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2 | 2 | | SENATE DOCKET, NO. 1871 FILED ON: 1/20/2023 |
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3 | 3 | | SENATE . . . . . . . . . . . . . . No. 794 |
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4 | 4 | | The Commonwealth of Massachusetts |
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5 | 5 | | _________________ |
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6 | 6 | | PRESENTED BY: |
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7 | 7 | | Susan L. Moran |
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8 | 8 | | _________________ |
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9 | 9 | | To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General |
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10 | 10 | | Court assembled: |
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11 | 11 | | The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: |
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12 | 12 | | An Act relative to MassHealth reimbursement for schools. |
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13 | 13 | | _______________ |
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14 | 14 | | PETITION OF: |
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15 | 15 | | NAME:DISTRICT/ADDRESS :Susan L. MoranPlymouth and BarnstableMathew J. Muratore1st Plymouth2/2/2023Michael O. MooreSecond Worcester2/15/2023David Paul Linsky5th Middlesex3/6/2023 1 of 4 |
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16 | 16 | | SENATE DOCKET, NO. 1871 FILED ON: 1/20/2023 |
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17 | 17 | | SENATE . . . . . . . . . . . . . . No. 794 |
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18 | 18 | | By Ms. Moran, a petition (accompanied by bill, Senate, No. 794) of Susan L. Moran, Mathew J. |
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19 | 19 | | Muratore, Michael O. Moore and David Paul Linsky for legislation relative to MassHealth |
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20 | 20 | | reimbursement for schools. Health Care Financing. |
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21 | 21 | | The Commonwealth of Massachusetts |
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22 | 22 | | _______________ |
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23 | 23 | | In the One Hundred and Ninety-Third General Court |
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24 | 24 | | (2023-2024) |
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25 | 25 | | _______________ |
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26 | 26 | | An Act relative to MassHealth reimbursement for schools. |
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27 | 27 | | Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority |
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28 | 28 | | of the same, as follows: |
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29 | 29 | | 1 SECTION 1. Section 72 of chapter 44 of the General Laws, as appearing in the 2020 |
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30 | 30 | | 2Official Edition, is hereby amended by striking, in line 8, the words “local government entity” |
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31 | 31 | | 3inserting in place thereof the following:- “local educational authority.” |
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32 | 32 | | 4 SECTION 2. Said section 72 of chapter 44 of the General Laws, as so appearing, is |
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33 | 33 | | 5hereby further amended by striking, in line 10, the words “local government entity” inserting in |
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34 | 34 | | 6place thereof the following:- “local educational authority.” |
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35 | 35 | | 7 SECTION 3. Said section 72 of chapter 44 of the General Laws, as so appearing, is |
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36 | 36 | | 8hereby further amended by striking, in line 13, the words “local government entity” inserting in |
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37 | 37 | | 9place thereof the following; “local educational authority.” |
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38 | 38 | | 10 SECTION 4. Said section 72 of chapter 44 of the General Laws, as so appearing, is |
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39 | 39 | | 11hereby further amended by striking the words “Any funds received by a local government entity |
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40 | 40 | | 12pursuant to the provisions of this section shall be considered unrestricted revenue of the local 2 of 4 |
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41 | 41 | | 13government entity and may be spent in accordance with any general or special law governing the |
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42 | 42 | | 14expenditure of the entity's revenues.” and inserting in place thereof the following:- “A local |
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43 | 43 | | 15educational agency which obtains MassHealth reimbursement for providing school-based |
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44 | 44 | | 16services, administrative activities or any other medical benefits to a school-age child under this |
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45 | 45 | | 17chapter, by and through its employees and agents, shall maintain the proceeds of such |
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46 | 46 | | 18reimbursement to fund school-based services and related administrative activities at any school |
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47 | 47 | | 19facility or school system which it operates or over which it has direct supervision or jurisdiction. |
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48 | 48 | | 20Said proceeds should not supplant existing or planned school health funding.” |
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49 | 49 | | 21 SECTION 5. Chapter 71 of the General Laws is hereby amended by inserting after |
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50 | 50 | | 22Section 98 the following section:- |
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51 | 51 | | 23 Section 99. (a) For the purposes of this section, the following words shall have the |
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52 | 52 | | 24following meanings: |
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53 | 53 | | 25 “Administrative activities”, those activities as defined in the local educational agency’s |
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54 | 54 | | 26provider contract with MassHealth. |
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55 | 55 | | 27 “Local educational agency”, any city, town, charter school, public health commission, or |
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56 | 56 | | 28school district. |
