Be it enacted by the Senate and House
of Representatives in General Court assembled, and by the authority of the
same, as follows:
SECTION 1. Chapter 6A of the General Laws is hereby amended by striking out section 16O, as appearing in the 2006 Official Edition, and inserting in place thereof the following section:—
Section 16O. (a) There shall be a health disparities council located within, but not subject to the control of, the executive office of health and human services. The council shall make recommendations to reduce and eliminate racial and ethnic disparities in access to quality health care and in health outcomes within the commonwealth, including disparities related to breast, cervical, prostate and colorectal cancers, strokes, and heart attacks, heart disease, diabetes, infant mortality, lupus, HIV/AIDS, asthma and other respiratory illnesses. The council may consider environmental, housing and other relevant matters contributing to these disparities. The council shall make recommendations to increase racial and ethnic diversity in the health care workforce, including doctors, nurses and physician assistants. The council shall maintain ongoing communication and coordination with the health care quality and cost council, established by section 16K of chapter 6A.
(b) The council shall consist of 35 members and shall be comprised of: (i) : 3 members of the house of representatives who shall be appointed by the speaker of the house, 1 of whom is designated co-chair by the speaker, and 3 members of the senate appointed by the senate president, 1 of whom is designated co-chair by the senate president; (ii) the secretary of health and human services, ex-officio, the commissioner of public health, ex-officio, the director of the office of multicultural health in the department of public health, ex-officio, the director of Medicaid, ex-officio, or their designees; (iii) 8 persons from communities disproportionately affected by health disparities, 4 of whom are appointed by the speaker and 4 of whom are appointed by the senate president; and (iv) 17 persons appointed by the co-chairs, 2 of whom are experts in health disparities from foundations or academic institutions and 1 from each list of nominees submitted by each of the following organizations, including: the American Cancer Society, Massachusetts Division, Inc.; the American Heart Association, Massachusetts Affiliate, Inc.; the Massachusetts General Hospital; Brigham and Women's/Faulkner Hospitals, Inc.; the Dana Farber Cancer Institute, Inc.; the Massachusetts League of Community Health Centers, Inc.; the Massachusetts Medical Society; the Boston public health commission, established by chapter 147 of the acts of 1995; the health department of the city of Springfield; the health department of the city of Worcester; the Massachusetts School Nurse Organization, Inc.; the Massachusetts Association of Public Health Nurses, Inc.; the Massachusetts Association of Health Plans, Inc.; the Boston Medical Center Corporation; and the Massachusetts Public Health Association.
The representatives of nongovernmental organizations shall serve staggered 3-year terms and vacancies of unexpired terms shall be filled within 60 days by the appropriate appointing authority.
(c) The council shall meet at least bimonthly, at other times as determined by its rules, and when requested by either by both co-chairs or by 1 co-chair and any 9 members.
(d) The council shall submit a report annually by July 1st to the governor, the health care cost and quality council, established by section 16K of chapter 6A and the general court, by filing the report with the clerk of the house of representatives, the clerk of the senate, the joint committee on health care financing, and the joint committee on public health. The report shall include: (i) data on disparities in health care access and health outcomes, (ii) data on diversity in the health care workforce, (iii) recommendations for designing, implementing and improving programs and services, (iv) proposals for statutory and regulatory changes to reduce and eliminate disparities in access to quality health care services and health outcomes in the commonwealth, and (v) recommendations for improving diversity and cultural competency in the health care workforce.
SECTION 2. Section 7B of chapter 26 of the General Laws, as so appearing, is hereby amended by striking out subsection (b) and inserting in place thereof the following subsection:—
(b) Upon request, carriers licensed under chapters 175, 176A, 176B, and 176G and the office of Medicaid shall make information available to the bureau for the purposes of said chapter 111M. Such information shall be limited to the minimum amount of personal information necessary; shall not include information about diagnoses or treatments; and, except for the office of Medicaid, shall not include social security numbers. The information acquired under this section shall be confidential and shall not constitute a public record.
SECTION 3. Section 2PPP of chapter 29 of the General Laws, as so appearing, is hereby amended by striking out, in line 16, the figure “56” and inserting in place thereof the following words:— 35 of chapter 118G.
SECTION 4. Section 8B of chapter 62C of the General Laws, as so appearing, is hereby amended by striking out subsection (c) and inserting in place thereof the following subsection:—
(c) The statements and reports shall identify the carrier or employer, the covered individual and covered dependents, the insurance policy or similar numbers and the dates of coverage during the year, and shall provide other information as required by the commissioner of revenue for the purposes of said chapter 111M. Such information shall be limited to the minimum amount of personal information necessary; shall not include information about diagnoses or treatments; and, except for the office of Medicaid, shall not include social security numbers. The commissioner of revenue, in consultation with the commissioner of insurance, may specify the content and format of the statements and reports. The commissioner of revenue may disclose the information in the statements and reports to the division of insurance, the division of health care finance and policy and the commonwealth health insurance connector. The information in the statements and reports shall be confidential and shall not constitute a public record.
