Signed by Governor Deval Patrick

Highlights:

• In Massachusetts, a new bill number is assigned when a new version of the bill is drafted. The bill number was changed to S 2400 for the Senate and House Conference Report stages.

Highlights:

• In Massachusetts, a new bill number is assigned when a new version of the bill is drafted. The bill number was changed to S 2400 for the Senate and House Conference Report stages.

Vote Smart's Synopsis:

Vote to pass a bill that reduces state health care spending.

Highlights:

• Requires the State Attorney General to take action to prevent anti-competitive practices in the market, prevent “unreasonable” increases in health rates and prices, and prevent “adverse effects” on patient access and quality (Sec. 11).

• Establishes the Institute of Health Care Finance and Policy to monitor trends in health care costs and review providers suspected of engaging in anticompetitive behavior (Sec. 15).

• Requires the Secretary of Administration and Finance to meet with the House and Senate Committees on Ways and Means and jointly develop a projected economic growth benchmark, which will be reported on September 15th each year (Sec. 18).

• Establishes the Massachusetts e-Health Institute to implement a statewide system of electronic health records (Sec. 29).

• Requires that every 4 years the Department of Health, in consultation with the Institute of Health Care Finance and Policy, submit a health resource plan that identifies the healthcare needs of the state and the resources required to meet them (Sec. 50).

• Requires healthcare providers to disclose, upon patient request, the following (Sec. 83):
• The allowed charge for a proposed admission, procedure, or service including facility fees within 2 working days; or
• If unable to quote a specific amount to to disclose the estimated maximum allowed charge within 2 working days.

• Authorizes the Commissioner to impose a fine of up to $1000 on any health care provider in violation of the requirement to disclose the maximum allowed charge to the patient or prospective patient (Sec. 83).

• Requires the Secretary of the Executive Office to establish “fair and adequate” charges to be used by state institutions for general health supplies, care, accommodations, and rehabilitative services (Sec. 97).

• Establishes a Health Safety Net Office within the office of Medicaid to set reimbursement rates to community health centers/acute hospitals that provide healthcare services to low-income, uninsured/underinsured patients (Sec. 104).

• Establishes a personal care attendant quality home workforce council to assist consumers with finding personal care attendants (Sec. 104).

• Requires insurance carriers to disclose limitations of coverage relating to preexisting conditions (Sec. 137).

• Requires insurance carriers to establish a toll-free number and website that enables consumers to obtain information about the amount that the insured will be responsible to pay for a proposed admission, procedure, or service that is a medically necessary covered benefit including (Sec. 137):
• Any facility fee;
• Copayment;
• Deductible;
• Other out-of-pocket amount; and
• The actual or maximum estimated allowed amount and co-insurance for any covered health benefits.

• Establishes a small group wellness incentive program that will provide technical assistance and an annual subsidy to eligible small groups that implement evidence-based employee health and wellness programs (Sec. 160).

• Establishes the Health Care Quality and Finance Authority to set health care cost containment goals and implement health care delivery and payment models that will lower cost growth (Sec. 162).

• Requires the advisory board to the Health Care Quality and Finance Authority to establish a health care cost growth benchmark for statewide average growth no later than April 15 of each year (Sec. 162).

• Requires the Health Care Quality and Finance Authority to establish procedures for a “Beacon ACO” certification process (Sec. 162).

• Defines “Beacon ACO” as a certification given by the board of the Health Care Quality and Finance Authority to indicate that a provider organization meets certain standards regarding quality, cost containment, and patient protection (Sec. 162).

• Requires the Health Care Quality and Finance Authority to develop standards for alternative payment methods for use by the group insurance commission, Medicaid, and all other state-funded insurance programs (Sec. 162).

• Establishes the Distressed Community Hospital Trust Fund to improve ability of “qualified” community hospitals to serve populations in need more “effectively” (Sec. 173).

• Requires the Department of Health to create a model wellness guide for payers, employers, and consumers (Sec. 175).

• Requires the Department of Health to submit a health resource plan to the Governor and General Court no later than January 1, 2014 (Sec. 183).

• Requires the group insurance commission, MassHealth, and all other state-funded insurance programs to implement alternative payment methods no later than July 1, 2014 (Sec. 186).

• Establishes a commission to review price variation among health care providers (Sec. 190).

Full Bill Text