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| ACCOUNT | FY 2008 Conference |
FY 2008 Vetoes |
FY 2008 Overrides |
FY 2008 GAA |
|
|---|---|---|---|---|---|
| 4000-0112 | Youth-at-Risk Matching Grants | 5,705 | 0 | 0 | 5,705 |
| 4000-0265 | Community Health Center Grants | 1,700 | 0 | 0 | 1,700 |
| 4000-0300 | Executive Office of Health and Human Services and Medicaid Administration | 142,273 | 0 | 0 | 142,273 |
| 4000-0301 | MassHealth Auditing and Utilization Reviews | 2,200 | 0 | 0 | 2,200 |
| 4000-0352 | MassHealth Enrollment Outreach Grants | 3,500 | 0 | 0 | 3,500 |
| 4000-0355 | Health Care Quality and Cost Council | 1,000 | 0 | 0 | 1,000 |
| 4000-0430 | MassHealth CommonHealth Plan | 101,582 | 0 | 0 | 101,582 |
| 4000-0500 | MassHealth Managed Care | 2,884,675 | 0 | 0 | 2,884,675 |
| 4000-0700 | MassHealth Indemnity | 1,683,747 | -1,500 | 1,500 | 1,683,747 |
| 4000-0870 | MassHealth Basic Coverage | 117,206 | 0 | 0 | 117,206 |
| 4000-0875 | MassHealth Breast and Cervical Cancer Treatment | 5,422 | 0 | 0 | 5,422 |
| 4000-0880 | MassHealth Family Assistance Plan | 137,979 | 0 | 0 | 137,979 |
| 4000-0890 | MassHealth Premium Assistance and Insurance Partnership Program | 36,090 | 0 | 0 | 36,090 |
| 4000-0891 | MassHealth Insurance Partnership for Employers | 5,490 | 0 | 0 | 5,490 |
| 4000-0895 | Healthy Start Program | 18,135 | 0 | 0 | 18,135 |
| 4000-0990 | Children's Medical Security Plan | 15,223 | 0 | 0 | 15,223 |
| 4000-1400 | MassHealth HIV Plan | 16,591 | 0 | 0 | 16,591 |
| 4000-1405 | MassHealth Essential | 251,838 | 0 | 0 | 251,838 |
| 4000-1420 | Medicare Part D Phased Down Contribution | 233,916 | 0 | 0 | 233,916 |
| 4000-0320 | MassHealth Recoveries from Current and Prior Fiscal Years Retained Revenue | 225,000 | 0 | 0 | 225,000 |
| TOTAL | 5,889,274 | -1,500 | 1,500 | 5,889,274 | |
| account | description | amount |
|---|---|---|
| OFFICE OF THE SECRETARY OF HEALTH AND HUMAN SERVICES | 5,923,158,881 | |
| Budgetary Direct Appropriations | 5,889,274,147 | |
| Direct Appropriations | ||
| 4000-0112 | Youth-at-Risk Matching Grants
For matching grants to boys' and girls' clubs, YMCA and YWCA organizations, nonprofit community centers, and youth development programs; provided, that the secretary of health and human services shall award the full amount of each grant to each organization upon commitment of matching funds from the organization; provided further, that not less than $3,300,000 shall be expended for the Massachusetts Alliance of Boys and Girls Clubs; provided further, that not less than $50,000 shall be expended for the Methuen Branch of the Merrimack Valley YMCA; provided further, that not less than $80,000 shall be expended for the young parents program of the Newton Community Service Centers; provided further, that not less than $50,000 shall be expended for the Project Adventure Youth Leadership Program administered by Family Services Incorporated of Lawrence; provided further, that not less than $50,000 shall be expended for the West Suburban YMCA; provided further, that not less than $100,000 shall be expended for the YWCA of Newburyport; provided further, that not less than $50,000 shall be expended for the Chelsea YMCA; provided further, that not less than $100,000 shall be expended for the Springfield Day Nursery; provided further, that not less than $50,000 shall be expended to the Franklin Community Action Corporation for youth services; provided further, that not less than $25,000 shall be expended for the YMCA of Greater Lynn; provided further, that not less than $100,000 shall be expended for the Nazzaro Recreation Center; provided further that not less than $150,000 shall be expanded for nonprofit Youth Services in Andover; provided further, that not less than $50,000 shall be expended for programs at the YWCA of Haverhill; provided further, that not less than $50,000 shall be expended for the Oak Square YMCA that will service teens from ages 13 to 17, inclusive; provided further, that not less than $100,000 be expended for health and wellness programming at the YWCA of Greater Lawrence; provided further, that not less than $125,000 shall be expended for the Greater Worcester YMCA youth programs; provided further, that not less than $50,000 shall be expended for the Girls Incorporated of Holyoke; provided further, that not less than $50,000 shall be expended for programs at the Northeast Family YMCA; provided further, that not less than $35,000 shall be expended for the United Way of Tri-County for services at the Milford Youth Center; provided further, that not less than $500,000 shall be expended for youth programs in Massachusetts administered by the Cal Ripken, Sr. Foundation; provided further, that not less than $100,000 for Dot-Well youth services and out of school time activities; provided further, that not less than $100,000 shall be expended for the United Teen Equity Center in Lowell; provided further that not less than $50,000 shall be expended for the YMCA of Cape Cod; provided further, that not less than $250,000 shall be expended for the Children's Friend and Family Services of Salem; provided further, that not less than $40,000 shall be expended for the public partnership program between the greater Lynn YMCA and YWCA and the public partnership program between the town of Saugus and the Saugus YMCA and YWCA; provided further, that not less than $50,000 shall be expended for a community fitness and nutrition program for youth in the town of Watertown operated by Boston Boxing and Fitness, Inc.; provided further, that not less than $25,000 shall be expended for the YMCAs of Massachusetts, Inc., for distribution to its member YMCAs; provided further, that not less than $25,000 shall be expended for programs at the Fishing Academy, Incorporated; and provided further, that the secretary shall report to the house and senate committees on ways and means on the exact amount distributed in fiscal year 2008 by February 1, 2008 |