SECTION 5. Section 1 of chapter 62D of the General Laws, as so appearing, is hereby amended by striking out, in lines 73 and 74, the words “60 of chapter 118E” and inserting in place thereof the following words:— 39 of chapter 118G.
SECTION 6. Section 13 of said chapter 62D, as so appearing, is hereby amended by striking out clause (viii) and inserting in place thereof the following clause:—
(viii) the health safety net office for obligations to the Health Safety Net Fund for the cost of health care services paid from the fund under section 39 of chapter 118G;
SECTION 7. Section 12 of chapter 62E, as so appearing, is hereby amended by striking out, in lines 32 and 33, the words “55 to 60, inclusive of chapter 118E” and inserting in place thereof the following words:— 34 to 39, inclusive, of chapter 118G.
SECTION 8. Section 1 of chapter 111M of the General Laws, as so appearing, is hereby amended by inserting after the figure “1928”, in line 14, the words:— and section 1903(v), or Title XXI of the Social Security Act.
SECTION 9. Section 2 of Chapter 111M of the General Laws, as appearing in section 12 of chapter 58 of the acts of 2006, is hereby amended by striking out subsection (b) and inserting in place thereof the following paragraph:--
(b) Every person who files or is required to file an individual return as a resident of the commonwealth, either separately or jointly with a spouse, shall indicate on the return, in a manner prescribed by the commissioner of revenue, whether such person, as of the last day of the taxable year for which the return is filed, (i) had creditable coverage in force as required under paragraph (a) whether covered as an individual or as a named beneficiary of a policy covering multiple individuals, (ii) claims an exemption under section 3, or (iii) had a certificate issued under section 3 of chapter 176Q. If the person does not so indicate, or indicates that he did not have such coverage in force, then the tax shall be computed on the return without benefit of the personal exemption set forth in paragraph (b) of Part B of section 3 of chapter 62, or, in the case of a person who files jointly with a spouse, without benefit of one-half of the personal exemption set forth in such paragraph. If the person indicates that he had such coverage in force but the commissioner determines, based on the information available to him, that such requirement of paragraph (a) was not met, then the commissioner shall compute the tax for the taxable year without benefit of the personal exemption set forth in paragraph (b) of Part B of section 3 of chapter 62, or, in the case of a person who files jointly with a spouse, without benefit of one-half of the personal exemption set forth in such paragraph, first giving notice to such person of his intent to do so and an opportunity for a hearing, under rules prescribed by the commissioner. Whenever, under this section, the tax is computed without benefit of the personal exemption, or without benefit of one-half of the personal exemption, the difference between the tax so computed and the tax that would be computed in the absence of this section shall constitute a penalty assessed under this section. The commonwealth shall have all enforcement and collection procedures available under chapter 62C to collect such penalty assessed under this section.
SECTION 10. Subsection (b) of said section 2 of said chapter 111M, as amended by section 13 of said chapter 58, is hereby further amended in the first sentence, in line 34, by inserting after the words “who files” the words:-- or is required to file
SECTION 11. Said section 2 of said chapter 111M, as so appearing, is hereby amended by striking out, in line 66, the word “collected” and inserting in place thereof the following words:— assessed under this section that he collects.
SECTION 12. Section 3 of said chapter 111M, as so appearing, is hereby amended by striking out, in line 9, the words “penalties in subsection (b) of” and inserting in place thereof the following words:— penalty assessed under.
SECTION 13. Section 9C of chapter 118E of the General Laws, as so appearing, is hereby amended by striking out, in line 29, the figure “200” and inserting in place thereof the following figure:— 300.
SECTION 14. Said section 9C of said chapter 118E, as so appearing, is hereby further amended by striking out, in line 37, the figure “200” and inserting in place thereof the following figure:— 300.
SECTION 15. Section 23 of said chapter 118E, as amended by section 4 of chapter 42 of the acts of 2007, is hereby further amended by striking out, in lines 58 and 59, the words “uncompensated care pool under chapter 118G” and inserting in place thereof the following words:— health safety net fund trust fund under section 39 of chapter 118G.
SECTION 16. Section 54 of said chapter 118E, as so appearing, is hereby amended by striking out the second and third sentences and inserting in place thereof the following 3 sentences:— The executive office may reduce MassHealth premiums or copayments, or offer other incentives to encourage enrollees to comply with wellness goals. The executive office shall publish a report annually on the number of enrollees who meet at least 1 wellness goal, any reduction of copayments or premiums, and any other incentives provided because enrollees met wellness goals. The report shall be submitted to the general court, by filing it with the joint committee on health care financing, the house committee on ways and means, and the senate committee on ways and means.
SECTION 17. Section 5 of chapter 118G, as so appearing, is hereby amended by striking out, in line 32, the words “56 of chapter 118E” and inserting in place thereof the following figure:— 35.
SECTION 18. Section 6C of said chapter 118G, as so appearing, is hereby amended by striking out, in line 6, the words “more than 10” and inserting in place thereof the following words:— 11 or more full-time equivalent.
SECTION 19. Said section 6C of said chapter 118G, as so appearing, is hereby further amended by striking out, in line 9, the words “more than 10” and inserting in place thereof the following words:— 11 or more full-time equivalent.
