For health care services provided to medical assistance recipients under the executive office of health and human services' health care indemnity or third--party liability plan to medical assistance recipients not otherwise covered under the executive office's managed care or senior care plans and for MassHealth benefits provided to children, adolescents and adults under
section 9 of chapter 118E of the General Laws and clauses (a) to (d), inclusive, and clause (h) of subsection (2) of
section 9A of said chapter 118E and
section 16C of said chapter 118E; provided, that no funds shall be expended from this item for children and adolescents under clause (c) of said subsection (2) of said
section 9A of said chapter 118E whose household incomes, as determined by the executive office exceed 150 per cent of the federal poverty level; provided further, that children who have aged out of the custody of the department of children and families shall be eligible for benefits through the age limit specified in MassHealth's approved state plan; provided further, that the executive office may reduce MassHealth premiums or copayments or offer other incentives to encourage enrollees to comply with wellness goals; provided further, that funds shall be expended to eliminate pharmacy copayments for all MassHealth members; provided further, that funds shall be expended from this item for members who qualify for early intervention services; provided further that, notwithstanding this item, funds may be expended from this item for the purchase of third--party insurance including, but not limited to, Medicare for any medical assistance recipient; provided further, that funds may be expended from this item for activities relating to customer service; provided further, that funds may be expended from this item for activities relating to disability determinations or utilization management and review, including patient screenings and evaluations, regardless of whether such activities are performed by a state agency, contractor, agent or provider; provided further, that MassHealth shall expend $13,000,000 in the aggregate for acute care hospitals that have greater than 63 per cent of their gross patient service revenue from governmental payers and free care as determined by the executive office; provided further, that in fiscal year 2026, MassHealth shall maintain the same level of federally--optional chiropractic services that were in effect in fiscal year 2016 and that were included in its state plan or demonstration program in effect on January 1, 2002 for members enrolled in the primary care clinician program; provided further, that MassHealth shall continue to expend funds for expanded oral health benefits, including endodontic and prosthodontic services, for adult members, consistent with the benefits provided beginning on January 1, 2021; provided further, that dental services for adults shall be covered at least to the extent they were covered as of June 30, 2025; provided further, that not later than March 3, 2026, the executive office shall report to the house and senate committees on ways and means on: (i) dental coverage available to MassHealth recipients as of January 1, 2026 as it compares to dental coverage available to MassHealth recipients on January 1, 2010; (ii) utilization of dental services in fiscal year 2025 and fiscal year 2026; (iii) the actual and projected costs and revenue associated with dental coverage in fiscal year 2025 and fiscal year 2026; and (iv) the estimated cost effectiveness of dental coverage as a contributor to MassHealth total cost of care; provided further, that in fiscal year 2026, the executive office shall not fund programs relating to case management with the intention of reducing length of stay for neonatal intensive care unit cases; provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years; provided further, that no payments for special provider costs shall be made from this item without the prior written approval of the secretary of administration and finance; provided further, that not less than $250,000 shall be expended to the Baystate Franklin Medical Center in the city of Greenfield to support its family medicine residency program; provided further, that not later than December 5, 2025, $750,000 shall be equally distributed to the teaching community health centers with family medicine residency programs in the cities of Worcester and Lawrence and in the South Boston section of the city of Boston; provided further, that the executive office shall designate the Massachusetts League of Community Health Centers, Inc. to administer the funds and shall retain 5 per cent of the total funds; and provided further, that the executive office shall: (i) report to the house and senate committees on ways and means on the use of the funds by teaching community health centers; and (ii) audit said centers in order to confirm the use of the funds by each center for training purposes