5,705,000 |
| 4000-0265 | Community Health Center Grants
For a primary care workforce development and loan forgiveness grant program at community health centers, for the purpose of enhancing recruitment and retention of primary care physicians and other clinicians at community health centers throughout the Commonwealth; provided, that the grant shall be administered by the Massachusetts League of Community Health Centers in consultation with the secretary of the executive office of health and human services and relevant member agencies; and provided further, that the funds shall be matched by other public and private funds; and provided, further, that the League shall work with said secretary and said agencies to maximize all sources of public and private funds |
1,700,000 |
| 4000-0300 | Executive Office of Health and Human Services and Medicaid Administration
For the operation of the executive office, 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 and its agencies, when contracting for services on the islands of Martha's Vineyard and Nantucket, shall take into consideration the increased costs associated with the provision of goods, services, and housing on said islands; provided further, that the executive office shall monitor the expenditures and completion timetables for systems development projects and enhancements undertaken by all agencies under the purview of the secretariat, and shall ensure that all measures are taken to make such systems compatible with one another for enhanced interagency interaction; provided further, that the executive office shall continue to develop and implement the common client identifier; 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 the administrative, contracted services and non-personnel systems costs related to the implementation and operation of programs authorized by sections 9A to 9C, inclusive, and sections 16B and 16C of chapter 118E of the General Laws; provided further, that the costs shall include, but not be limited to, pre-admission screening, utilization review, medical consultants, disability determination reviews, health benefit managers, interagency service agreements, the management and operation of the central automated vendor payment system, including the recipient eligibility verification system, vendor contracts to upgrade and enhance the central automated vendor payment system, the Medicaid management information system and the recipient eligibility verification system MA21, costs related to the information technology chargebacks, contractors responsible for system maintenance and development, personal computers and other information technology equipment; provided further, that 50 per cent of the cost of provider point of service eligibility verification devices purchased shall be assumed by the providers utilizing the devices; provided further, that the executive office shall assume the full cost of provider point of service eligibility verification devices utilized by any and all participating dental care providers; provided further, that in consultation with the division of health care finance and policy, no rate increase shall be provided to existing Medicaid provider rates without taking all measures possible under Title XIX of the Social Security Act to ensure that rates of payment to providers do not exceed such rates as 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 expenditures for the purposes of each item appropriated for the purpose of programs authorized by chapter 118E of the General Laws shall be accounted for according to such purpose on the Massachusetts management accounting and reporting system not more than 10 days after the expenditures have been made by the Medicaid management information system; provided further, that no expenditures shall be made for the purpose of programs that are not federally reimbursable, except as specifically authorized herein, or unless made for cost containment efforts the purposes and amounts of which have been submitted to the house and senate committees on ways and means 30 days prior to making such expenditures; provided further, that the executive office may continue to recover provider overpayments made in the current and prior fiscal years through the Medicaid management information system, and that the recoveries shall be considered current fiscal year expenditure refunds; 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 the purpose of funding 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, that the federal financial participation received from claims filed for the costs of outreach and eligibility activities performed at certain hospitals or by community health centers which are funded in whole or in part by federally permissible in-kind services or provider donations from the hospitals or health centers, shall be credited to this item and may be expended without further appropriation in an amount specified in the agreement with each donating provider hospital or health center; provided further, that notwithstanding any