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57 | 57 | | 29 “Individualized education program”, a written statement, developed and approved in |
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58 | 58 | | 30accordance with federal special education law in a form established by the department of |
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59 | 59 | | 31elementary and secondary education of the Commonwealth that identifies a student's special |
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60 | 60 | | 32education needs and describes the services a local educational agency shall provide to meet those |
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61 | 61 | | 33needs. 3 of 4 |
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62 | 62 | | 34 “School-age child”, any person of ages three through twenty-two who has not attained a |
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63 | 63 | | 35high school diploma or its equivalent. |
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64 | 64 | | 36 “School-based Medicaid provider”, any local educational agency that provides School |
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65 | 65 | | 37Based Services to Members and performs administrative activities on behalf of the executive |
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66 | 66 | | 38office of health and human services pursuant to their provider contract with MassHealth. |
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67 | 67 | | 39 “School-based services”, any medically necessary MassHealth covered services, as |
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68 | 68 | | 40delineated in the Medicaid State Plan, which are provided to a member by a school-based |
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69 | 69 | | 41Medicaid provider. |
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70 | 70 | | 42 “School personnel”, a School-Based Medicaid Provider’s salaried and/or contract staff |
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71 | 71 | | 43operating under a contractual agreement with the School-Based Medicaid Provider. School |
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72 | 72 | | 44Personnel include, but are not limited to, nurses, therapists, special education administrators, |
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73 | 73 | | 45psychologists, social workers, school counselors, and clerical support. |
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74 | 74 | | 46 (b) The executive office of health and human services together with the executive office |
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75 | 75 | | 47of education shall ensure that each local educational agency enrolled with the division as a |
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76 | 76 | | 48MassHealth provider shall implement a plan to obtain MassHealth reimbursement of school- |
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77 | 77 | | 49based services, administrative activities and any other medical benefits provided by such local |
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78 | 78 | | 50educational agency to any school-age child who is an eligible beneficiary of MassHealth in |
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79 | 79 | | 51accordance with this chapter, Title XIX and Title XXI as appropriate. |
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80 | 80 | | 52 (c) Notwithstanding any other law or regulation to the contrary, any local educational |
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81 | 81 | | 53agency enrolled with the division as a MassHealth provider of school-based services, |
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82 | 82 | | 54administrative activities and any other medical benefits shall be entitled to submit claims to |
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83 | 83 | | 55MassHealth for reimbursement for providing, by and through its employees or agents, such 4 of 4 |
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84 | 84 | | 56services and medical benefits to any school-age child who is an eligible beneficiary. Any school- |
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85 | 85 | | 57based services, administrative activities or other medical benefits provided by a local educational |
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86 | 86 | | 58agency to a school-age child who is an eligible beneficiary under this chapter shall be |
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87 | 87 | | 59reimbursable by MassHealth regardless of whether said school-age child participates in an |
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88 | 88 | | 60individualized education program, an individual health care plan, or a plan under Section 504 of |
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89 | 89 | | 61the Rehabilitation Act of 1973, or whether said school-based services, administrative activities or |
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90 | 90 | | 62other medical benefits are provided at no charge to any school-age child who is not an eligible |
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91 | 91 | | 63beneficiary. |
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92 | 92 | | 64 (d) A local educational agency which obtains MassHealth reimbursement for providing |
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93 | 93 | | 65school-based services, administrative activities or any other medical benefits to a school-age |
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94 | 94 | | 66child under this chapter, by and through its employees and agents, shall maintain the proceeds of |
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95 | 95 | | 67such reimbursement to fund school-based services and related administrative activities at any |
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96 | 96 | | 68school facility or school system which it operates or over which it has direct supervision or |
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97 | 97 | | 69jurisdiction. Said proceeds should not supplant existing or planned school health funding, and |
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98 | 98 | | 70shall be used for such purposes including, without limitation, school-based services and other |
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99 | 99 | | 71school health programming, which may include enhanced capacity to provide comprehensive |
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100 | 100 | | 72behavioral health support, case management, health education, social emotional learning and |
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101 | 101 | | 73health support, outreach and enrollment, school health infrastructure development, and other |
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102 | 102 | | 74related school health services. |
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