Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S755 Compare Versions

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

Old	New	Differences
1	1	1 of 1
2	2	SENATE DOCKET, NO. 854 FILED ON: 1/18/2023
3	3	SENATE . . . . . . . . . . . . . . No. 755
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Patricia D. Jehlen
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 clarifying rate setting processes for home health and home care services.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Patricia D. JehlenSecond MiddlesexCarmine Lawrence Gentile13th Middlesex1/26/2023Vanna Howard17th Middlesex1/31/2023Susannah M. Whipps2nd Franklin2/2/2023Sal N. DiDomenicoMiddlesex and Suffolk2/8/2023Anne M. GobiWorcester and Hampshire2/9/2023Joanne M. ComerfordHampshire, Franklin and Worcester2/9/2023Mathew J. Muratore1st Plymouth2/10/2023Thomas M. Stanley9th Middlesex2/10/2023John F. KeenanNorfolk and Plymouth2/14/2023Michael O. MooreSecond Worcester2/15/2023Rebecca L. RauschNorfolk, Worcester and Middlesex2/23/2023Michael D. BradySecond Plymouth and Norfolk3/1/2023 1 of 3
16	16	SENATE DOCKET, NO. 854 FILED ON: 1/18/2023
17	17	SENATE . . . . . . . . . . . . . . No. 755
18	18	By Ms. Jehlen, a petition (accompanied by bill, Senate, No. 755) of Patricia D. Jehlen, Carmine
19	19	Lawrence Gentile, Vanna Howard, Susannah M. Whipps and other members of the General
20	20	Court for legislation to clarify rate setting processes for home health and home care services.
21	21	Health Care Financing.
22	22	[SIMILAR MATTER FILED IN PREVIOUS SESSION
23	23	SEE SENATE, NO. 774 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 clarifying rate setting processes for home health and home care services.
30	30	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
31	31	of the same, as follows:
32	32	1 SECTION 1: Section 13D of Chapter 118E of the general laws is amended after the
33	33	2second paragraph by inserting the following new paragraph:
34	34	3 Such rates for home health agencies, as defined under section 51K of chapter 111, shall
35	35	4be established at least biennially. In setting such rates, the executive office shall use as base year
36	36	5costs for rate determination purposes the reported costs of the calendar year not more than 4
37	37	6years prior to the current rate year, adjusted for reasonableness and to incorporate any new
38	38	7regulatory costs imposed since said base year costs. In establishing rates of payment to home
39	39	8health agencies, the executive office shall consider all costs which must be incurred by
40	40	9efficiently and economically operated providers. The rates shall also include an allowance for 2 of 3
41	41	10reasonable administrative expenses and a reasonable profit factor, as determined by the executive
42	42	11office. Such cost analysis shall include, but not be limited to, the following: costs of similar
43	43	12services provided in other care settings; use of national or regional indices to measure increases
44	44	13or decreases in reasonable costs incurred since the base year costs; the revision of existing
45	45	14historical cost bases, where applicable, to reflect changing norms or models of efficient service
46	46	15delivery; and other means to encourage the cost-efficient delivery of services. In determining the
47	47	16methodology for setting rates, the Secretary shall consult with stakeholders impacted by the
48	48	17rates. The Secretary shall, concurrent with the completion of setting such rates, provide a report
49	49	18to the house and senate committees on ways and means detailing how the rates issued under this
50	50	19paragraph were analyzed and revised; provided further, that the report shall compare the
51	51	20inflationary considerations made in the adopted rate with the most recent “Home Health Agency
52	52	21Market Basket” index posted by the United States Department of Health and Human Services,
53	53	22Centers for Medicare and Medicaid Services; provided further, that if the adopted rate does not
54	54	23rely on the “Home Health Agency Market Basket” index for the purpose of determining
55	55	24inflationary adjustments, then the report will simulate what the rate would have been if such
56	56	25index was a factor in rate development.
57	57	26 SECTION 2: Section 4 of Chapter 19A is hereby amended by adding after Section 4D the
58	58	27following new section:
59	59	28 Section 4E: In establishing rates of payment pursuant to the second paragraph of section
60	60	2913C of chapter 118E of the M.G.L., the executive office shall consider changes to the state
61	61	30minimum wage or changes to employer payroll tax obligations as governmental mandates that
62	62	31affect the costs of providing homemaker and personal care homemaker services to elderly clients
63	63	32under this section. 3 of 3
64	64	33 The executive office shall also consider and analyze rates of payment and wages
65	65	34associated with providing similar services in both the public and private settings. In calculating
66	66	35operating costs, the executive office shall consider costs of; health insurance, employee benefits
67	67	36and training, payroll taxes, technology costs, administrative allocation and staff salaries using the
68	68	37latest available national or regional indices and benchmarked to the latest available Bureau of
69	69	38Labor Statistics median wage data. Nothing in this section shall be construed as limiting
70	70	39consideration of other governmental mandates or operating costs that affect the cost of providing
71	71	40services pursuant to section 4 of chapter 19A of the General Laws. In determining the
72	72	41methodology for setting rates, the Secretary shall consult with stakeholders impacted by the
73	73	42rates.
74	74	43 The Secretary of Elder Affairs shall, concurrent with the promulgation of the final rates
75	75	44of payment for services under section 4 of chapter 19A, issue a report to the House and Senate
76	76	45committees on ways and means detailing how the rates promulgated were analyzed and
77	77	46determined in compliance with the provisions set forth in the second paragraph of section 13C of
78	78	47chapter 118E of the General Laws. The report shall detail the department’s analysis of changes in
79	79	48the costs of providing homemaker and personal care homemaker services since the immediately
80	80	49preceding rate determination; provided further, that the report shall compare the inflationary
81	81	50considerations made in the adopted rate with the most recent “Home Health Agency Market
82	82	51Basket” index posted by the United States Department of Health and Human Services, Centers
83	83	52for Medicare and Medicaid Services; provided further, that if the adopted rate does not rely on
84	84	53the “Home Health Agency Market Basket” index for the purpose of determining inflationary
85	85	54adjustments, then the report will simulate what the rate would have been if such index was a
86	86	55factor in rate development.