This is not the official budget document.

General Appropriations Act FY2008

Outside Section 45
Data Current as of:  10/29/2007




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Health Safety Net Trust Improvement Plan

SECTION 45.   Notwithstanding any general or special law to the contrary, the health safety net office, established in section 35 of chapter 118G of the General Laws shall enter into an interdepartmental service agreement with the office of Medicaid to develop and implement a plan to achieve the improvements in the operations, management, payment processes and data integrity of the health safety net trust fund, consistent with, but not limited to, the provisions of subclauses (ii) to (v), inclusive, of subsection (b). Said plan shall include, but not be limited to: (i) a review and analysis of free care and emergency bad debt claims submitted in the most recent 3-year period to determine the patterns most appropriate and promising for targeted audits and reviews; (ii) a cost effective approach to maximizing the identification of all sources of third-party liability for patients receiving free care or emergency services; (iii) a cost-effective approach to establishing an ongoing claims and utilization review system for uncompensated care claims that is effective in identifying and disallowing inappropriate claims, but also takes into consideration the practicality of said approach considering the small volume of claims relative to other payers that make routine use of claims and utilization review systems, and (iv) an approach that maximizes the use of existing eligibility determination and review systems, coordination of benefits, claims review and provider integrity systems, ISAs and related program and provider integrity contracts available to the office of Medicaid for achieving the management improvements required under this section. Said plan, and a proposed timeline for implementation of all components of the plan, shall be submitted to the joint committee on health care financing and the house and senate committees on ways and means no later than October 30, 2007. The office and the office of Medicaid shall jointly submit a report to joint committee on health care financing and the house and senate committees on ways and means no later than March 15, 2009, outlining the results of the management improvements implemented pursuant to said plan and provisions of this section and making any necessary recommendations for further improvements and reforms of the health safety net trust fund and its operations.