Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1354 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. 3877 FILED ON: 1/17/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 1354
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Daniel Cahill
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 address the financial sustainability of the Health Safety Net.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Daniel Cahill10th Essex1/17/2025 1 of 4
16	16	HOUSE DOCKET, NO. 3877 FILED ON: 1/17/2025
17	17	HOUSE . . . . . . . . . . . . . . . No. 1354
18	18	By Representative Cahill of Lynn, a petition (accompanied by bill, House, No. 1354) of Daniel
19	19	Cahill relative to financing the Health Safety Net Trust Fund. Health Care Financing.
20	20	The Commonwealth of Massachusetts
21	21	_______________
22	22	In the One Hundred and Ninety-Fourth General Court
23	23	(2025-2026)
24	24	_______________
25	25	An Act to address the financial sustainability of the Health Safety Net.
26	26	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
27	27	of the same, as follows:
28	28	1 SECTION 1. Section 2OOO of Chapter 29 of the general laws is hereby amended by
29	29	2striking the third sentence in the second paragraph in its entirety and inserting in place thereof
30	30	3the following:-
31	31	4 Money from the fund shall be transferred to the Health Safety Net Trust Fund, or any
32	32	5successor fund, as necessary to provide payments to acute hospitals and community health
33	33	6centers for reimbursable health services. No less than the amounts in subsection (b) of section
34	34	7189 of chapter 149 of the general laws shall be annually transferred to the Health Safety Net
35	35	8Trust Fund.
36	36	9 SECTION 2. Section 189 of chapter 149 of the general laws is here by amended in
37	37	10subsection (b) by striking “$30,000,000” and replacing with “$60,000,000”. 2 of 4
38	38	11 SECTION 3. Section 64 of Chapter 118E of the General Laws, as appearing in the 2022
39	39	12Official Edition, is hereby amended by inserting after the definition of “Resident” the following
40	40	13new definition:-
41	41	14 "Supplemental shortfall assessment'', an amount equal to 50 percent of the annual
42	42	15revenue shortfall in the Health Safety Net Trust fund as determined by the executive office
43	43	16pursuant to subsection (a) of section 68A.
44	44	17 SECTION 4. Section 66 of Chapter 118E of the General Laws, as so appearing, is hereby
45	45	18amended in subsection (b) by striking out clause (i) and inserting in place thereof the following:-
46	46	19“all amounts paid by hospitals and managed care organizations under sections 67, 68 and 68A;”.
47	47	20 SECTION 5. Section 66 of Chapter 118E of the General Laws, as so appearing, is hereby
48	48	21further amended in subsection (b) by inserting after the words “money transferred”, the
49	49	22following:- “by the executive office in accordance with section 68A of this chapter,”.
50	50	23 SECTION 6. Chapter 118E of the General Laws, as so appearing, is hereby amended by
51	51	24adding the following new section:-
52	52	25 Section 68A. Supplemental MCO Assessment to Fund Shortfall
53	53	26 (a) No later than April 1 of the year preceding the start of the fund fiscal year, the
54	54	27executive office shall estimate the projected total reimbursable health services provided by acute
55	55	28hospitals and community health centers and emergency bad debt costs, the total funding
56	56	29available and any projected shortfall after adjusting for reimbursement payments to hospitals and
57	57	30community health centers. If a shortfall in revenue is estimated to exist in any fund fiscal year to
58	58	31cover projected costs for reimbursement of health services, the executive office shall allocate 50 3 of 4
59	59	32percent of that shortfall amount to managed care organizations subject to an assessment in
60	60	33section 68 of Chapter 118E and that are not Medicaid managed care organizations.
61	61	34 (b) The executive office shall allocate the supplemental shortfall assessment in a manner
62	62	35consistent with the methods promulgated by the executive office to determine the managed care
63	63	36liability defined in section 68, with the exception that the supplemental shortfall assessment shall
64	64	37only be assessed to managed care organizations that are not Medicaid managed care
65	65	38organizations.
66	66	39 (c) The supplemental shortfall assessment shall be paid to the Health Safety Net Trust
67	67	40Fund, established in section 66, by managed care organizations subject to the assessment on a
68	68	41monthly basis and shall be assessed on all managed care organization services subject to
69	69	42assessment. The executive office shall finalize the supplemental surcharge amount for each fund
70	70	43fiscal year using best available data no later than 60 days after the fund fiscal year end.
71	71	44 (d) The secretary of health and human services shall implement the supplemental
72	72	45shortfall assessment described in this section and shall promulgate regulations necessary to
73	73	46support implementation of said assessment. In promulgating such regulations, the secretary of
74	74	47health and human services shall, at a minimum: (i) establish set assessment rates for the
75	75	48supplemental shortfall assessment; (ii) establish any necessary reporting requirements for
76	76	49managed care organizations; (iii) establish an appropriate mechanism for enforcing each
77	77	50managed care organization’s supplemental shortfall assessment liability to the Health Safety Net
78	78	51Trust Fund, established in section 66, if a managed care organization rendering managed care
79	79	52organization services subject to assessment does not make a scheduled payment to the Health
80	80	53Safety Net Trust Fund; (iv) specify an appropriate mechanism for determination and payment of 4 of 4
81	81	54a managed care organization’s supplemental shortfall assessment liability to the Health Safety
82	82	55Net Trust Fund; (v) identify the managed care organization services subject to the supplemental
83	83	56shortfall assessment; (vi) specify an appropriate mechanism for the determination of a managed
84	84	57care organization’s liability in cases of merger or transfer of ownership; and (vii) specify an
85	85	58appropriate mechanism by which any amounts paid by a managed care organization in excess of
86	86	59its supplemental shortfall assessment may be refunded or otherwise credited to the managed care
87	87	60organization.
88	88	61 SECTION 7. Section 69 of Chapter 118E of the General Laws, as so appearing, is hereby
89	89	62amended in subsection (b) by striking out the second sentence and inserting in place thereof the
90	90	63following:- “If a shortfall in revenue exists in any fund fiscal year to cover projected costs for
91	91	64reimbursement of health services, the office shall allocate 50 percent of that shortfall in a manner
92	92	65that reflects each hospital's proportional financial requirement for reimbursements from the fund,
93	93	66including, but not limited to, the establishment of a graduated reimbursement system and under
94	94	67any additional regulations promulgated by the office.”