general or special law to the contrary, the executive office shall require the commissioner of mental health to 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 the secretary shall ensure that supplemental Medicaid rates required pursuant to section 128 of chapter 58 of the acts of 2006 are implemented in fiscal year 2008; provided further, that notwithstanding section 1 of chapter 118G of the General Laws or any general or special law to the contrary, for fiscal year 2008 the definition of a "pediatric specialty unit" shall mean an acute care hospital with a burn center verified by the American Burn Center and the American College of Surgeons and a level 1 trauma center for pediatrics verified by the American College of Surgeons or a pediatric unit of an acute care hospital in which the ratio of licensed pediatric beds to total licensed hospital beds as of July 1, 1994, exceeded 0.20; provided further, that in calculating that ratio, licensed pediatric beds shall include the total of all pediatric service beds, and the total of all licensed hospital beds shall include the total of all licensed acute care hospital beds, consistent with Medicare's acute care hospital reimbursement methodology as put forth in the Provider Reimbursement Manual Part 1, Section 2405.3G; provided further, that a hospital with a unit designated as a pediatric specialty unit, or an acute care hospital with a burn center verified by the American Burn Center and the American College of Surgeons and a level 1 trauma center for pediatrics verified by the American College of Surgeons as defined in this item shall be exempt from the inpatient and outpatient efficiency standards being applied to their rate methodology; provided further, that in calculating rates of payment for children enrolled in MassHealth receiving inpatient services at acute care pediatric hospitals and pediatric subspecialty units as defined in section 1 of chapter 118G of the General Laws, the executive office shall make a supplemental payment, if necessary, sufficient to assure that inpatient SPAD and outlier payments for discharges with a case mix acuity greater than 5.0 shall be at least equal to 85 per cent of the expenses incurred in providing services to those children; provided further, that the executive office, in fiscal year 2008, shall not eliminate payment to hospital outpatient departments for primary care provided to MassHealth members; provided further, that the executive office shall not reduce the outpatient rates for any specialty hospital which limits its admissions to patients under active diagnosis and treatment of the eyes, ears, nose, and throat, below that which was granted during hospital fiscal year 2005; provided further, that a new methodology shall be established for rates reimbursed by the commonwealth through the division of health care finance and policy and the executive office of health and human services to cover the cost of care provided by any health care facility licensed by the department of public health as a non-acute chronic hospital with no fewer than 500 licensed beds as of June 30, 2007, with no fewer than 150,000 Medicaid patient days in the state fiscal year ended June 30, 2007, and with an established geriatric teaching program for physicians, medical students, and other health professionals, as follows: (1) the rate for any such facility shall be developed collaboratively through an agreement among the office of Medicaid, the division of health care finance and policy, and any such health care facility; provided, that the process for development of this rate shall include a mechanism to adjust the rate to account for costs outside the reasonable control of the facility that may arise after the rate has been established; (2) the reimbursement methodology shall incorporate the following components: (a) utilization of the payment methodology in effect during fiscal year 2006 together with the most recent 403 cost report filed with the division of health care finance and policy, (b) a per diem rate shall be established which reimburses the full cost, including capital, for both acute and administratively necessary services, (c) a separate per diem rate shall be established which reimburses the full cost, including capital, for long term care services, (d) both rates shall include the full cost, not otherwise reimbursed, of teaching and research activities, and (e) rates shall be inflated over the base year period by the applicable medicare market basket inflation factors; (3) until such time as the new reimbursement methodology is established pursuant to this section, the per diem rates for any such facility shall be increased by at least 13 dollars per day over the rates in effect on April 1, 2007 for the year starting July 1, 2007, and by 5 percent annually for each subsequent year; provided, that notwithstanding this section or any contractual or other provision of law, such facility shall have the right to an increase to the rate then in effect to account for costs outside the reasonable control of such facility that may arise; and (4) notwithstanding any other provision of law, in no event will the rates of payment be lower than the highest rate in effect for such facility in the previous state fiscal year; provided further, that the secretary shall ensure that all Medicaid benefit restorations, program expansions, and rate increases required pursuant to chapter 58 of the acts of 2006 are implemented in fiscal year 2008; provided