Signed by Governor Deval Patrick

Vote Smart's Synopsis:

Vote to adopt a conference report that establishes Accountable Care Organizations and limits payments to health care providers.

Highlights:

• Authorizes a provider organization to become certified as an Accountable Care Organization (ACO) for a period of 2 years (Sec. 15).

• Defines “provider organization” as any organization that contracts with insurance carriers for payment of health care services including, but not limited to, physician organizations, provider networks, and independent practice organizations (Sec. 1).

• Establishes certain goals for Accountable Care Organizations including, but not limited to, the following (Sec. 15):
• Reduce the growth of health care costs;
• Improve the quality of health care services;
• Ensure patient access to health care services;
• Promote alternative payment methodologies;
• Improve access to primary care services;
• Promote patient-centered care;
• Adopt new health care technologies; and
• Promote community-based wellness programs.

• Requires Accountable Care Organizations to perform the following (Sec. 15):
• Receive reimbursements or compensation using alternative payment methodologies;
• Coordinate financial payments among providers;
• Provide a full range of medically necessary services, including behavioral and physical health services;
• Provide patients with relevant price information about health care services; and
• Engage patients in shared decision-making, including decisions about palliative and long-term care.

• Requires the Health Policy Commission to establish a health care spending growth target for 2013 to 2017 that is equal to the growth rate of the potential Gross State Product from 2013 to 2017 (Sec. 9).

• Specifies that the growth rate of the potential Gross State Product for 2013 is 3.6 percent (Sec. 9).

• Requires the Health Policy Commission to establish a health care spending growth target for 2018 to 2022 that is equal to the Gross State Product minus 0.5 percent from 2018 to 2022 (Sec. 9).

• Establishes the Massachusetts wellness program tax credit for businesses that implement certain wellness programs (Sec. 41).

• Specifies that the amount of the Massachusetts wellness program tax credit shall be equal to 25 percent of the costs of implementing a wellness program, up to a maximum of $10,000 per business per fiscal year (Sec. 41).

• Authorizes the Executive Office of Health and Human Services to establish rates of payment for health care services and to limit future rate increases (Sec. 123).

• Prohibits an individual from initiating legal action against a health care provider unless the individual has given the health care provider 182 days written notice (Sec. 221).

• Prohibits a hospital from requiring a nurse to work mandatory overtime, except in an emergency situation when the safety of the patient requires it and when no reasonable alternative exists (Sec. 103).

• Requires the Executive Office of Health and Human Services to conduct at least 5 public hearings in “geographically diverse areas” on the proposed plan, and to provide interested individuals with an opportunity to submit their comments verbally or in writing (Sec. 14).

Full Bill Text