Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1366 Compare Versions

Only one version of the bill is available at this time.

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1	1	1 of 1
2	2	HOUSE DOCKET, NO. 2058 FILED ON: 1/15/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 1366
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Sean Garballey and Richard M. Haggerty
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 protect medically fragile children.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Sean Garballey23rd Middlesex1/15/2025Richard M. Haggerty30th Middlesex1/15/2025 1 of 3
16	16	HOUSE DOCKET, NO. 2058 FILED ON: 1/15/2025
17	17	HOUSE . . . . . . . . . . . . . . . No. 1366
18	18	By Representatives Garballey of Arlington and Haggerty of Woburn, a petition (accompanied by
19	19	bill, House, No. 1366) of Sean Garballey and Richard M. Haggerty for legislation to further
20	20	regulate the criteria for continuous skilled nursing services. Health Care Financing.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Fourth General Court
24	24	(2025-2026)
25	25	_______________
26	26	An Act to protect medically fragile children.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Section 24 of Chapter 12C of the General Laws is hereby amended by
30	30	2adding at the end of the first paragraph the following sentence:
31	31	3 In developing the biennial report, the center shall seek input from nurses who provide
32	32	4continuous skilled nursing care and patients and family members of patients that receive
33	33	5continuous skilled nursing care and include in the report information about direct care
34	34	6experiences.
35	35	7 SECTION 2. Chapter 118E of the General Laws is hereby amended by adding the
36	36	8following section:-
37	37	9 Section 83. (a) Notwithstanding any general or special law to the contrary, and subject to
38	38	10appropriation, the executive office of health and human services shall increase the budget for
39	39	11continuous skilled nursing care, as defined in 101 CMR 361 and 130 CMR 403.402, by an
40	40	12amount that ensures: 2 of 3
41	41	13 (1) At least 75 percent of continuous skilled nursing hours authorized by MassHealth are
42	42	14filled on or before July 1, 2025;
43	43	15 (2) At least 80 percent of continuous skilled nursing hours authorized by MassHealth are
44	44	16filled on or before July 1, 2026; and
45	45	17 (3) At least 85 percent of continuous skilled nursing hours authorized by MassHealth are
46	46	18filled on or before July 1, 2027, and shall remain at 85 percent or above thereafter.
47	47	19 (b) The executive office of health and human services may require any portion of the
48	48	20budget increases provided for in this section to be used exclusively to increase the wage payment
49	49	21rate of nurses providing continuous skilled nursing care.
50	50	22 (c) To satisfy the requirements in subsection (a), the executive office of health and human
51	51	23services shall require MassHealth to submit an annual report no later than January 1 that:
52	52	24 (1) demonstrates that MassHealth has not changed its authorization criteria for
53	53	25continuous skilled nursing services in a way that is more restrictive and results in a reduction in
54	54	26the amount of authorized hours that would have been authorized previously; and
55	55	27 (2) includes the following information from the immediately preceding calendar year: (i)
56	56	28the number of filled and unfilled continuous skilled nursing hours authorized by MassHealth; (ii)
57	57	29the number of appeals received by MassHealth for the denial or modification of continuous
58	58	30skilled nursing hours and the number of patients that filed an appeal; (iii) the number of patients
59	59	31that received a reduction in the amount of authorized continuous skilled nursing hours; and (iv)
60	60	32the number of authorized continuous skilled nursing hours reduced from the immediately
61	61	33preceding calendar year, if any. 3 of 3
62	62	34 (d) The executive office of health and human services, in collaboration with MassHealth
63	63	35and after consultation with the Massachusetts Pediatric Nursing Care Campaign, shall
64	64	36promulgate regulations to implement this section.
65	65	37 (e) Nothing in this section shall be construed to prohibit filling 85 percent of the
66	66	38continuous skilled nursing hours authorized by MassHealth prior to July 1, 2027.
67	67	39 SECTION 3. Notwithstanding any general or special law to the contrary, the office of
68	68	40Medicaid shall review the wage payment rates established by home health agencies that provide
69	69	41continuous skilled nursing care, as defined in 101 CMR 361.00 and 130 CMR 403.402, for the
70	70	42providers of those services. The office shall provide: (i) an aggregated overview of the wage
71	71	43payment rates paid by home health agencies to staff or contracted nurses providing continuous
72	72	44skilled nursing care, including any increases in said wage rates resulting from increases in
73	73	45Medicaid rates paid to home health agencies for continuous skilled nursing care in state fiscal
74	74	46years 2022, 2023 and 2024; (ii) an aggregated breakdown of said wage rates as applied to the
75	75	47acuity level of patients receiving continuous skilled nursing care; (iii) an aggregated breakdown
76	76	48of said wage rates as applied to the licensure level of the providers of continuous skilled nursing
77	77	49care; and (iv) recommendations on criteria to be included in any future reporting by home health
78	78	50agencies receiving an increase of continuous skilled nursing care rates provided by the office.
79	79	51The office shall provide this report not later than March 1, 2027 to the clerks of the senate and
80	80	52house of representatives, the joint committee on health care financing and the senate and house
81	81	53committees on ways and means. Home health agencies providing continuous skilled nursing care
82	82	54shall provide all information and documentation requested by the office of Medicaid to compile
83	83	55the required report under this section.