Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S802 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. 543 FILED ON: 1/17/2023
3	3	SENATE . . . . . . . . . . . . . . No. 802
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Michael F. Rush
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 to improve health care cost accountability.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Michael F. RushNorfolk and SuffolkVanna Howard17th Middlesex1/31/2023Paul McMurtry11th Norfolk2/8/2023 1 of 3
16	16	SENATE DOCKET, NO. 543 FILED ON: 1/17/2023
17	17	SENATE . . . . . . . . . . . . . . No. 802
18	18	By Mr. Rush, a petition (accompanied by bill, Senate, No. 802) of Michael F. Rush, Vanna
19	19	Howard and Paul McMurtry for legislation to improve health care cost accountability. Health
20	20	Care Financing.
21	21	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE SENATE, NO. 812 OF 2021-2022.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Third General Court
26	26	(2023-2024)
27	27	_______________
28	28	An Act to improve health care cost accountability.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 SECTION 1. Section 1 of Chapter 224 6D of the Acts of 2012 is amended by adding the
32	32	2following:-
33	33	3 “Weighted Average Payer Rate” or “WAPR”, a measure by which a sum of the inpatient
34	34	4revenue per discharge and outpatient revenue per visit is separately calculated for Commercial,
35	35	5Medicare, and Medicaid. A weighted average of the three resulting values is derived, with the
36	36	6Net Patient Service Revenue - based payer mix of the three payers serving as weights.
37	37	7 SECTION 2. Section 8(a) of Chapter 224 6D of the Acts of 2012 is amended by striking
38	38	8out Section 8(a) and adding the following 2 of 3
39	39	9 (a)Not later than October 1 of every year, the commission shall hold public hearings
40	40	10based on the report submitted by the center for health information and analysis under section 16
41	41	11of chapter 12C comparing the growth in total health care expenditures to the health care growth
42	42	12benchmark for the previous calendar year. The hearings shall examine health care provider,
43	43	13provider organization, and private and public health care payer costs, prices, weighted average
44	44	14payer rates, and cost trends, with particular attention to factors that contribute to cost growth
45	45	15within the commonwealth’s health care system.
46	46	16 SECTION 3. Section 8(e) of Chapter 224 6D of the Acts of 2012 is amended by striking
47	47	17out Section 8(e)(i) and adding the following
48	48	18 (i) in the case of providers and provider organizations, testimony concerning payment
49	49	19systems, care delivery models, payer mix, cost structures, administrative and labor costs, capital
50	50	20and technology cost, adequacy of public payer reimbursement levels, reserve levels, utilization
51	51	21trends, relative price, weighted average payer rate, quality improvement and care-coordination
52	52	22strategies, investments in health information technology, the relation of private payer
53	53	23reimbursement levels to public payer reimbursements for similar services, efforts to improve the
54	54	24efficiency of the delivery system, efforts to reduce the inappropriate or duplicative use of
55	55	25technology and the impact of price transparency on prices
56	56	26 SECTION 4. Section 13(d) of Chapter 224 6D of the Acts of 2012 is amended by striking
57	57	27out Section 10(d)(v) and adding the following
58	58	28 (v) provider cost and cost trends including the weighted average payer rate in comparison
59	59	29to total health care expenditures statewide 3 of 3
60	60	30 SECTION 5. Section 13(d) of Chapter 224 6D of the Acts of 2012 is amended by striking
61	61	31out Section 13(d)(xii) and adding the following
62	62	32 (xii) the weighted average payer rate paid to each acute hospital and physician
63	63	33organization; (xiii) any other factors that the commission determines to be in the public interest.
64	64	34 SECTION 6. Section 1 of Chapter 224 12C of the Acts of 2012 is amended by inserting
65	65	35the following
66	66	36 “Weighted Average Payer Rate” or “WAPR”, a measure by which a sum of the inpatient
67	67	37revenue per discharge and outpatient revenue per visit is separately calculated for Commercial,
68	68	38Medicare, and Medicaid. A weighted average of the three resulting values is derived, with the
69	69	39Net Patient Service Revenue- based payer mix of the three payers serving as weights.
70	70	40 SECTION 7. Section 10(b) of Chapter 224 12C of the Acts of 2012 is amended by
71	71	41inserting following section
72	72	42 (12) the weighted average payer rate paid to each acute care hospital and physician
73	73	43organization
74	74	44 SECTION 8. Section 16(a) of Chapter 224 12C of the Acts of 2012 is amended by adding
75	75	45the following after the words “patient centered medical homes.”
76	76	46 (6) the weighted average payer rate paid to each acute care hospital, and physician
77	77	47organization, respectively.