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