Section 15 Community Hospital and Health Center Investment Trust Fund 2

Said chapter 29 is hereby further amended by striking out section 2TTTT and inserting in place thereof the following section:-

2TTTT. (a) There shall be a Community Hospital and Health Center Investment Trust Fund to be expended, without further appropriation, by the secretary of health and human services. The fund shall consist of money from public and private sources, including gifts, grants and donations, interest earned on such money, any other money authorized by the general court and specifically designated to be credited to the fund and any funds provided from other sources. Money in the fund shall be used to provide annual financial support in an amount not to exceed $25,000,000 per fiscal year, consistent with the terms of this section, to eligible acute care hospitals and community health centers. The secretary, as trustee, shall administer the fund and shall make expenditures from the fund consistent with this section.

(b) The secretary may incur expenses and the comptroller may certify amounts for payment in sufficient amount satisfy in anticipation of expected receipts; provided, however, that, subject to subsection (e), no expenditure shall be made from the fund which shall cause the fund to be deficient at the close of a fiscal year. Subject to subsection (i), revenues deposited in the fund that are unexpended at the end of a fiscal year shall not revert to the General Fund and shall be available for expenditure in the following fiscal year.

(c) The secretary shall periodically direct payments from the fund to eligible acute care hospitals and community health centers. To be eligible to receive payment from the fund, an acute care hospital shall (1) be an acute care hospital licensed under section 51 of chapter 111; (2) have a statewide relative price less than 0.90, as calculated by the center for health information and analysis pursuant to section 10 of chapter 12C according to data from the most recent available year; (3) have a public payer mix equal to or greater than 60 per cent, as calculated by the center for health information and analysis according to data from the most recent available year; and (4) not be owned, financially consolidated or corporately affiliated with a provider organization, as defined by section 1 of chapter 6D, that: (A) owns or controls 2 or more acute care hospitals; and (B) the total net assets of all affiliated acute care hospitals within the provider organization is greater than $600,000,000, as calculated by the center for health information and analysis according to data from the most recent available year. For purposes of the previous sentence, a hospital's mere clinical affiliation with a provider organization, absent ownership, financial consolidation or corporate affiliation, shall not disqualify an eligible hospital from payments authorized under this section. To be eligible to receive payment from the fund, a community health center must be certified as a community health center by the MassHealth program under 130 CMR 405.000 or any successor regulation.

(d) In directing payments in a given fiscal year, the secretary shall allocate payments to eligible acute care hospitals and community health centers in the following manner: (1) 50 per cent of payments shall be directed to eligible acute care hospitals in the form of Medicaid supplemental payments or other appropriate mechanism; and (2) 50 per cent of payments shall be directed to community health centers in the following manner and allocation: 25 per cent of the total community health center allocation shall be directed to community health centers in the form of grants, and 75 per cent of the total community health center allocation shall be directed to community health centers in the form of enhanced Medicaid payments. The secretary shall establish by regulation or other appropriate written issuance any further eligibility criteria for allocation of payments pursuant to this subsection.

(e) The secretary may require as a condition of receiving payment from the fund any such reasonable condition of payment that the secretary determines necessary to ensure the availability, to the extent possible, of federal financial participation for the payments, and the secretary may incur expenses and the comptroller may certify amounts for payment in anticipation of expected receipt of federal financial participation for the payments. Subject to appropriation, an amount equal to the total annual anticipated federal financial participation generated by the payments shall be transferred to the Community Hospital and Health Center Investment Trust Fund not later than June 30.

(f) The secretary may promulgate regulations as necessary to carry out this section.

(g) Not later than October 15 of each fiscal year, the secretary shall file a report with the joint committee on health care finance and the house and senate committees on ways and means detailing the allocation and recipient of each payment during the prior fiscal year, including any payments made under subsection (i).

(h) An amount equal to the total receipts from the penalty established under chapter 63E shall be transferred from the General Fund to the Community Hospital and Health Center Investment Trust Fund before the end of each fiscal year.

(i) In the event that the total amount in the fund in a given fiscal year is sufficient to provide the maximum amount of annual financial support specified in subsection (a) to eligible acute care hospitals and community health centers, any remaining revenues deposited in the fund under subsection (h) shall revert to the General Fund to support increased investments in primary care and behavioral health in a manner that maximizes federal financial participation.

This section, along with three others, restructures and recapitalizes the existing Community Hospital Reinvestment Trust Fund to target independent community hospitals and community health centers and maximizes federal financial participation on payments from the fund.