further, that the executive office shall include smoking and tobacco use cessation treatment and information within MassHealth covered services pursuant to section 108 of chapter 58 of the acts of 2006; provided further, that with respect to section 6036 of the Deficit Reduction Act of 2005, the executive office shall assist applicants and recipients born in Massachusetts to obtain a copy of a birth certificate for the purpose of establishing eligibility for Medicaid at no cost to said individuals, and shall provide such additional assistance as may be needed by those applicants and recipients born outside of Massachusetts; provided further, that the executive office shall not, by amendment to the state plan or amendment to the section 1115 demonstration program, elect any state option to increase premiums and cost sharing or reduce benefits pursuant to sections 1916A and 1937 of the Social Security Act as amended by chapter 4 of Title VI of the Deficit Reduction Act of 2005, Pub. L. No. 109171 with respect to any category of persons eligible for medical benefits under chapter 118E as said chapter was in effect on January 1, 2006, unless the executive office has given 90 days notice to the legislature and has received approval of the proposed plan from a majority of the legislature; provided further, that the executive office shall develop a process whereby all participating providers who have signed the Virtual Gateway Services Agreement shall have access to the contents of the consolidated summary of any individual's application submitted through the virtual gateway; provided further, that said information access shall comply with all HIPPA requirements and state privacy laws; provided further, that not later than September 1, 2007, the executive office of health and human services shall submit a report to the house and senate committees on ways and means detailing planned fiscal year 2008 expenditures by the executive office as funded by chargebacks to the 17 executive office cluster agencies; provided further, that not less than $200,000 shall be expended for a Health Care Reform Outreach and Education unit within the executive office for the purpose of coordinating statewide activities in marketing, outreach, and the dissemination of educational materials related to state law changes contained in Chapter 58 of the Acts of 2006; provided further, that the unit shall collaborate with the office of Medicaid, the executive office of administration and finance, the division of unemployment assistance, the department of revenue, the division of insurance, the Commonwealth Health Insurance Connector Authority, and the recipients of enrollment outreach grants pursuant to item 4000-0352, to develop common strategies, best practices, and guidelines for providing informational support and assistance to consumers, employers, and businesses; and provided further, that any projection of deficiency in item 4000-0320, 4000-0430, 4000-0500, 4000-0600, 4000-0700, 4000-0870, 4000-0875, 4000-0880, 4000-0890, 4000-0891, 4000-0895, 4000-0990, 4000-1400 or 4000-1405, shall be reported to the house and senate committees on ways and means not less than 90 days before the projected exhaustion of funding and that any unexpended balance in these accounts shall revert to the General Fund on June 30, 2008 |
142,273,307 |
| 4000-0301 | MassHealth Auditing and Utilization Reviews
For the costs of MassHealth provider and member audit and utilization review activities including, but not limited to, eligibility verification, disability evaluations, provider financial and clinical audits and other initiatives intended to enhance program integrity |
2,200,000 |
| 4000-0352 | MassHealth Enrollment Outreach Grants
For MassHealth enrollment outreach grants to public and private nonprofit groups to be administered by the executive office in consultation with the Health Care Reform Outreach and Education Unit; provided, that grants shall be awarded to groups statewide, including areas in which the United States Census deems there exists a high percentage of uninsured individuals and areas in which there are limited health care providers; provided further, that funds shall be awarded as grants to community and consumer-focused public and private nonprofit groups to provide enrollment assistance, education and outreach activities directly to consumers who may be eligible for MassHealth, the Commonwealth Care Program, or the Commonwealth Choice Program, and who may require individualized support due to geography, ethnicity, race, culture, immigration or disease status and representative of communities throughout the commonwealth; provided further, that funds shall be allocated to provide informational support and technical assistance to recipient organizations and to promote appropriate and effective enrollment activities through the statewide health access network; provided further, that the cost of information support and technical assistance shall not exceed 10 per cent of the appropriation and shall not be used to defray current state obligations to provide this assistance; provided further, that in awarding said grants, the executive office of health and human services, in consultation with the Health Care Reform Outreach and Education Unit, shall provide written guidance to selected grantees with specific strategies of how to expend funds in the most efficient manner to target populations and avoid duplication of activities, including examples of best practices among prior year outreach grant recipients; and provided further, that the secretary shall report to the house and senate committees on ways and means on the exact amounts distributed in fiscal year 2008 by February 1, 2008 and the extent to which any portion of resulting expenditures are eligible for federal reimbursement |
