Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S917 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. 1126 FILED ON: 1/15/2025
3	3	SENATE . . . . . . . . . . . . . . No. 917
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	John C. Velis
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 address the financial sustainability of the Health Safety Net.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :John C. VelisHampden and Hampshire 1 of 4
16	16	SENATE DOCKET, NO. 1126 FILED ON: 1/15/2025
17	17	SENATE . . . . . . . . . . . . . . No. 917
18	18	By Mr. Velis, a petition (accompanied by bill, Senate, No. 917) of John C. Velis for legislation
19	19	to address the financial sustainability of the Health Safety Net. Health Care Financing.
20	20	[SIMILAR MATTER FILED IN PREVIOUS SESSION
21	21	SEE SENATE, NO. 811 OF 2023-2024.]
22	22	The Commonwealth of Massachusetts
23	23	_______________
24	24	In the One Hundred and Ninety-Fourth General Court
25	25	(2025-2026)
26	26	_______________
27	27	An Act to address the financial sustainability of the Health Safety Net.
28	28	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
29	29	of the same, as follows:
30	30	1 SECTION 1. Section 2OOO of Chapter 29 of the general laws is hereby amended by
31	31	2striking the third sentence in the second paragraph in its entirety and inserting in place thereof
32	32	3the following:- Money from the fund shall be transferred to the Health Safety Net Trust Fund, or
33	33	4any successor fund, as necessary to provide payments to acute hospitals and community health
34	34	5centers for reimbursable health services. No less than the amounts in subsection (b) of section
35	35	6189 of chapter 149 of the general laws shall be annually transferred to the Health Safety Net
36	36	7Trust Fund.
37	37	8 SECTION 2. Section 189 of chapter 149 of the general laws is here by amended in
38	38	9subsection (b) by striking “$30,000,000” and replacing with “$60,000,000”. 2 of 4
39	39	10 SECTION 3. Section 64 of Chapter 118E of the General Laws, as appearing in the 2022
40	40	11Official Edition, is hereby amended by inserting after the definition of “Resident” the following
41	41	12new definition:-
42	42	13 "Supplemental shortfall assessment'', an amount equal to 50 percent of the annual
43	43	14revenue shortfall in the Health Safety Net Trust fund as determined by the executive office
44	44	15pursuant to subsection (a) of section 68A.
45	45	16 SECTION 4. Section 66 of Chapter 118E of the General Laws, as so appearing, is hereby
46	46	17amended in subsection (b) by striking out clause (i) and inserting in place thereof the following:-
47	47	18“all amounts paid by hospitals and managed care organizations under sections 67, 68 and 68A;”.
48	48	19 SECTION 5. Section 66 of Chapter 118E of the General Laws, as so appearing, is hereby
49	49	20further amended in subsection (b) by inserting after the words “money transferred”, the
50	50	21following:- “by the executive office in accordance with section 68A of this chapter,”.
51	51	22 SECTION 6. Chapter 118E of the General Laws, as so appearing, is hereby amended by
52	52	23adding the following new section:-
53	53	24 Section 68A. Supplemental MCO Assessment to Fund Shortfall
54	54	25 (a) No later than April 1 of the year preceding the start of the fund fiscal year, the
55	55	26executive office shall estimate the projected total reimbursable health services provided by acute
56	56	27hospitals and community health centers and emergency bad debt costs, the total funding
57	57	28available and any projected shortfall after adjusting for reimbursement payments to hospitals and
58	58	29community health centers. If a shortfall in revenue is estimated to exist in any fund fiscal year to
59	59	30cover projected costs for reimbursement of health services, the executive office shall allocate 50 3 of 4
60	60	31percent of that shortfall amount to managed care organizations subject to an assessment in
61	61	32section 68 of Chapter 118E and that are not Medicaid managed care organizations.
62	62	33 (b) The executive office shall allocate the supplemental shortfall assessment in a manner
63	63	34consistent with the methods promulgated by the executive office to determine the managed care
64	64	35liability defined in section 68, with the exception that the supplemental shortfall assessment shall
65	65	36only be assessed to managed care organizations that are not Medicaid managed care
66	66	37organizations.
67	67	38 (c) The supplemental shortfall assessment shall be paid to the Health Safety Net Trust
68	68	39Fund, established in section 66, by managed care organizations subject to the assessment on a
69	69	40monthly basis and shall be assessed on all managed care organization services subject to
70	70	41assessment. The executive office shall finalize the supplemental surcharge amount for each fund
71	71	42fiscal year using best available data no later than 60 days after the fund fiscal year end.
72	72	43 (d) The secretary of health and human services shall implement the supplemental
73	73	44shortfall assessment described in this section and shall promulgate regulations necessary to
74	74	45support implementation of said assessment. In promulgating such regulations, the secretary of
75	75	46health and human services shall, at a minimum: (i) establish set assessment rates for the
76	76	47supplemental shortfall assessment; (ii) establish any necessary reporting requirements for
77	77	48managed care organizations; (iii) establish an appropriate mechanism for enforcing each
78	78	49managed care organization’s supplemental shortfall assessment liability to the Health Safety Net
79	79	50Trust Fund, established in section 66, if a managed care organization rendering managed care
80	80	51organization services subject to assessment does not make a scheduled payment to the Health
81	81	52Safety Net Trust Fund; (iv) specify an appropriate mechanism for determination and payment of 4 of 4
82	82	53a managed care organization’s supplemental shortfall assessment liability to the Health Safety
83	83	54Net Trust Fund; (v) identify the managed care organization services subject to the supplemental
84	84	55shortfall assessment; (vi) specify an appropriate mechanism for the determination of a managed
85	85	56care organization’s liability in cases of merger or transfer of ownership; and (vii) specify an
86	86	57appropriate mechanism by which any amounts paid by a managed care organization in excess of
87	87	58its supplemental shortfall assessment may be refunded or otherwise credited to the managed care
88	88	59organization.
89	89	60 SECTION 7. Section 69 of Chapter 118E of the General Laws, as so appearing, is hereby
90	90	61amended in subsection (b) by striking out the second sentence and inserting in place thereof the
91	91	62following:- “If a shortfall in revenue exists in any fund fiscal year to cover projected costs for
92	92	63reimbursement of health services, the office shall allocate 50 percent of that shortfall in a manner
93	93	64that reflects each hospital's proportional financial requirement for reimbursements from the fund,
94	94	65including, but not limited to, the establishment of a graduated reimbursement system and under
95	95	66any additional regulations promulgated by the office.”