4000-0601 MassHealth Senior Care

For health care services provided to MassHealth members who are seniors including those provided through the Medicare Savings Program, and for the operation of the MassHealth senior care options program 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 recipients in prior fiscal years; provided further, that notwithstanding any general or special law to the contrary, for the purposes of an individual's eligibility for the Senior Care Options program, an individual is deemed to reach the age of 65 on the first day of the month in which his or her 65th birthday occurs; provided further, that funds shall be expended from this item to maintain a personal needs allowance of $72.80 per month for individuals residing in nursing and rest homes who are eligible for MassHealth, emergency aid to the elderly, the disabled and children program or supplemental security income; provided further, that notwithstanding any general or special law to the contrary, for any nursing home facility or non-acute chronic disease hospital that provides kosher food to its residents, the executive office of health and human services, in consultation with the center for health information and analysis and 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 to reflect the high dietary costs incurred in providing kosher food; provided further, that the secretary of health and human services shall report by January 29, 2026 to the house and senate committees on ways and means on the implementation of the Medicare Savings Program (MSP) expanded program eligibility for seniors that was effective on or after January 1, 2020; provided further, that said report shall include: (i) the number of members whose household incomes, as determined by the executive office, exceed 133 per cent of the federal poverty level that are enrolled in Medicare Savings Programs during each month of the prior fiscal year; (ii) total enrollment in the Qualified Medicare Beneficiary (QMB) program, Specified Low Income Medicare Beneficiary (SLMB) Program and Qualifying Individual (QI) Program; (iii) total annual spending on Medicare premiums and cost-sharing for such members; and (iv) total annual transfers from the prescription advantage program in line item 9110-1455 and Health Safety Net Trust Fund to fund the MSP expanded program eligibility; and provided further, that notwithstanding any general or special law to the contrary, nursing facility rates to be effective on October 1, 2025 under sections 13D and 85 of chapter 118E of the General Laws may be developed using the costs of calendar year 2019