3,500,000 |
| 4000-0355 | Health Care Quality and Cost Council
For the operation of a health care quality and cost council established pursuant to section 16K of chapter 6A of the General Laws to promote high-quality, cost-effective, patient-centered care |
1,000,000 |
| 4000-0430 | MassHealth CommonHealth Plan
For the commonhealth program to provide primary and supplemental medical care and assistance to disabled adults and children under sections 9A, 16 and 16A of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to the recipients in prior fiscal years; provided further, that the executive office shall maximize federal reimbursement for state expenditures made on behalf of such adults and children; provided further, that children shall be determined eligible for the medical care and assistance if they meet the disability standards as defined by the executive office, which standards shall be no more restrictive than the standards in effect on July 1, 1996; and provided further, that the executive office shall process commonhealth applications within 45 days of receipt of a completed application or within 90 days if a determination of disability is required |
101,582,264 |
| 4000-0500 | MassHealth Managed Care
For health care services provided to medical assistance recipients under the executive office's primary care clinician/mental health and substance abuse plan or through a health maintenance organization under contract with the executive office and for MassHealth benefits provided to children, adolescents and adults under clauses (a), (b), (c), (d) and (h) of subsection (2) of section 9A and section 16C of chapter 118E of the General Laws; provided, that no funds shall be expended from this item for children and adolescents under clause (c) of said subsection (2) of said section 9A of said chapter 118E whose family incomes, as determined by the executive office, exceeds 150 per cent of the federal poverty level; provided further, that funds may be expended from this item for health care services provided to the recipients in prior fiscal years; provided further, that expenditures from this item shall be made only for the purposes expressly stated herein; provided further, that the secretary of health and human services and the commissioner of mental health shall report quarterly to the house and senate committees on ways and means relative to the performance of the managed care organization under contract with the executive office to administer the mental health and substance abuse benefit; provided further, that such quarterly reports shall include, but not be limited to, analyses of utilization trends, quality of care and costs across all service categories and modalities of care purchased from providers through the mental health and substance abuse program, including those services provided to clients of the department of mental health; provided further, that in conjunction with the new Medicaid management information system project, said executive office shall continue to study the feasibility of modifying its claim payment system, in collaboration with the MassHealth behavioral health contractor, to routinely process for payment valid claims for medically necessary covered medical services to eligible recipients with psychiatric and substance abuse diagnoses on a timely basis in an effort to avoid delay and expenses incurred by lengthy appeals processes; provided further, that said secretary shall report to the house and senate committee on ways and means any proposed modifications to said payment system, and a timeline of steps to be taken to implement said modifications; provided further, that not less than $14,000,000 shall be expended for disproportionate share payments for inpatient services provided at pediatric specialty hospitals and units, including pediatric chronic and rehabilitation long-term care hospitals as allowable under federal law; provided further, that not less than $2,000,000 of said $14,000,000 shall be expended as a grant to said pediatric chronic and rehabilitation long-term care hospital for which federal financial participation and federal approval need not be obtained; provided further, that $11,900,000 shall be expended on disproportionate share payments to high public payer hospitals; provided further, that the executive office shall ensure that actuarially sound rates for a publicly-operated entity pursuant to section 122 of chapter 58 of the acts of 2006 are implemented in fiscal year 2008; and provided further, that notwithstanding any general or special law to the contrary, the secretary of health and human services shall not reassign to a managed care plan under contract with the office of MassHealth the behavioral health benefit of any eligible person when the benefit is managed by MassHealth's specialty behavioral health managed care contactor, after the benefit is elected by or initially assigned to that person, unless the person provides written or verbal consent to the reassignment; provided further that, no later than December 1, 2007, the office of Medicaid shall submit a Medicaid Transformation Grant, federal funding opportunity number HHS-2007-CMS-MTG-0010, to