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Budget Summary FY2011

Outside Section 154
Data Current as of:  8/6/2010




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global payment system for high-risk pediatric asthma patients

SECTION 154.   Notwithstanding any general or special law to the contrary, the executive office of health and human services shall develop a global or bundled payment system for high-risk pediatric asthma patients enrolled in the MassHealth program, designed to prevent unnecessary hospital admissions and emergency room utilization. Consistent with the National Asthma Education and Prevention Program guidelines developed by the National Institutes of Health, the global or bundled payments shall reimburse expenses necessary to manage pediatric asthma, including, but not limited to, patient education, environmental assessments, mitigation of asthma triggers and purchase of necessary durable medical equipment. The executive office may pursue demonstration authority for this program from the federal center for Medicare and Medicaid Services pursuant to the Patient Protection and Affordable Care Act, Public Law 111-148 or other federal law. The global or bundled payments shall be designed to ensure a financial return on investment through the reduction of costs related to hospital and emergency room visits and admissions not later than 2 years after the effective date of this act. This high-risk pediatric asthma global or bundled payment demonstration project shall be piloted in communities with high rates of uncontrolled childhood asthma. The executive office of health and human services shall consult with the providers that manage the Community Asthma Initiative at Children's Hospital Boston and with other relevant providers in the commonwealth in designing and implementing the high-risk pediatric asthma global or bundled payment demonstration program and shall collaborate with participating entities in evaluating the efficacy of the program. The executive office of health and human services shall report its findings on the cost effectiveness of this program to the joint committee on health care financing, the joint committee on public health and the house and senate committees on ways and means not later than December 31, 2012.