Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S903 Compare Versions

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

Old	New	Differences
1	1	1 of 1
2	2	SENATE DOCKET, NO. 2361 FILED ON: 1/17/2025
3	3	SENATE . . . . . . . . . . . . . . No. 903
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Pavel M. Payano
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 improving access to post acute services.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Pavel M. PayanoFirst Essex 1 of 5
16	16	SENATE DOCKET, NO. 2361 FILED ON: 1/17/2025
17	17	SENATE . . . . . . . . . . . . . . No. 903
18	18	By Mr. Payano, a petition (accompanied by bill, Senate, No. 903) of Pavel M. Payano for
19	19	legislation to improve the ability for patients to receive specialized medical care after an acute
20	20	illness or surgery. 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 improving access to post acute services.
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. Notwithstanding any general or special law to the contrary, the Office of
30	30	2Medicaid shall, in consultation with the Massachusetts Health and Hospital Association and its
31	31	3non-acute care hospitals, take actions to support community discharge for MassHealth patients
32	32	4currently awaiting discharge in post-acute care hospitals to provide improved access to patients
33	33	5awaiting acute hospital care. Such actions shall include, but not be limited to, the following: (i)
34	34	6revising language describing approval for administrative days in MassHealth beneficiary notices
35	35	7regarding service determinations in non-acute care hospitals; (ii) adopting a transparent approach
36	36	8regarding adverse determinations for MassHealth beneficiary receiving non-acute hospital
37	37	9services, including standard timelines, coverage criteria, and appeals processes that are clear to
38	38	10providers and consumers; and (iii) expanding and developing community resources to support
39	39	11discharge to independent living in community settings for MassHealth beneficiaries with
40	40	12chronic, medically complex conditions. 2 of 5
41	41	13 SECTION 2. Section 13A of Chapter 118E of the General Laws, shall be amended by
42	42	14inserting at the end thereof the following:
43	43	15 To establish Medicaid rates for non-acute care hospitals, the division of medical
44	44	16assistance shall use as base year costs for rate determination purposes the reported costs of the
45	45	17calendar year not more than 2 years prior to the current rate year.
46	46	18 SECTION 3. Sections 38 and 41 of Chapter 197 of the Acts of 2024 are hereby repealed.
47	47	19 SECTION 4. Subsection (b) of section 24 of Chapter 197 of the Acts of 2024 shall be
48	48	20amended by inserting after the words “acute care hospital”, the words “non-acute care hospital”.
49	49	21 SECTION 5. (a) For the purposes of this section, the following words shall have the
50	50	22following meanings unless the context clearly requires otherwise:
51	51	23 “Payer” the group insurance commission under chapter 32A of the General Laws, the
52	52	24division of medical assistance under chapter 118E of the General Laws, insurance companies
53	53	25organized under chapter 175 of the General Laws, non-profit hospital service corporations
54	54	26organized under chapter 176A of the General Laws, medical service corporations organized
55	55	27under chapter 176B of the General Laws, health maintenance organizations organized under
56	56	28chapter 176G of the General Laws and preferred provider organizations organized under chapter
57	57	29176I of the General Laws, or a utilization review organization acting under contract with the
58	58	30aforementioned entities.
59	59	31 (b) Notwithstanding any general or special law to the contrary, all payers shall not require
60	60	32prior authorization for the transition of any inpatient of an acute care hospital or non-acute
61	61	33hospital to home health agencies certified by the Centers for Medicare and Medicaid Services 3 of 5
62	62	34 SECTION 6. Section 16CC of the General Laws, as appearing in the 2022 official
63	63	35edition, shall be amended by inserting at the end thereof the following:
64	64	36 (k) The secretary of health and human services shall establish within the statewide long
65	65	37term care ombudsman office a complex care ombudsman program to assist acute & post-acute
66	66	38care hospitals with discharges to lower level post-acute care settings; provided further, that such
67	67	39program shall ensure that at least one complex care case manager shall be assigned to each of the
68	68	405 EMS regions of the state to assist the hospitals in each region with discharges to lower level
69	69	41post-acute care settings”.