the Centers for Medicare & Medicaid Services (CMS) to fund a MassHealth e-Prescribing pilot project to introduce electronic prescription writing (e-prescribing) to Medicaid providers for developing, piloting, evaluating and rolling out a real-time decision support solution that can be integrated into providers' workflow that will be accomplished by integrating prior authorization, preferred drug lookup, and other components of Affiliated Computer Services'(ACS, Mass Health's claims processing contractor) application used by MassHealth providers with the Rx Gateway for prescription routing and related services already under development by MA-SHARE (Massachusetts Simplifying Healthcare Among Regional Entities), the commonwealth's public-private collaborative for health information exchange; and provided further, that the office of Medicaid shall forward a copy of this application to the house and senate committee on ways and means and the house and senate chairpersons of the joint committee on health care financing |
2,884,675,464 |
| 4000-0700 | MassHealth Indemnity
For health care services provided to medical assistance recipients under the executive office's health care indemnity/ third party liability plan and medical assistance recipients not otherwise covered under the executive office's managed care or senior care plans, and for MassHealth benefits provided to children, adolescents and adults under clauses (a), (b), (c), (d) and (h) of subsection (2) of section 9A and section 16C of chapter 118E of the General Laws; provided, that no funds shall be expended from this item for children and adolescents under clause (c) of said subsection (2) of said section 9A of said chapter 118E whose family incomes, as determined by the executive office, exceeds 150 per cent of the federal poverty level; provided further, that children who have aged out of the custody of the department of social services shall be eligible for benefits until they reach age 21; provided, that funds may be expended from this item for health care services provided to the recipients in prior fiscal years; provided further, that notwithstanding the foregoing, funds may be expended from this item for the purchase of third party insurance including, but not limited to, Medicare for any medical assistance recipient including, but not limited to, seniors; provided further, that the executive office may reduce MassHealth premiums or copayments or offer other incentives to encourage enrollees to comply with wellness goals, the executive office shall report annually to the joint committee on health care financing and the house and senate ways and means on the number of enrollees who met at least 1 wellness goal, any reduction of copayments or premiums, and any other incentives provide because enrollees met wellness goals; provided further, that the executive office shall not, in the fiscal year 2008, fund programs relating to case management with the intention of reducing length of stay for neonatal intensive care unit cases; provided further, that funds may be expended from this item for activities relating to disability determinations or utilization management and review, including patient screenings and evaluations, regardless of whether such activities are performed by a state agency, contractor, agent or provider; provided further, that the executive office shall submit a report to the executive office of administration and finance and the house and senate committees on ways and means not later than March 1, 2008 detailing the activities described in the preceding proviso to be expended from this item during fiscal year 2008; and provided further, that not less than $10,000,000 shall be expended to pay for an increase in Medicaid rates for community health centers, as defined in section 1 of chapter 118G of the General Laws |
1,683,746,704 |
| 4000-0870 | MassHealth Basic Coverage
For health care services provided to adults participating in the medical assistance program pursuant to clause (g) of subsection (2) of section 9A of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to the recipients in prior fiscal years |
117,206,280 |
| 4000-0875 | MassHealth Breast and Cervical Cancer Treatment
For the provision of benefits to eligible women who require medical treatment for either breast or cervical cancer in accordance with 1902(a)(10)(A)(ii)(XVIII) of the Breast and Cervical Cancer Prevention and Treatment Act of 2000, Public Law 106-354, and in accordance with section 10D of chapter 118E of the General Laws; provided, that the executive office shall provide those benefits to women whose income, as determined by the executive office, does not exceed 250 per cent of the federal poverty level, subject to continued federal approval; provided further, that eligibility for the benefits shall be extended solely for the duration of the cancerous condition; provided further, that before the provision of any benefits covered by this item, the executive office shall require screening for either breast or cervical cancer at the comprehensive breast and cervical cancer early detection program operated by the department of public health, in accordance with item 4570-1512 of section 2D; and provided further, that funds may be expended from this item for health care services provided to these recipients in prior fiscal years |
5,422,343 |
| 4000-0880 | MassHealth Family Assistance Plan
