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HOUSE DOCKET, NO. 2058 FILED ON: 1/15/2025
HOUSE . . . . . . . . . . . . . . . No. 1366
The Commonwealth of Massachusetts
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PRESENTED BY:
Sean Garballey and Richard M. Haggerty
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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 protect medically fragile children.
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PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Sean Garballey23rd Middlesex1/15/2025Richard M. Haggerty30th Middlesex1/15/2025 1 of 3
HOUSE DOCKET, NO. 2058 FILED ON: 1/15/2025
HOUSE . . . . . . . . . . . . . . . No. 1366
By Representatives Garballey of Arlington and Haggerty of Woburn, a petition (accompanied by
bill, House, No. 1366) of Sean Garballey and Richard M. Haggerty for legislation to further
regulate the criteria for continuous skilled nursing services. 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 protect medically fragile children.
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 24 of Chapter 12C of the General Laws is hereby amended by
2adding at the end of the first paragraph the following sentence:
3 In developing the biennial report, the center shall seek input from nurses who provide
4continuous skilled nursing care and patients and family members of patients that receive
5continuous skilled nursing care and include in the report information about direct care
6experiences.
7 SECTION 2. Chapter 118E of the General Laws is hereby amended by adding the
8following section:-
9 Section 83. (a) Notwithstanding any general or special law to the contrary, and subject to
10appropriation, the executive office of health and human services shall increase the budget for
11continuous skilled nursing care, as defined in 101 CMR 361 and 130 CMR 403.402, by an
12amount that ensures: 2 of 3
13 (1) At least 75 percent of continuous skilled nursing hours authorized by MassHealth are
14filled on or before July 1, 2025;
15 (2) At least 80 percent of continuous skilled nursing hours authorized by MassHealth are
16filled on or before July 1, 2026; and
17 (3) At least 85 percent of continuous skilled nursing hours authorized by MassHealth are
18filled on or before July 1, 2027, and shall remain at 85 percent or above thereafter.
19 (b) The executive office of health and human services may require any portion of the
20budget increases provided for in this section to be used exclusively to increase the wage payment
21rate of nurses providing continuous skilled nursing care.
22 (c) To satisfy the requirements in subsection (a), the executive office of health and human
23services shall require MassHealth to submit an annual report no later than January 1 that:
24 (1) demonstrates that MassHealth has not changed its authorization criteria for
25continuous skilled nursing services in a way that is more restrictive and results in a reduction in
26the amount of authorized hours that would have been authorized previously; and
27 (2) includes the following information from the immediately preceding calendar year: (i)
28the number of filled and unfilled continuous skilled nursing hours authorized by MassHealth; (ii)
29the number of appeals received by MassHealth for the denial or modification of continuous
30skilled nursing hours and the number of patients that filed an appeal; (iii) the number of patients
31that received a reduction in the amount of authorized continuous skilled nursing hours; and (iv)
32the number of authorized continuous skilled nursing hours reduced from the immediately
33preceding calendar year, if any. 3 of 3
34 (d) The executive office of health and human services, in collaboration with MassHealth
35and after consultation with the Massachusetts Pediatric Nursing Care Campaign, shall
36promulgate regulations to implement this section.
37 (e) Nothing in this section shall be construed to prohibit filling 85 percent of the
38continuous skilled nursing hours authorized by MassHealth prior to July 1, 2027.
39 SECTION 3. Notwithstanding any general or special law to the contrary, the office of
40Medicaid shall review the wage payment rates established by home health agencies that provide
41continuous skilled nursing care, as defined in 101 CMR 361.00 and 130 CMR 403.402, for the
42providers of those services. The office shall provide: (i) an aggregated overview of the wage
43payment rates paid by home health agencies to staff or contracted nurses providing continuous
44skilled nursing care, including any increases in said wage rates resulting from increases in
45Medicaid rates paid to home health agencies for continuous skilled nursing care in state fiscal
46years 2022, 2023 and 2024; (ii) an aggregated breakdown of said wage rates as applied to the
47acuity level of patients receiving continuous skilled nursing care; (iii) an aggregated breakdown
48of said wage rates as applied to the licensure level of the providers of continuous skilled nursing
49care; and (iv) recommendations on criteria to be included in any future reporting by home health
50agencies receiving an increase of continuous skilled nursing care rates provided by the office.
51The office shall provide this report not later than March 1, 2027 to the clerks of the senate and
52house of representatives, the joint committee on health care financing and the senate and house
53committees on ways and means. Home health agencies providing continuous skilled nursing care
54shall provide all information and documentation requested by the office of Medicaid to compile
55the required report under this section.