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SENATE DOCKET, NO. 1034 FILED ON: 1/15/2025
SENATE . . . . . . . . . . . . . . No. 870
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Patricia D. Jehlen
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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 clarifying rate setting processes for home health and home care services.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :Patricia D. JehlenSecond MiddlesexAngelo J. Puppolo, Jr.12th Hampden1/27/2025Hannah Kane11th Worcester1/27/2025Michael O. MooreSecond Worcester1/27/2025Paul K. Frost7th Worcester1/28/2025Joanne M. ComerfordHampshire, Franklin and Worcester1/28/2025Paul W. MarkBerkshire, Hampden, Franklin and
Hampshire
2/10/2025Jacob R. OliveiraHampden, Hampshire and Worcester2/10/2025James B. EldridgeMiddlesex and Worcester2/11/2025Thomas M. Stanley9th Middlesex2/14/2025Sal N. DiDomenicoMiddlesex and Suffolk2/20/2025John F. KeenanNorfolk and Plymouth2/20/2025Manny Cruz7th Essex2/25/2025Adam J. Scanlon14th Bristol3/3/2025Michael D. BradySecond Plymouth and Norfolk3/3/2025 1 of 3
SENATE DOCKET, NO. 1034 FILED ON: 1/15/2025
SENATE . . . . . . . . . . . . . . No. 870
By Ms. Jehlen, a petition (accompanied by bill, Senate, No. 870) of Patricia D. Jehlen, Angelo J.
Puppolo, Jr., Hannah Kane, Michael O. Moore and other members of the General Court for
legislation to clarify rate setting processes for home health and home care services. Health Care
Financing.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 755 OF 2023-2024.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
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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. 2 of 3
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
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 SECTION 2. Section 4 of Chapter 19A is hereby amended by adding after Section 4D the
27following new section:
28 Section 4E. In establishing rates of payment pursuant to the second paragraph of section
2913C of chapter 118E of the M.G.L., the executive office shall consider changes to the state
30minimum wage or changes to employer payroll tax obligations as governmental mandates that
31affect the costs of providing homemaker and personal care homemaker services to elderly clients
32under this section. 3 of 3
33 The executive office shall also consider and analyze rates of payment and wages
34associated with providing similar services in both the public and private settings. In calculating
35operating costs, the executive office shall consider costs of; health insurance, employee benefits
36and training, payroll taxes, technology costs, administrative allocation and staff salaries using the
37latest available national or regional indices and benchmarked to the latest available Bureau of
38Labor Statistics median wage data. Nothing in this section shall be construed as limiting
39consideration of other governmental mandates or operating costs that affect the cost of providing
40services pursuant to section 4 of chapter 19A of the General Laws. In determining the
41methodology for setting rates, the Secretary shall consult with stakeholders impacted by the
42rates.
43 The Secretary of Elder Affairs shall, concurrent with the promulgation of the final rates
44of payment for services under section 4 of chapter 19A, issue a report to the House and Senate
45committees on ways and means detailing how the rates promulgated were analyzed and
46determined in compliance with the provisions set forth in the second paragraph of section 13C of
47chapter 118E of the General Laws. The report shall detail the department’s analysis of changes in
48the costs of providing homemaker and personal care homemaker services since the immediately
49preceding rate determination; provided further, that the report shall compare the inflationary
50considerations made in the adopted rate with the most recent “Home Health Agency Market
51Basket” index posted by the United States Department of Health and Human Services, Centers
52for Medicare and Medicaid Services; provided further, that if the adopted rate does not rely on
53the “Home Health Agency Market Basket” index for the purpose of determining inflationary
54adjustments, then the report will simulate what the rate would have been if such index was a
55factor in rate development.