For MassHealth benefits under clause (c) of subsection (2) of section 9A and section 16C of chapter 118E of the General Laws as amended by chapter 58 of the acts of 2006 for children and adolescents whose family incomes as determined by the executive office are above 150 per cent of the federal poverty level; and provided further, that funds may be expended from this item for health care services provided to the children and adolescents in prior fiscal years |
137,978,838 |
| 4000-0890 | MassHealth Premium Assistance and Insurance Partnership Program
For the cost of health insurance premium subsidies paid to employees of small businesses participating in the insurance reimbursement program under section 9C of chapter 118E of the General Laws, as amended by chapter 58 of the acts of 2006 |
36,090,197 |
| 4000-0891 | MassHealth Insurance Partnership for Employers
For the cost of health insurance subsidies paid to employers participating in the insurance reimbursement program under section 9C of chapter 118E of the General Laws; provided, that the executive office shall directly market the program to private human service providers that deliver human and social services under contract with departments within the executive office and the executive office of elder affairs for the purpose of mitigating health insurance costs to the employers and their employees; provided further, that the executive office of health and human services shall report quarterly to the house and senate committees on ways and means and the executive office of administration and finance monthly expenditure data for the program, including the total number of employers participating in the program, the percentage of the employers who purchased health insurance for employees prior to participating in the program and total monthly expenditures delineated by payments to small employers and self-employed persons for individual, 2-person family and family subsidies; and provided further, that the executive office of health and human services shall seek federal reimbursement for the payments to employers |
5,490,312 |
| 4000-0895 | Healthy Start Program
For the healthy start program to provide medical care and assistance to pregnant women and infants residing in the commonwealth pursuant to section 10E of chapter 118E of the General Laws; provided, that the executive office shall no later than February 14, 2008, report annually to the house and senate committees on ways and means on the population served by the program delineated by the federal poverty level; and provided further, that funds may be expended from this item for health care services provided to these persons in prior fiscal years |
18,135,134 |
| 4000-0990 | Children's Medical Security Plan
For the children's medical security plan to provide primary and preventive health services for uninsured children from birth through age 18; provided, that the executive office shall prescreen enrollees and applicants for Medicaid eligibility; provided further, that no applicant shall be enrolled in the program until the applicant has been denied eligibility for the MassHealth program; provided further, that the MassHealth benefit request shall be used as a joint application to determine the eligibility for both MassHealth and the children's medical security plan; provided further, that the executive office shall maximize federal reimbursements for state expenditures made on behalf of the children; provided further, that the executive office shall expend all necessary funds from this item to ensure the provision of the maximum benefit levels for this program, as authorized by section 10F of chapter 118E of the General Laws; provided further, that the maximum benefit levels for this program shall be made available only to those children who have been determined by the executive office to be ineligible for MassHealth benefits; and provided further, that funds may be expended from this item for health care services provided to these persons in prior fiscal years |
15,223,144 |
| 4000-1400 | MassHealth HIV Plan
For the purposes of providing MassHealth benefits to persons with a diagnosis of human immunodeficiency virus with incomes up to 200 per cent of the federal poverty level; provided, that funds may be expended from this item for health care services provided to these persons in prior fiscal years |
16,591,488 |
| 4000-1405 | MassHealth Essential
For the operation of a program of preventive and primary care for chronically unemployed persons who are not receiving unemployment insurance benefits and who are not eligible for medical assistance but who are determined by the executive office of health and human services to be long-term unemployed; provided, that such persons shall meet the eligibility requirements established under the MassHealth program as established in section 9A of chapter 118E of the General Laws; provided further, that persons eligible under subsection (7) of section 16D of chapter 118E shall be also eligible to receive benefits under this item; provided further, that the income of such persons shall not exceed 100 per cent of the federal poverty level; provided further, that said eligibility requirements shall not exclude from eligibility persons who are employed intermittently or on a non-regular basis; provided further, that the provision of care to such persons under this program may, taking into account capacity, continuity of care, and geographic considerations, be restricted to certain providers; provided further, that the secretary is hereby authorized to limit or close enrollment if necessary in order to ensure that expenditures from this item do not exceed the amount appropriated herein; provided, however, that no such limitation shall be implemented unless the secretary has given 90 days notice to the house and senate committees on ways and means and the joint committee on health care financing; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
