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Budget Summary FY2015

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40000300 - EOHHS and MassHealth Administration
Data Current as of:  10/17/2014





Account Description FY2014
Spending
FY2015
GAA
4000-0300 EOHHS and MassHealth Administration
For the operation of the executive office of health and human services, including the operation of the managed care oversight board; provided, that the executive office shall provide technical and administrative assistance to agencies under the purview of the secretariat receiving federal funds; provided further, that the executive office shall ensure that any collaborative assessments for children receiving services from multiple agencies within the secretariat shall be performed within existing resources; provided further, that funds appropriated in this item shall be expended for administrative and contracted services related to the implementation and operation of programs authorized by chapter 118E of the General Laws; provided further that on or before December 31, 2014, not less than $100,000 shall be provided to Noble Hospital, a federal and state disproportionate share hospital that is geographically isolated, to improve the access entry way for all patients, especially those challenged with disabilities, provided that such funds are matched by an equal or greater amount by Noble Hospital; provided further, that in consultation with the center for health information and analysis, no rate increase shall be provided to existing Medicaid provider rates without taking all measures possible under Title XIX of the Social Security Act, as codified at 42 U.S.C. chapter 7, subchapter XIX, to ensure that rates of payment to providers do not exceed the rates that are necessary to meet only those costs which must be incurred by efficiently and economically operated providers in order to provide services of adequate quality; provided further, that funds may be expended for the operation of the office of health equity within the executive office of health and human services; provided further, that the executive office shall contract with Martha's Vineyard Community Services, Inc. for no less than $60,000 to increase access to health and human services on Martha's Vineyard and Nantucket, and such funds shall be used to cover feasible travel costs associated with arranging access to health and human services; provided further, that no expenditures shall be made that are not federally reimbursable, including those related to Titles XIX or XXI of the Social Security Act, as codified at 42 U.S.C. chapter 7, subchapters XIX or XXI or the MassHealth demonstration waiver pursuant to section 1115(a) of said Social Security Act, as codified at 42 U.S.C. section 1315(a) or the community first demonstration waiver pursuant to section 1115 of the Social Security Act, as codified at 42 U.S.C. section 1315, whether made by the executive office or another commonwealth entity, except as required for: (a) the equivalent of MassHealth Standard benefits for children under age 21 who are in the care or custody of the department of youth services or the department of children and families; (b) dental benefits provided to clients of the department of developmental services who are age 21 or over; or (c) cost containment efforts the purposes and amounts of which have been submitted to the executive office for administration and finance and the house and senate committees on ways and means 30 days prior to making these expenditures; provided further, that the office of Medicaid shall apply an add-on to reimburse the managed care organizations and senior care organizations under contract with the commonwealth for the full costs associated with the Affordable Care Act's annual insurer fee, as specified in section 9010(a) of the Affordable Care Act, Public Law 111-148; provided, that said add-on shall be exclusive of any additional rate increase currently being proposed for the fiscal year 2015; provided further, that subject to the availability of federal financial participation, said add-on shall include the related tax liability for the annual insurer fee; provided further, that MassHealth shall provide a report, not later than March 2, 2015, to the house and senate committees on ways and means and the joint committee on health care financing on the amount of reimbursement of the Affordable Care Act's insurer fee and the related tax liability and the methodology for calculating said reimbursement to the managed care organizations and senior care organizations; provided further, that the executive office of health and human services may continue to recover provider overpayments made in the current and prior fiscal years through the Medicaid management information system, and that these recoveries shall be considered current fiscal year expenditure refunds; provided further, that funds shall be provided in an amount not less than the total appropriated in item 1599-2009 in section 2 of chapter 182 of the acts of 2008; provided further, that of the amount allocated in this line item, the office of Medicaid shall provide a 2 per cent rate increase for Medicaid managed care organizations that are under contract with the commonwealth to deliver managed care services to Masshealth and care plus enrollees; provided further, that the executive office may collect directly from a liable third party any amounts paid to contracted providers under chapter 118E of the General Laws for which the executive office later discovers another third party is liable if no other course of recoupment is possible; provided further, that no funds shall be expended for interpretive services directly or indirectly related to a settlement or resolution agreement with the office of civil rights or any other office, group, or entity; provided further, that interpretive services currently provided shall not give rise to enforceable legal rights for any party or to an enforceable entitlement to interpretive services; provided further, $150,000 shall be expended for the work of the Massachusetts unaccompanied homeless youth commission to determine the scope of need among unaccompanied youth and young adults ages 24 and younger who are experiencing homelessness, and to identify and implement potential models for appropriate service delivery to unaccompanied homeless youth in urban, suburban, and rural areas of the commonwealth; provided further, that in calculating rates of payment for children enrolled in MassHealth receiving inpatient and outpatient services at acute care pediatric hospitals and pediatric specialty units as defined in section 8A of chapter 118E of the General Laws, the executive office shall make a supplemental payment to any acute care pediatric hospital and pediatric specialty unit in the commonwealth, above base rates, to compensate for high-complexity pediatric care in an amount not less than the amount appropriated in this item in chapter 38 of the acts of 2013; provided further, that not less than $1,000,000 shall be expended for costs associated with the purchase and renovation of a mental health and drug and alcohol rehabilitation facility in the town of Petersham to serve the North Quabbin region and North Central Massachusetts; provided further, that notwithstanding any general or special law to the contrary, the commissioner of mental health shall approve any prior authorization or other restriction on medication used to treat mental illness in accordance with written policies, procedures, and regulations of the department of mental health; provided further, that not later than January 16, 2015, the executive office of health and human services shall submit a report to the house and senate committees on ways and means detailing the methodology used to project caseload and utilization in fiscal year 2014 and fiscal year 2015; provided further, that the executive office of health and human services shall report to the house and senate committees on ways and means not later than January 13, 2015 on the number of members served in the dual eligible initiative, the average expenditure per member, the average expenditure per member prior to the demonstration project and the number of clients that receive care at skilled nursing facilities; provided further, that the executive office shall submit to the house and senate committees on ways and means and the joint committee on health care financing not later than December 5, 2014 a report detailing utilization of the Health Safety Net Trust Fund established pursuant to section 66 of said chapter 118E; provided further, that the report shall include: (a) the number of persons whose medical expenses were billed to the Health Safety Net Trust Fund in fiscal year 2014; (b) the total dollar amount billed to the Health Safety Net Trust Fund in fiscal year 2014; (c) the demographics of the population using the Health Safety Net Trust Fund; and (d) the types of services paid for out of the Health Safety Net Trust Fund in fiscal year 2014; provided further, that any projection of deficiency in item 4000-0430, 4000-0500, 4000-0600, 4000-0640, 4000-0700, 4000-0875, 4000-0880, 4000-0885, 4000-0940, 4000-0950, 4000-0990, 4000-1400, 4000-1420 or 4000-1425 shall be reported to the house and senate committees on ways and means not less than 90 days before the projected exhaustion of funding; provided further, that any unexpended balance in these accounts shall revert to the General Fund on June 30, 2015; and provided further, that for the purposes of long-term health care cost savings and enhanced patient care, the commonwealth shall recognize telehealth remote patient monitoring provided by home health agencies as a service to clients otherwise reimbursable through Medicaid
92,085,813 91,557,569