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Home > Health and Human Services > Health & Human Services > 4000-0300 - Budget Summary

40000300 - EOHHS and Medicaid Administration
Data Current as of:  8/10/2018

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Account	Description	FY2018 Spending	FY2019 GAA
4000-0300	EOHHS and Medicaid 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 the executive office shall continue to develop and implement the common client identifier; provided further, that funds appropriated in this item shall be expended for administrative and contracted services related to the implementation and operation of programs under chapter 118E of the General Laws; 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 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 shall not exceed the rates that are necessary to meet the cost of 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 under the department of public health and the executive office of health and human services; provided further, that no expenditures, whether made by the executive office or another commonwealth entity, 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 approved under section 1115(a) of the Social Security Act, as codified at 42 U.S.C. section 1315(a) act or the community first section 1115 demonstration waiver under section 1115 of the Social Security Act, as codified at 42 U.S.C section 1315, except as required for: (a) for the administration of the executive office; (b) for the equivalent of MassHealth standard benefits for children under 21 years of age who are in the care or custody of the department of youth services or the department of children and families; (c) for dental benefits provided to clients of the department of developmental services who are 21 years of age or older; (d) for managed care capitation payments for MassHealth members who are residents of institutions for mental disease for more than 15 days in any calendar month and otherwise as explicitly authorized; or (e) for cost-containment efforts, the purposes and amounts of which shall be submitted to the executive office for administration and finance and the house and senate committees on ways and means not less than 30 days before making these expenditures; 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 said chapter 118E, the executive office shall make a supplemental payment not less than $14,800,000 to any acute care pediatric hospital and pediatric specialty unit in the commonwealth, above base rates, to compensate for high-complexity pediatric care; 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 said chapter 118E, the executive office shall make a supplemental payment not less than $3,000,000 to any acute care pediatric hospital and pediatric specialty unit in the commonwealth, above base rates, to compensate for high-complexity pediatric care; 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 these 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 said chapter 118E for which the executive office later discovers another third party is liable if no other course of recoupment is possible; provided further, that 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 notwithstanding any general or special law to the contrary, that the commissioner of mental health shall approve any prior authorization or other restriction on medication used to treat mental illness under written policies, procedures and regulations of the department of mental health; 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 15, 2019 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 a report not later than November 30, 2018 to the house and senate committees on ways and means and the joint committee on health care financing detailing utilization in fiscal year 2018 of the Health Safety Net Trust Fund established in section 66 of said chapter 118E of the General Laws, including: (a) the number of persons whose medical expenses were billed to the Health Safety Net Trust Fund; (b) the total dollar amount billed to the Health Safety Net Trust Fund; (c) the age, income level and insurance status of recipients using the Health Safety Net Trust Fund; (d) the types of services paid for out of the Health Safety Net Trust Fund; and (e) the amount disbursed from the Health Safety Net Trust Fund to each hospital and community health center; provided further, that the office of Medicaid shall coordinate with the health policy commission in the development of care delivery and payment models in the MassHealth program, including patient-centered medical homes and accountable care organizations, in order to ensure alignment of such models with the commission's certification programs under sections 14 and 15 of chapter 6D of the General Laws; provided further, that any unexpended balance in these accounts shall revert to the General Fund on June 30, 2019; provided further, that not later than January 15, 2019, 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 2018 and fiscal year 2019; provided further, that the executive office shall submit monthly MassHealth caseload reports in a searchable electronic format to the executive office for administration and finance and the house and senate committees on ways and means by the 15th day of the subsequent month; provided further, that not less than $250,000 shall be expended for the Brookline Community Mental Health Center to expand the Healthy Lives program; provided further, that not less than $250,000 shall be provided for the purposes defined in item 1599-2009 in section 2 of chapter 182 of the acts of 2008; provided further, that not less than $50,000 shall be expended for Martha's Vineyard Community Service to increase access and cover feasible travel costs associated with arranging access to health and human services on Martha's Vineyard and Nantucket; provided further, that said funds shall be expended equally for the counties of Nantucket and Dukes County; provided further, that not less than $108,445 shall be expended for continued operation of the Autism Insurance Resource Center at the University of Massachusetts Medical School's Eunice Kennedy Shriver Center to provide information, technical assistance and support to families of individuals with autism, including individuals enrolled in MassHealth; provided further, that not less than $500,000 shall be made available to a western Massachusetts academic medical center with 3 community health centers for the costs associated with the intake, assessment, treatment and care of evacuees from the commonwealth of Puerto Rico and the Virgin Islands of the United States who are receiving community health services at the western Massachusetts academic medical center and community health centers; and provided further, that the secretary may cumulatively transfer up to $2,343,000 to line items within the secretariat to fund collective bargaining obligations associated with the quarter point agreement	99,333,530	104,535,714

Veto Explanation:   I am striking language which directs payments from item 4000-0700 and reducing that item by $11.8 M because the supplemental payments for acute pediatric care are duplicative of increases already built into FY19 MassHealth base payment rates for Boston Children's Hospital and Shriners Hospitals for Children in Boston and Springfield. Further, I am striking language which earmarks funding for programs not recommended and reducing the appropriation for this item accordingly.

 
 

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