SECTION 20. Section 18B of said chapter 118G, as so appearing, is hereby amended by striking out, in line 9, the figure "90" and inserting in place thereof the following figure:— 180.
SECTION 21. Said section 18B of said chapter 118G, as so appearing, is hereby further amended by striking out, in lines 25 and 26, the words “from the uncompensated care pool, under chapter 118E” and inserting in place thereof the following words:— reimbursed by the health safety net office under section 39.
SECTION 22. Section 35 of said chapter 118G, inserted by section 15 of chapter 61 of the acts of 2007, is hereby amended by adding the following subsection:—
(c) The office shall enter into an interdepartmental service agreement with the office of Medicaid to develop and implement a plan to enhance oversight of and to improve the operations, management, payment processes and data integrity of the Health Safety Net Trust Fund, consistent with, but not limited to, subclauses (2) to (5), inclusive, of subsection (b).
The plan shall include: (i) an analysis of free care and emergency bad debt claims submitted in the most recent 3-year period to determine patterns most appropriate and promising for targeted audits and reviews; (ii) a cost-effective approach to maximizing the identification of all sources of third-party liability for patients receiving free care or emergency services; (iii) a cost-effective approach to establishing an ongoing claims and utilization review system for uncompensated care claims that effectively identifies and disallows inappropriate claims, but also takes into consideration the practicality of said approach considering the small volume of claims relative to other payers that make routine use of claims and utilization review systems, (iv) an approach that maximizes the use of existing eligibility determination and review systems, coordination of benefits, claims review and provider integrity systems, interdepartmental service agreements and related program and provider integrity contracts available to the office of Medicaid for achieving the management improvements required under this section, and (v) a proposed timeline for implementation.
The health safety net office shall annually submit a progress report on the plan to the general court, by filing it with the clerk of the house and the clerk of the senate, the joint committee on health care financing, the house committee on ways and means, and the senate committee on ways and means.
SECTION 23. Section 188 of chapter 149 of the General Laws, as appearing in the 2006 Official Edition, is hereby amended by striking out the definition of “Employer” and inserting in place thereof the following definition:—
“Employer”, an employing unit as defined in section 1 of chapter 151A or in section 1 of chapter 152.
SECTION 24. Subsection (d) of said section 188 of said chapter 149, as so appearing, is hereby further amended by adding the following sentence:— The division of unemployment assistance shall promulgate regulations necessary to implement this section.
SECTION 25. The definition of “Employer” in section 1 of chapter 151F, as so appearing, is hereby amended by striking the last sentence and inserting in place thereof the following sentence:— The word “employer” shall not include sole proprietors or tax exempt organizations, as described in section 501 of the Internal Revenue Code, that are exclusively staffed by volunteers.
SECTION 26. Chapter 151F of the General Laws, as so appearing, is hereby amended by striking out section 2 and inserting in place thereof the following section:—
Section 2. Each employer with 11 or more full-time equivalent employees in the commonwealth shall adopt and maintain a cafeteria plan that satisfies 26 U.S.C. 125 and the regulations promulgated by the connector. The employer shall provide a copy of the cafeteria plan if requested by the connector.
SECTION 27. The definition of “Group health plan” in section 1 of chapter 176J of the General Laws, as so appearing, is hereby amended by adding the following sentence:—— For purposes of this definition, “partnership” shall include a limited liability company with more than 1 member, and a member of such a limited liability company shall be deemed to be a partner.
SECTION 28. Section 10 of said chapter 176J, as so appearing, is hereby amended by striking out, in line 5, the words “19 and 26” and inserting in place thereof the words:— 18 and 26.
SECTION 29. Chapter 58 of the acts of 2006 is hereby amended by striking out section 136 and inserting in place thereof the following section:—
Section 136. The website established under section 16L of chapter 6A of the General Laws shall be operational and shall include links to other websites that display comparative cost and quality information no later than September 1, 2007. The website shall include comparative cost information by facility, by clinician or physician group practice for obstetrical services, physician office visits, high-volume elective surgical procedures, high-volume diagnostic tests, and high-volume therapeutic procedures no later than March 1, 2008. Cost information shall include the average payment made on behalf of insured patients for each service or category of service received by each facility, clinician or physician practice
SECTION 30. The commonwealth health insurance connector, established by chapter 176Q of the General Laws, shall publish a report on implementation of subsection (b) of section 3 of chapter 118H, including the number of eligible individuals enrolled in the commonwealth care health insurance program and the projected premium contribution amounts to be paid by employers. The report shall be submitted by January 1, 2008 to the general court, by filing it with the clerk of the house, the clerk of the senate, the joint committee on health care financing, the house committee on ways and means, and the senate committee on ways and means.
SECTION 31. The first progress report on the plan for oversight and improvement of the Health Safety Net Trust Fund, required under subsection (c) of section 35 of chapter 118G of the General Laws, shall be submitted by April 30, 2008.
SECTION 32. Sections 2, 4, and 10 shall take effect on January 1, 2008.