Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H979 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. 1374 FILED ON: 1/18/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 979
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Mark J. Cusack
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 relative to transparency of hospital margins & ensuring hospital efficiency.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Mark J. Cusack5th Norfolk1/18/2023 1 of 3
16	16	HOUSE DOCKET, NO. 1374 FILED ON: 1/18/2023
17	17	HOUSE . . . . . . . . . . . . . . . No. 979
18	18	By Representative Cusack of Braintree, a petition (accompanied by bill, House, No. 979) of
19	19	Mark J. Cusack relative to the public reporting of hospital margins. Financial Services.
20	20	[SIMILAR MATTER FILED IN PREVIOUS SESSION
21	21	SEE HOUSE, NO. 1232 OF 2021-2022.]
22	22	The Commonwealth of Massachusetts
23	23	_______________
24	24	In the One Hundred and Ninety-Third General Court
25	25	(2023-2024)
26	26	_______________
27	27	An Act relative to transparency of hospital margins & ensuring hospital efficiency.
28	28	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
29	29	of the same, as follows:
30	30	1 SECTION 1. Chapter 12C of the General Laws, as so appearing in the 2020 edition, is
31	31	2hereby amended by inserting after section 8 the following new section:-
32	32	3 8A. Reporting of Hospital Margins
33	33	4 (a) If in any fiscal year, an Acute Hospital, as defined in this chapter, reports to the center
34	34	5an operating margin that exceeds 5 percent, the center shall hold a public hearing within 60 days.
35	35	6The Acute Hospital shall submit testimony on its overall financial condition and the continued
36	36	7need to sustain an operating margin that exceeds 5 percent. The Acute Hospital shall also submit
37	37	8testimony on efforts the Acute Hospital is making to advance health care cost containment and
38	38	9health care quality improvement; and whether, and in what proportion to the total operating
39	39	10margin, the Acute Hospital will dedicate any funds to reducing health care costs. The center 2 of 3
40	40	11shall review such testimony and issue a final report on the results of the hearing. In
41	41	12implementing the requirements of this Section, the center shall utilize data collected by hospitals
42	42	13pursuant to the requirements of Section 2 of this act.
43	43	14 (b) The center for health information and analysis shall examine hospital efficiency for
44	44	15all hospitals under section 8 of chapter 12C of the General Laws by annually publishing the
45	45	16margins for hospitals for commercial, Medicare and Medicaid lines of business and utilizing data
46	46	17submitted as part of the Registered Provider Organization process to report on the underlying
47	47	18cost structure for hospitals.
48	48	19 (c) Academic medical centers shall report to the center for health information analysis
49	49	20and the health policy commission information on the portion of revenues and expenses that are
50	50	21devoted to teaching and research. The center shall annually issue a report on the case-mix of
51	51	22hospitals and the relationship of case-mix to commercial reimbursements.
52	52	23 SECTION 2. Notwithstanding any special or general law to the contrary, the center for
53	53	24health and information and analysis, in consultation with the division of insurance, shall
54	54	25promulgate regulations on or before July 1, 2023 to establish a uniform methodology for
55	55	26calculating and reporting inpatient and outpatient costs, including direct and indirect costs, for all
56	56	27hospitals under section 8 (8A) of chapter 12C of the General Laws. The center shall, as necessary
57	57	28and appropriate, promulgate regulations or amendments to its existing regulations to require
58	58	29hospitals to report cost and cost trend information in a uniform manner including, but not limited
59	59	30to, uniform methodologies for reporting the cost and cost trend for categories of direct labor,
60	60	31debt service, depreciation, advertising and marketing, bad debt, stop-loss insurance, malpractice
61	61	32insurance, health information technology, medical management, development, fundraising, 3 of 3
62	62	33research, academic costs, charitable contributions, and operating margins for all commercial
63	63	34business and for all state and federal government business, including but not limited to Medicaid,
64	64	35Medicare, insurance through the group insurance commission and federal Civilian Health and
65	65	36Medical Program of the Uniformed Services. The center shall, before adopting regulations under
66	66	37this section, consult with the group insurance commission, the Centers for Medicare and
67	67	38Medicaid Services, the attorney general, and representatives from the Massachusetts Hospital
68	68	39Association, the Massachusetts Medical Society, the Massachusetts Association of Health Plans,
69	69	40the Blue Cross and Blue Shield of Massachusetts, the Massachusetts Health Information
70	70	41Management Association, and the Massachusetts Health Data Consortium.