4000-0300 EOHHS and Medicaid Administration

For the operation of the executive office of health and human services; 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 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 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 only those costs which shall be incurred by efficiently and economically operated providers in order to provide services of adequate quality; 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), except: (i) as required for the administration of the executive office; (ii) as required 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; (iii) as required for dental benefits provided to clients of the department of developmental services who are 21 years of age or older; (iv) as required for managed care capitation payments related to MassHealth members enrolled in a MassHealth managed care program who are residents of institutions for mental disease for more than 15 days in any calendar month; (v) as required 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; or (vi) otherwise as explicitly authorized with the prior written approval of the secretary of administration and finance; 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 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 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 a total of $40,000,000 may be expended from items 4000-0700 and 4000-1426 during the fiscal year 2021 accounts payable period to pay for services delivered during fiscal year 2021; provided further, that the secretary of health and human services, with the written approval of the secretary of administration and finance, may authorize transfers of surplus among items 4000-0320, 4000-0430, 4000-0500, 4000-0601, 4000-0641, 4000-0700, 4000-0875, 4000-0880, 4000-0885, 4000-0940, 4000-0950, 4000-0990, 4000-1400, 4000-1420 and 4000-1426 for the purpose of reducing any deficiency in these items; provided further, that any such transfer shall be made not later than September 30, 2021; and provided further, that any projected aggregate deficiency among these items shall be reported to the house and senate committees on ways and means not less than 90 days before the projected exhaustion of total funding