Report to Legislature on Claims-Based Reimbursement System
SECTION 76.
Notwithstanding any general or special law to the contrary, the secretary of health and human services shall submit a report on the reimbursement methodology to be used in hospital fiscal year 2008 for health services from the Health Safety Net Trust Fund as determined by the health safety net office pursuant to section 39 of chapter 118G of the General Laws. The report shall detail all modifications made to the payment systems in effect for acute hospitals used by the United States Department of Health and Human Services Centers for Medicare & Medicaid Services to administer the Medicare Program under Title XVIII of the Social Security Act, including any adjustments to account for: (1) the differences between the program administered by the office and the Title XVIII Medicare program, including the services and benefits covered; (2) grouper and DRG relative weights for purposes of calculating the payment rates to reimburse acute hospitals at rates no less than the rates they are reimbursed by Medicare; (3) the extent and duration of covered services; (4) the populations served; and (5) any other adjustments based upon circumstances of individual hospitals. The report shall also detail what, if any, adjustments were made under clause (4) for disproportionate share hospitals, as defined in section 1 of said chapter 118G, or for a free-standing pediatric hospital with a disproportionately low volume of Title XVIII payments. The secretary shall submit the report to the joint committee on health care financing and the house and senate committees on ways and means on or before August 1, 2007.