Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H2461 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. 2851 FILED ON: 1/16/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 2461
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Hannah Kane
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 ensure the efficient operation of hospitals.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Hannah Kane11th Worcester1/16/2025Carmine Lawrence Gentile13th Middlesex1/21/2025 1 of 4
16	16	HOUSE DOCKET, NO. 2851 FILED ON: 1/16/2025
17	17	HOUSE . . . . . . . . . . . . . . . No. 2461
18	18	By Representative Kane of Shrewsbury, a petition (accompanied by bill, House, No. 2461) of
19	19	Hannah Kane and Carmine Lawrence Gentile relative to the efficient operation of hospitals.
20	20	Public Health.
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 ensure the efficient operation of hospitals.
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. Chapter 6D of the General Laws is hereby amended by inserting after
30	30	2section 21 the following new language: -
31	31	3 Section 22. Ensuring the Efficient Operation of Hospitals
32	32	4 (a) The commission shall develop an index to measure and ensure hospital efficiency. In
33	33	5developing the hospital efficiency index, the commission shall consider existing measures of
34	34	6hospital efficiency, which shall include but not be limited to the following:
35	35	7 i. Measures of low-value care and potentially avoidable utilization, including but
36	36	8not limited to avoidable hospital admissions, hospital readmissions, avoidable emergency
37	37	9department visits, preventable medical errors, hospital-acquired infections, unnecessarily
38	38	10extended length of stay, and use of low-value services and treatments, developed in consultation
39	39	11with the Betsy Lehman Center; 2 of 4
40	40	12 ii.Measures that examine inpatient and outpatient hospital payment levels compared
41	41	13with hospital performance on standard quality measure set, as established by the center for health
42	42	14information and analysis pursuant to section 14 of chapter 12C;
43	43	15 iii.Measures that examine the hospital’s cost of delivering care compared to other
44	44	16hospitals, including but not limited to measures of cost per case, ratios comparing costs to
45	45	17payments, average length of stay, efficient use of bed capacity, and measures of hospital
46	46	18operating expenses per case or service delivered, and compared to Medicare reimbursement rates
47	47	19and national trends; and
48	48	20 iv.Measures of administrative waste and other unnecessary administrative spending,
49	49	21including but not limited to, foregone opportunities due to lack of clinical and operational
50	50	22integration, redundant staffing, unnecessary duplication of procedures and diagnostic testing,
51	51	23lack of electronic medical records and interoperability of patient medical records.
52	52	24 (b) The commission shall develop each component of the efficiency measure for
53	53	25application at both the hospital and the system level, unless the commission deems that certain
54	54	26measures would be more appropriately applied at the system level.
55	55	27 (c) Prior to publishing the hospital efficiency index under subsection (a), the commission
56	56	28shall hold a public hearing. The commission shall provide public notice of such hearing at least
57	57	2945 days prior to the date of the hearing, including notice to the joint committee on health care
58	58	30financing. The commission shall identify as witnesses for the public hearing a representative
59	59	31sample of hospitals, hospital systems, payers, including public and private payers, consumer
60	60	32organizations, employer representatives, and such other interested parties as the commission may
61	61	33determine. Any other interested parties may testify at the hearing. 3 of 4
62	62	34 (d) The commission shall evaluate the index every two years and may modify the index.
63	63	35Prior to publishing an updated index, the commission shall hold a public hearing as set forth in
64	64	36subsection (c).
65	65	37 (e) The commission shall publish an annual report on its website and include as part of its
66	66	38annual hearings, pursuant to section 8, hospital performance, in the aggregate and by individual
67	67	39hospital, on each component of the index.
68	68	40 (f)The commission, in consultation with the center for health information and analysis
69	69	41shall promulgate regulations governing the collection of data sufficient to monitor hospital
70	70	42efficiency.
71	71	43 (g) The commission shall develop recommendations governing the enforcement of the
72	72	44hospital efficiency index by the state and private and commercial payers. The commission’s
73	73	45recommendations shall include, but not be limited to the following:
74	74	46 i. Requiring commercial insurers, Medicaid, and group insurance commission to
75	75	47directly apply efficiency adjustments to hospital contracts based on performance on the
76	76	48efficiency index;
77	77	49 ii.Requiring the hospital to enter into an efficiency correction action plan if a
78	78	50hospital performs poorly on the index overall or on any component of the index; and
79	79	51 iii.Prohibiting commercial, Medicaid, and the group insurance commission payment
80	80	52for low value care or other hospital services related to potentially avoidable utilization, provided
81	81	53that consumers are protected from balance billing for such services. 4 of 4
82	82	54 The commission, in consultation with the center for health information and analysis, the
83	83	55office of Medicaid, the group insurance commission, and the division of insurance, shall file a
84	84	56report containing its recommendations for enforcement of the hospital efficiency index with the
85	85	57house and senate committees on ways and means and the joint committee on health care
86	86	58financing and shall be published and made available to the public no later than July 1, 2026.