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DEVALL. PATRICK Governor
TIMOTHYP. MURRAY Lieutenant Governor
JUDYANNBIGBY.M.D. Secretary

Tel: (617) 573-1600
Fax: (617) 573-1890
www.mass.gov/eohhs
March 1,2010

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Cindy Mann
Deputy Administrator
Centers for Medicare and Medicaid Services
U.S. Department of Health and Human Services
7500 Security Boulevard
Baltimore, Maryland 21244
Dear Ms. Mann:
In my capacity as Secretary of the Executive Office of Health and Human Services for the Commonwealth of Massachusetts, I am submitting to the Centers for Medicare and Medicaid Services for approval the enclosed amendment to the Massachusetts Section 1115 Demonstration Project (1 l-W-00030/1). This amendment addresses critical needs of the Commonwealth. While remaining steadfast in our joint commitment with the federal government to ensure universal access to affordable, comprehensive health insurance for our residents, we are also committed to supporting the mission of hospitals that are key providers of services to low-income individuals.
We offer these proposals as a bridge to a more patient-centered and sustainable payment system that will be based on the recommendations of the Commonwealth's Special Commission on the Health Care Payment System. We believe that the changes proposed by the commission will result in an improved provider payment system while encouraging and rewarding the best outcomes for patients. Planning for this substantial and groundbreaking effort is underway and we look forward to discussing it with you as part of our upcoming waiver renewal proposal.
Thank you for your consideration of this request. We look forward to discussing the proposed amendment with you and your staff in more detail. Without your support, Massachusetts health reform would not be the enormous success and national model that it is today.
Sincerely,