Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H1221 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 1
2	2	HOUSE DOCKET, NO. 817 FILED ON: 1/17/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 1221
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	David Paul Linsky
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act ensuring protections for physicians and hospitals that contract with Medicaid managed
13	13	care organizations.
14	14	_______________
15	15	PETITION OF:
16	16	NAME:DISTRICT/ADDRESS :DATE ADDED:David Paul Linsky5th Middlesex1/17/2023 1 of 2
17	17	HOUSE DOCKET, NO. 817 FILED ON: 1/17/2023
18	18	HOUSE . . . . . . . . . . . . . . . No. 1221
19	19	By Representative Linsky of Natick, a petition (accompanied by bill, House, No. 1221) of David
20	20	Paul Linsky relative to physicians and hospitals that contract with Medicaid managed care
21	21	organizations. Health Care Financing.
22	22	[SIMILAR MATTER FILED IN PREVIOUS SESSION
23	23	SEE HOUSE, NO. 1289 OF 2021-2022.]
24	24	The Commonwealth of Massachusetts
25	25	_______________
26	26	In the One Hundred and Ninety-Third General Court
27	27	(2023-2024)
28	28	_______________
29	29	An Act ensuring protections for physicians and hospitals that contract with Medicaid managed
30	30	care organizations.
31	31	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
32	32	of the same, as follows:
33	33	1 SECTION 1. Section 12 of Chapter 118E of the General Laws, is hereby amended by
34	34	2inserting after the last paragraph the following paragraph:-
35	35	3 Reimbursement from managed care organizations that contract with the executive office
36	36	4for hospital and physician services provided to beneficiaries under this chapter shall be subject to
37	37	5negotiation between providers of medical services and managed care organizations and shall not
38	38	6be limited or determined through contracts between the executive office and managed care
39	39	7organizations, including accountable care organizations and dual-eligible health plans. 2 of 2
40	40	8 SECTION 2. The last sentence of the first paragraph of Section 13E1/2 of Chapter 118E
41	41	9of the General Laws, is hereby amended by inserting after the word “services” the following
42	42	10words:-
43	43	11 provided further, that acute hospital and non-acute hospital reimbursement from managed
44	44	12care organizations that contract with the executive office shall for health services provided to
45	45	13beneficiaries under this chapter be subject to negotiation between those hospitals and managed
46	46	14care organizations and shall not be limited or determined through contracts between the
47	47	15executive office and managed care organizations, including accountable care organizations and
48	48	16dual-eligible health plans.
49	49	17 SECTION 3. Section 13F of Chapter 118E of the General Laws, is hereby amended by
50	50	18inserting after subsection c the following subsection:-
51	51	19 (d) the executive office shall not, in its contracts with acute hospitals and non-acute
52	52	20hospitals or through any other rule or regulation, require hospitals to accept fee-for-service rates
53	53	21established by the office of Medicaid for non-emergency services provided to beneficiaries
54	54	22enrolled in managed care organizations including for accountable care organizations and dual-
55	55	23eligible health plans. The office may require hospitals that are not in a managed care
56	56	24organization’s provider network to accept fee-for-service rates established by the office for
57	57	25emergency services only.