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Budget Summary FY2015

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40000600 - MassHealth Senior Care
Data Current as of:  10/17/2014





Account Description FY2014
Spending
FY2015
GAA
4000-0600 MassHealth Senior Care
For health care services provided to MassHealth members who are seniors and for the operation of the MassHealth senior care options initiative under section 9D of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to these recipients in prior fiscal years; provided further, that funds shall be expended for the community choices initiative; provided further, that no payment for special provider costs shall be made from this item without the prior written approval of the secretary of administration and finance; provided further, that benefits of the community choices initiative shall not be reduced below the services provided in fiscal year 2014; provided further, that the eligibility requirements for this demonstration project shall not be more restrictive than those established in fiscal year 2014; provided further, that funds shall be expended from this item to implement the pre-admission counseling and assessment program under the fourth paragraph of section 9 of said chapter 118E, which shall be implemented on a statewide basis through the aging and disability resource consortia; provided further, that notwithstanding any general or special law to the contrary, funds shall be expended from this item to maintain a personal needs allowance of $72.80 per month for individuals residing in nursing homes and rest homes who are eligible for MassHealth, emergency aid to the elderly, disabled and children program or supplemental security income; provided further, that notwithstanding any general or special law to the contrary, for any nursing home or non-acute chronic disease hospital that provides kosher food to its residents, the executive office of elder affairs, in consultation with the center for health information and analysis, in recognition of the special innovative program status granted by the executive office of health and human services, shall continue to make the standard payment rates established in fiscal year 2006 to reflect the high dietary costs incurred in providing kosher food; provided further that effective October 1, 2014, for the fiscal year ending June 30, 2015, the executive office of health and human services shall establish nursing facility Medicaid rates that are up to $47,476,982 in payments above the payments made to nursing facilities for fiscal year 2014, for the purpose of establishing the base year at calendar year 2007 costs; provided further, that the $47,476,982 in payments shall be subject to the availability of federal financial participation; provided further, that the executive office of health and human services shall notify the secretary of administration and finance and the chairs of the house and senate committee on ways and means prior to October 1, 2014, on the ability to obtain federal financial participation; provided further, that if federal financial participation is not available for said payments, the executive office of health and human services shall maintain the rates at the 2005 base year and shall make a one-time supplemental payment for nursing facility Medicaid rates for an amount not less than $23,738,491; 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 March 2, 2015 on: (i) the extent to which quality indicators and other measures are incorporated into the determination of payment rates and amounts dispersed to nursing facilities; and (ii) a proposal to enhance the incorporation of quality indicators and other measures into nursing facility rates; provided further, that in fiscal year 2015, MassHealth shall expend not less than the amount expended in fiscal year 2014 to reimburse nursing home facilities for bed hold days; provided further, that to the extent feasible, MassHealth shall reimburse such facilities for up to 20, but not fewer than 10 medical leave of absence days; provided further, that MassHealth shall guarantee 10 nonmedical leave of absence days; provided further, that not later than January 1, 2015, MassHealth shall report to the house and senate committees on ways and means on: (a) the number of nursing facility clients on a leave of absence, delineated by nursing facility, by medical leave of absence and nonmedical leave of absence and the total number of days on leave of absence; (b) monthly capacity levels per nursing homes and the monthly total number of empty beds per nursing facility; (c) the average payment amount per nursing facility client; and (d) the aggregate payment amount per nursing facility by month; provided further, that no nursing home may reassign a patient's bed during a leave of absence eligible for reimbursement under this item; and provided further, that MassHealth shall reimburse nursing home leave of absence days at a rate of not less than $30 per day
2,825,425,207 3,197,069,129