70	70	42 SECTION 7. Notwithstanding any general or special law to the contrary, the Secretary of
71	71	43Health and Human Services or a designee, in conjunction with the Division of Medical
72	72	44Assistance, shall establish a regional pilot program to increase the capacity of staffed long-term
73	73	45care beds, beds for patients with dementia diagnoses, and beds for geriatric patients with
74	74	46psychiatric diagnoses in the state’s nursing facilities; provided, that the pilot may review the
75	75	47prior temporary program that added short-term rehabilitation capacity in all regions of
76	76	48Massachusetts and shall support patient care transitions to reduce the number of patients who are
77	77	49medically ready for discharge but are not able to be transferred due to capacity constraints for
78	78	50post-acute care services; provided further, that the executive office shall consult with the
79	79	51Massachusetts Health and Hospital Association, the Mass. Senior Care Association, LeadingAge
80	80	52Massachusetts, the Massachusetts Association of Behavioral Health Systems and other
81	81	53stakeholder groups to identify the capabilities necessary for nursing facilities to accept and care
82	82	54for additional patients in the identified categories and the workforce training necessary to support
83	83	55these capabilities, including programs to increase recruitment and retention of 1:1 nursing care 4 of 5
84	84	56staff for residents and best practices to treat residents diagnosed with Alzheimer’s disease or
85	85	57dementia.
86	86	58 SECTION 8. Section 1 of Chapter 215 of the General Laws, as appearing in the 2022
87	87	59official edition, shall be amended by inserting at the end thereof the following.
88	88	60 There shall be an Office of Adult Guardianship and Conservatorship Oversight within the
89	89	61Administrative Office of the Probate and Family Court to increase court oversight of guardians
90	90	62and conservators and guardian and conservator arrangements to protect older adults and adults
91	91	63with disabilities from abuse, financial exploitation, and neglect. Within said office there shall be
92	92	64an ombudsman who shall work across the divisions of the court to assist with the scheduling or
93	93	65expediting of cases before the courts or assist with other procedures.
94	94	66 SECTION 9. Chapter 215 of the general laws, as appearing in the 2022 official edition,
95	95	67shall be amended by inserting at the end thereof the following:
96	96	68 Section XX. Probate courts may schedule weekly or bi-weekly block sessions of
97	97	69healthcare cases for matters within their jurisdiction addressing the appointment or expansion of
98	98	70guardians, conservators, health care proxies or other matters that may be placed within their
99	99	71jurisdiction.
100	100	72 SECTION 10. Notwithstanding any general or special law to the contrary, the Secretary
101	101	73of Health and Human Services or a designee shall establish a task force to consider the co-
102	102	74location of medical services at skilled nursing facilities including behavioral health and
103	103	75substance use disorder treatment services, building capacity for telehealth services, and the
104	104	76provision of devices and broadband services to support telehealth services in skilled nursing
105	105	77facilities. 5 of 5
106	106	78 SECTION 11. Notwithstanding any general or special law to the contrary, the Secretary
107	107	79of Health and Human Services or a designee shall establish a pilot program for existing skilled
108	108	80nursing facilities s to serve as a teaching skilled nursing facilities to utilize and disseminate best
109	109	81practices in skilled nursing facility care in conjunction with nursing facility staff, students,
110	110	82teaching hospitals, and academic institutions to improve care for nursing home residents and
111	111	83foster careers in long-term care and geriatrics.
112	112	84 SECTION 12. Notwithstanding any general or special law to the contrary, the Secretary
113	113	85of Health and Human Services or a designee, in conjunction with the Administrative Office of
114	114	86the Trial Court, shall develop a public outreach campaign to recruit individuals including but not
115	115	87limited to retired attorneys, doctors, nurses, and social workers to serve as guardians and
116	116	88conservators for patients who have no identified persons to serve in these roles on their behalf. In
117	117	89the development of said outreach campaign, the Secretary shall consult with the Massachusetts
118	118	90Health & Hospital Association, Honoring Choices Massachusetts, the Massachusetts
119	119	91Guardianship Policy Institute, Massachusetts Bar Association, and other organizations that serve
120	120	92in roles to support guardians and conservators.