continue to be designated as community health centers under hospital licensure, provided they continue to satisfy the requirements of sections (a), (b) and (d) above.

SECTION 3. Chapter 118E of the General Laws is hereby amended by inserting after section 13A, the following new section:- Section 13B: Community health centers; rates and terms of payment Participation in the medical assistance program shall be limited to those providers licensed under section 57E of chapter 111 of the general laws. The following reimbursement requirements shall apply: (i) a community health center shall be reimbursed by the division of medical assistance for the reasonable cost of its services; (ii) a community health center which

provides MassHealth services through contracts with entities licensed pursuant to chapter 176G of the general laws shall receive a supplemental payment from the division of medical assistance for any shortfall between

the reasonable cost of its services and the amount it received through such managed care contracts; and (iii) each entity with a managed care contract with the division of medical assistance, which entity also is licensed pursuant to chapter 176G of the general laws and whose Medicaid and other governmental funding comprise 75% or more of its total revenues, shall be funded by the division of medical assistance under such contract at a level which will enable such an entity to pay for no less than the reasonable cost of services provided by the community health centers with which it contracts, provided that commencing July 1, 2001, the division of medical assistance shall fund such managed care contracts at a level which will enable such an entity to pay community health centers at the same rates that are paid to community health centers by Medicaid managed care organizations not licensed pursuant to chapter 176G of the general laws.

SECTION 4. Section 1 of chapter 118G of the General Laws in hereby amended by the striking the definition of "community health center" and inserted in place thereof the following definition:– An entity described under section 57E of chapter 111 of the general laws.