251,837,625 |
| 4000-1420 | Medicare Part D Phased Down Contribution
For the purposes of making payment to the federal Centers for Medicare and Medicaid Services in compliance with Title XIX of the Social Security Act, as amended by the Medicare Prescription Drug Improvement and Modernization Act of 2003 |
233,916,047 |
| account | description | amount |
|---|---|---|
| Retained Revenues | ||
| 4000-0320 | MassHealth Recoveries from Current and Prior Fiscal Years Retained Revenue
The executive office may expend an amount not to exceed $225,000,000 from the monies received from recoveries of any current or prior year expenditures and collections from liens, estate recoveries, third party recoveries, drug rebates, accident and trauma recoveries, case mix recoveries, computer audits, insurance recoveries, provider overpayment recoveries, bankruptcy settlements, Masspro and Healthpro refunds, medicaid fraud returns, data match returns, Medicare appeals, and program and utilization review audits; provided, that additional categories of recoveries and collections, including the balance of any personal needs accounts collected from nursing and other medical institutions upon a recipient's death and held by the executive office for more than 3 years, may, notwithstanding any general or special law to the contrary, be credited to this item; provided further, that any revenues collected by the division that are not attributable to the aforementioned categories shall be deposited in the General Fund and shall be tracked separately; provided further, that additional categories of recoveries and collections may be credited to this item after providing written notice to the house and senate committees on ways and means; provided further, that no funds from this item shall be used for the purposes of item 4000-0300; provided further, that expenditures from this item shall be limited solely to payments for the provision of medical care and assistance rendered in the current fiscal year; and provided further, that the executive office shall file quarterly with the house and senate committees on ways and means, a report delineating the amount of current year rebates from pharmaceutical companies or other current year collections which are being used to supplement current year expenditures |
225,000,000 |
| account | description | amount | ||||
|---|---|---|---|---|---|---|
| Intragovernmental Service Spending | 33,884,734 | |||||
| 4000-0102 | Chargeback for Human Services Transportation
For the cost of transportation services for health and human services clients and the operation of the health and human services transportation office
|
7,252,388 | ||||
| 4000-0103 | Chargeback for Human Services Core Administrative Functions
For the costs of core administrative functions performed within the executive office of health and human services; provided, that the secretary of the executive office of health and human services may, notwithstanding any general or special law to the contrary, identify administrative activities and functions common to the separate agencies, departments, offices, divisions, and commissions within the executive office and may designate such functions "core administrative functions" in order to improve administrative efficiency and preserve fiscal resources; provided further, that common functions that may be designated core administrative functions include, human resources, financial management, information technology, legal and facilities; provided further, that all employees performing functions so designated may be employed by the executive office, and the executive office shall charge the agencies, departments, offices, divisions, and commissions for such services; provided further, that upon the designation of a function as a core administrative function, the employees of each agency, department, office, or commission who perform such core administrative functions may be transferred to the executive office of health and human services; provided further, that the reorganization shall not impair the civil service status of any such transferred employee who immediately before the effective date of this act either holds a permanent appointment in a position classified under chapter 31 of the General Laws or has tenure in a position by reason of section 9A of chapter 30 of the General Laws; and provided further, that nothing in this item shall impair or change an employee's status, rights, or benefits under chapter 150E of the General Laws
|
26,632,346 | ||||
| account | description | amount |
|---|---|---|
| Federal Grant Spending | 43,038,205 | |
| 4000-0713 | Youth Development State Collaboration
For the purposes of a federally funded grant entitled, Youth Development State Collaboration |
222,227 |
| 4000-9401 | Community Mental Health Services
For the purposes of a federally funded grant entitled, Community Mental Health Services |
8,559,524 |
| 4000-9402 | Substance Abuse Prevention and Treatment Block Grant
For the purposes of a federally funded grant entitled, Substance Abuse Prevention and Treatment Block Grant |
34,256,454 |