1 of 1
HOUSE DOCKET, NO. 650 FILED ON: 1/10/2025
HOUSE . . . . . . . . . . . . . . . No. 767
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Carmine Lawrence Gentile
_________________
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 clarifying rate setting processes for home health and home care services.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Carmine Lawrence Gentile13th Middlesex1/10/2025Bruce J. Ayers1st Norfolk2/12/2025Manny Cruz7th Essex2/24/2025James B. EldridgeMiddlesex and Worcester2/10/2025Paul K. Frost7th Worcester1/27/2025Natalie M. Higgins4th Worcester1/24/2025Patricia D. JehlenSecond Middlesex2/13/2025Hannah Kane11th Worcester1/27/2025Mary S. Keefe15th Worcester3/4/2025Joseph D. McKenna18th Worcester1/28/2025Paul McMurtry11th Norfolk2/6/2025Samantha Montaño15th Suffolk3/11/2025Jacob R. OliveiraHampden, Hampshire and Worcester2/6/2025Angelo J. Puppolo, Jr.12th Hampden1/24/2025Lindsay N. Sabadosa1st Hampshire1/27/2025Adam J. Scanlon14th Bristol2/27/2025Danillo A. Sena37th Middlesex3/10/2025Thomas M. Stanley9th Middlesex2/13/2025 1 of 4
HOUSE DOCKET, NO. 650 FILED ON: 1/10/2025
HOUSE . . . . . . . . . . . . . . . No. 767
By Representative Gentile of Sudbury, a petition (accompanied by bill, House, No. 767) of
Carmine Lawrence Gentile and others clarifying rate setting processes for home health and home
care services. Elder Affairs.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act clarifying rate setting processes for home health and home care services.
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 13D of Chapter 118E of the general laws is amended after the
2second paragraph by inserting the following new paragraph:
3 Such rates for home health and continuous skilled nursing agencies, as defined under
4section 51K of chapter 111, shall be established and reviewed at least biennially. In setting such
5rates, the executive office shall use as base year costs for rate determination purposes the
6reported costs of the calendar year not more than 4 years prior to the current rate year, adjusted
7for reasonableness and to incorporate any new regulatory costs imposed since said base year
8costs. In establishing rates of payment to home health agencies, the executive office shall
9consider all costs which must be incurred by efficiently and economically operated providers.
10The rates shall also include an allowance for reasonable administrative expenses and a
11reasonable profit factor, as determined by the executive office. Such cost analysis shall include,
12but not be limited to, the following: costs of similar services provided in other care settings; use 2 of 4
13of national or regional indices to measure increases or decreases in reasonable costs incurred
14since the base year costs; the revision of existing historical cost bases, where applicable, to
15reflect changing norms or models of efficient service delivery; and other means to encourage the
16cost-efficient delivery of services. The Secretary shall, concurrent with the completion of setting
17such rates, provide a report to the house and senate committees on ways and means detailing
18how the rates issued under this paragraph were analyzed and revised; provided further, that the
19report shall compare the inflationary considerations made in the adopted rate with the most
20recent “Home Health Agency Market Basket” index posted by the United States Department of
21Health and Human Services, Centers for Medicare and Medicaid Services; provided further, that
22if the adopted rate does not rely on the “Home Health Agency Market Basket” index for the
23purpose of determining inflationary adjustments, then the report will simulate what the rate
24would have been if such index was a factor in rate development. In determining the methodology
25for setting rates, the Secretary shall consult with stakeholders impacted by the rates.
26
27 SECTION 2: Section 4 of Chapter 19A is hereby amended by adding after Section 4D the
28following new section:
29
30 SECTION 4E: In establishing rates of payment pursuant to the second paragraph of
31section 13C of chapter 118E of the M.G.L., the executive office shall consider changes to the
32state minimum wage or changes to employer payroll tax obligations as governmental mandates
33that affect the costs of providing homemaker and personal care homemaker services to elderly
34clients under this section. 3 of 4
35
36 The executive office shall also consider and analyze rates of payment and wages
37associated with providing similar services in both the public and private settings. In calculating
38operating costs, the executive office shall consider costs of; health insurance, employee benefits
39and training, payroll taxes, technology costs, administrative allocation and staff salaries using the
40latest available national or regional indices and benchmarked to the latest available Bureau of
41Labor Statistics median wage data. Nothing in this section shall be construed as limiting
42consideration of other governmental mandates or operating costs that affect the cost of providing
43services pursuant to section 4 of chapter 19A of the General Laws. In determining the
44methodology for setting rates, the Secretary shall consult with stakeholders impacted by the
45rates.
46
47 The Secretary of Elder Affairs shall, concurrent with the promulgation of the final rates
48of payment for services under section 4 of chapter 19A, issue a report to the House and Senate
49committees on ways and means detailing how the rates promulgated were analyzed and
50determined in compliance with the provisions set forth in the second paragraph of section 13C of
51chapter 118E of the General Laws. The report shall detail the department’s analysis of changes in
52the costs of providing homemaker and personal care homemaker services since the immediately
53preceding rate determination; provided further, that the report shall compare the inflationary
54considerations made in the adopted rate with the most recent “Home Health Agency Market
55Basket” index posted by the United States Department of Health and Human Services, Centers
56for Medicare and Medicaid Services; provided further, that if the adopted rate does not rely on 4 of 4
57the “Home Health Agency Market Basket” index for the purpose of determining inflationary
58adjustments, then the report will simulate what the rate would have been if such index was a
59factor in rate development.