Section 69

Section 69 Managed Care Organization Services Assessment 11

Said section 66 of chapter said 118E, is hereby amended by striking out subsection (b) and inserting in place thereof the following subsection:-
(b) The fund shall consist of: (i) all amounts paid by hospitals and MCOs under sections 67 and 68; (ii) all appropriations for the purpose of payments to acute hospitals or community health centers for health services provided to uninsured and underinsured residents; (iii) any transfers from the Commonwealth Care Trust Fund established in section 2OOO of chapter 29; (iv) any transfers from the Safety Net Provider Trust Fund established in section 2AAAAA of said chapter 29; (v) any transfers from the Hospital Investment and Performance Trust Fund established in section 2TTTTT of said chapter 29; (vi) any transfers from the Managed Care Organization Services Reinvestment Trust Fund established in section 2FFFFFF; and (v) all property and securities acquired by and through the use of money belonging to the fund and all interest thereon. There shall also be credited to the fund an amount equal to any federal financial participation claimed and received by the commonwealth for eligible expenditures made from the fund and financed by money transferred from the Hospital Investment and Performance Trust Fund established in said section 2TTTTT of said chapter 29, the Managed Care Organization Services Reinvestment Trust Fund established in section 2FFFFFF, or from the Safety Net Provider Trust Fund established in said section 2AAAAA of said chapter 29. To accommodate timing discrepancies between the receipt of such revenue and related expenditures, the comptroller may certify for payment amounts not to exceed the most recent revenue estimates as certified by the secretary of health and human services to be transferred, credited or deposited under this subsection. Annually, the office shall transfer an amount equal to all amounts paid by privately-owned, nonfederal hospitals under subsection (b) of section 67 to the Non-Acute Care Hospital Reimbursement Trust Fund established in section 2WWWW of said chapter 29. The office shall annually transfer from the non-federal money in the fund: (A) an amount equal to the MCO reinvestment revenue amount to the Managed Care Organization Services Reinvestment Trust Fund established in section 2FFFFFF of said chapter 29; (B) an amount equal to the health agency dedicated revenue amount to the Health Agency Dedicated Trust Fund established in section 2EEEEEE of said chapter 29; (C) an amount equal to the health policy commission revenue amount to the Payment Reform Trust Fund established in section 7 of said chapter 6D; (D) an amount equal to the immunization revenue amount to the Vaccine Purchase Trust Fund established in section 24N of chapter 111; and (E) $33,700,000 to the Behavioral Health Access and Crisis Intervention Trust Fund established in section 2WWWWW of said chapter 29. The office shall expend amounts in the fund, except for amounts transferred to the Non-Acute Care Hospital Reimbursement Trust Fund, the Managed Care Organization Services Reinvestment Trust Fund, the Health Agency Dedicated Trust Fund, the Vaccine Purchase Trust Fund, and the Behavioral Health Access and Crisis Intervention Trust Fund, for payments to hospitals and community health centers for reimbursable health services provided to uninsured and underinsured residents, consistent with the requirements of this section, section 69 and the regulations adopted by the office. The amount collected pursuant to clause 7 of the definition of total MCO services assessment amount in section 64 of chapter 118E shall be dedicated to reducing the shortfall, as described in subsection (b) of section 69 of chapter 118E, for year prior to the assessment year. The office shall also annually expend money from the fund for the expenses of the executive office, including the health safety net office under subsection (a), for the administration of the health safety net and related assessments. The office shall also expend not more than $6,000,000 annually from the fund for demonstration projects that use case management and other methods to reduce the liability of the fund to acute hospitals. Any annual balance remaining in the fund after these payments have been made shall be retained in the fund and shall not revert to the General Fund. All interest earned on the amounts in the fund shall be deposited or retained in the fund. The director shall from time-to-time requisition from the fund amounts that the director considers necessary to meet the current obligations of the office for the purposes of the fund and estimated obligations for a reasonable future period.

Summary

This section, along with other related sections, creates a unified assessment mechanism for all managed care organization assessments.