Governor Deval Patrick's Budget Recommendation - House 2 Fiscal Year 2009

Governor's Budget Recommendation FY 2009

Outside Section 33



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Transfers Among Health Care Funds

SECTION 33.   (a) Notwithstanding any general or special law to the contrary, on or before October 1, 2008 and without further appropriation, the comptroller shall transfer from the General Fund to the Health Safety Net Trust Fund, established pursuant to section 35 of chapter 118G of the General Laws and in this subsection called the fund, the greater of $45,000,000 or one-twelfth of the total expenditures to hospitals and community health centers required pursuant to subsection (b), for the purpose of making initial gross payments to qualifying acute care hospitals for the hospital fiscal year beginning October 1, 2008. These payments shall be made to hospitals before, and in anticipation of, the payment by hospitals of their gross liability to the fund. The comptroller shall transfer from the fund to the General Fund not later than June 30, 2009, the amount of the transfer authorized by this subsection and any allocation thereof as certified by the director of the health safety net office.
          (b) Notwithstanding any general or special law to the contrary, the comptroller shall, in consultation with the state treasurer, the secretary of administration and finance and the secretary of health and human services, develop a schedule for transferring funds among the General Fund, the Commonwealth Care Trust Fund, established by section 2OOO of chapter 29 of the General Laws and the Health Safety Net Trust Fund, established by section 36 of chapter 118G of the General Laws. Not less than $1,292,561,456 shall be transferred from the General Fund to the Commonwealth Care Trust Fund and not less than $62,996,382 shall be transferred from the Commonwealth Care Trust Fund to the Health Safety Net Trust Fund. The hospital fiscal year 2009 payment amount to each hospital shall be funded by the Health Safety Net Trust Fund. Payments may be made either as safety net care payments under the Commonwealth's 1115 waiver, or as an adjustment to Title XIX service rate payments, or a combination thereof;. The executive office of health and human services and the health safety net office may use other federally permissible funding mechanisms available for public service hospitals, as defined in 114.1 CMR 36.02, to reimburse up to $70,000,000 of uncompensated care at the hospitals using sources distinct from the funding made available to the Health Safety Net Trust Fund. The executive office of health and human services shall make expenditures required for fiscal year 2008 under section 122 of chapter 58 of the acts of 2006. The schedule shall provide for transfers in increments considered appropriate to meet the cash flow needs of these funds. The transfers shall not begin before July 1, 2008 and shall be completed on or before June 30, 2009. The secretary of administration and finance, in consultation with the secretary of health and human services and the executive director of the commonwealth health insurance connector, shall on a quarterly basis evaluate the revenue needs of the health safety net program funded by the Health Safety Net Trust Fund and the Commonwealth Care subsidized health insurance program funded from the Commonwealth Care Trust Fund, and if necessary, transfer monies between these funds for the purpose of ensuring that sufficient revenues are available to support projected program expenditures.
          (c) Notwithstanding any general or special law to the contrary, the comptroller shall, in consultation with the office of the state treasurer, the executive office of administration and finance and the executive office of health and human services, develop a schedule and make a series of transfers not to exceed $251,000,000 from the General Fund to the MassHealth provider payment account in the Medical Assistance Trust Fund, established by section 2QQQ of chapter 29 of the General Laws, if the comptroller has determined that General Fund revenues are sufficient to accommodate the schedule of transfers. These funds may be expended only for services provided during state or federal fiscal year 2009, and no amounts previously or subsequently transferred into the Medical Assistance Trust Fund may be expended on payments described in the 1115 demonstration waiver for services provided during state fiscal year 2009 or payments described in the state plan for services provided during federal fiscal year 2009. All payments from the Medical Assistance Trust Fund shall be subject to the availability of federal financial participation, shall be made only in accordance with federally-approved payment methods, shall be consistent with federal funding requirements and all federal payment limits as determined by the secretary of health and human services, and shall be subject to the terms and conditions of an agreement with the executive office of health and human services. The secretary of the executive office of health and human services shall make a payment of up to $148,000,000 from the Medical Assistance Trust Fund to the Cambridge public health commission's hospital network for dates of service in state and federal fiscal year 2009 only after the Cambridge public health commission transfers up to $74,000,000 of its funds to the Medical Assistance Trust Fund, using a federally permissible source of funds which shall fully satisfy the non-federal share of such payment.
          (d) Notwithstanding any general or special law to the contrary, the comptroller, in consultation with the secretary of health and human services, shall develop a schedule for transferring not less than $28,000,000 from the General Fund to the Essential Community Provider Trust Fund, established in section 2PPP of chapter 29 of the General Laws, for the purpose of making expenditures as described in this section in fiscal year 2009. The secretary shall authorize expenditures by the division of health care finance and policy from the fund without further appropriation for the purpose of (1) grants to financially distressed MassHealth providers that provide emergency care, behavioral health, and routine care for MassHealth and Commonwealth Care members; (2) grants to financially viable MassHealth providers that are essential providers to MassHealth and Commonwealth Care members; (3) a program, which may be based on the Medicare Management Performance Demonstration or similar models, to provide financial incentives to small group practices with MassHealth Primary Care Clinician Plan enrollment of between 100 and 1,000 members, which must (a) report specified clinical data, (b) achieve specified clinical benchmarks in service delivery and care management, and (c) implement an electronic medical record system within specified timeframes and with specified data sharing capacity; (4) a program to provide financial incentives to encourage the establishment of systems of care in communities with high concentrations of MassHealth, Commonwealth Care, and Group Insurance Commission membership to engage hospitals, community health centers, community mental health centers, physicians, and other providers, and to reward such providers based upon their ability to timely deliver expected health outcomes in a lower cost setting; and (5) a program to review and address, as needed, payments for behavioral health care to MassHealth members in community hospital settings, and coordination of inpatient and outpatient care in such settings. The secretary, in consultation with the division, shall determine which entities meet the purposes and criteria described in this section. The executive office shall structure expenditures under this section to maximize allowable federal reimbursement under Title XIX. All federal financial participation received for expenditures from the Essential Community Provider Trust Fund shall be deposited in the General Fund, and shall be available for further appropriation for purposes specified in this subsection.
 
 

Summary:
This section authorizes several transfers among health care funds, including the Commonwealth Care Trust Fund, Medical Assistance Trust Fund, Health Safety Net Trust Fund, and Essential Community Provider Trust Fund.



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