Mass. Gen. Laws ch. 29, sec. 2WWWW — MA Code / Part I / Title III / Chapter 29 / Section 2WWWW
Non&ndash;Acute Care Hospital Reimbursement Trust Fund
Status: in_force

Section 2WWWW. (a) There shall be a Non–Acute Care Hospital Reimbursement Trust Fund to be administered by the secretary of health and human services. There shall be credited to the fund: (i) any transfers from the Health Safety Net Trust Fund established in section 66 of chapter 118E; (ii) an amount equal to any federal financial participation revenues claimed and received by the commonwealth for eligible expenditures made from the fund; (iii) any revenue from appropriations or other money authorized by the general court and specifically designated to be credited to the fund; and (iv) interest earned on any money in the fund. Amounts credited to the fund shall be expended without further appropriation. (b) Money in the fund shall be expended for Medicaid payments to: (i) nonpublic hospitals licensed by the department of public health under section 51 of chapter 111 but not defined as acute-care hospitals under section 25B of said chapter 111; and (ii) nonpublic hospitals licensed as inpatient facilities by the department of mental health under section 19 of chapter 19 and regulations promulgated thereunder but not categorized as Class VII licensees under the regulations; provided, that money in the fund may also be expended for payments to such hospitals necessary to reconcile prior-year assessment amounts due to timing discrepancies in the calculation of the ratio described in subsection (b) of section 67 of chapter 118E. (c) Revenues generated from clauses (i) and (ii) of subsection (a) shall be expended exclusively for the entities identified in subsection (b) and shall not be used to replace payment commitments in effect as of March 1, 2017. The expenditures shall be established by the executive office of health and human services in a manner consistent with the requirements and conditions of federal financial participation under 42 U.S.C. 1396b(w) and 42 C.F.R. 433.68, including the prohibitions against hold harmless provisions as defined under 42 U.S.C. 1396b(w)(4) and 42 C.F.R. 433.68(f) and shall be made only under federally-approved payment methods and consistent with federal funding requirements and all federal payment limits as determined by the secretary of health and human services. Federal financial participation shall be sought in a manner that achieves the maximum amount of federal revenue such that the assessment amount equals the state share of the qualifying Medicaid hospital payments related to this section. (d) The schedule of payment amounts to be established and distributed by the executive office of health and human services under this section shall be developed in a manner that: (i) promotes the provider capacity, access and utilization management needs of the MassHealth program as those needs are determined by the secretary of health and human services; (ii) may consider the cost of services delivered by providers for which the providers are not fully reimbursed or otherwise compensated, including, but not limited to, inpatient, outpatient, and physician bad debt, free care and services delivered in good faith reliance on authorization; (iii) may consider existing Medicaid reimbursement rates above base rates including but not limited to those provided to chronic disease rehabilitation hospitals that serve solely children and adolescents; and (iv) is proportional, to the extent possible, to the respective assessed amounts paid by each class of hospitals relative to this section. The executive office shall consult with trade organizations representing rehabilitation hospital providers, chronic care hospital providers and psychiatric hospital providers in the development and implementation of the payments. In order to accommodate timing discrepancies between the receipt of 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 section. Money remaining in the fund at the end of a fiscal year shall not revert to the General Fund and shall be available for expenditure in subsequent fiscal years. (e) Annually, not later than September 30, the executive office of health and human services shall file a report with the house and senate committees on ways and means which shall include: (i) a detailed accounting of all money transferred, credited or deposited into and from the fund; (ii) the reasons for any unspent amount in the fund; and (iii) an analysis of the respective assessed amounts paid by each class of hospitals and the respective payments received by each class of hospitals relative to this section.

Section 2WWWW. (a) There shall be a Non–Acute Care Hospital Reimbursement Trust Fund to be administered by the secretary of health and human services. There shall be credited to the fund: (i) any transfers from the Health Safety Net Trust Fund established in section 66 of chapter 118E; (ii) an amount equal to any federal financial participation revenues claimed and received by the commonwealth for eligible expenditures made from the fund; (iii) any revenue from appropriations or other money authorized by the general court and specifically designated to be credited to the fund; and (iv) interest earned on any money in the fund. Amounts credited to the fund shall be expended without further appropriation.

(b) Money in the fund shall be expended for Medicaid payments to: (i) nonpublic hospitals licensed by the department of public health under section 51 of chapter 111 but not defined as acute-care hospitals under section 25B of said chapter 111; and (ii) nonpublic hospitals licensed as inpatient facilities by the department of mental health under section 19 of chapter 19 and regulations promulgated thereunder but not categorized as Class VII licensees under the regulations; provided, that money in the fund may also be expended for payments to such hospitals necessary to reconcile prior-year assessment amounts due to timing discrepancies in the calculation of the ratio described in subsection (b) of section 67 of chapter 118E.

(c) Revenues generated from clauses (i) and (ii) of subsection (a) shall be expended exclusively for the entities identified in subsection (b) and shall not be used to replace payment commitments in effect as of March 1, 2017. The expenditures shall be established by the executive office of health and human services in a manner consistent with the requirements and conditions of federal financial participation under 42 U.S.C. 1396b(w) and 42 C.F.R. 433.68, including the prohibitions against hold harmless provisions as defined under 42 U.S.C. 1396b(w)(4) and 42 C.F.R. 433.68(f) and shall be made only under federally-approved payment methods and consistent with federal funding requirements and all federal payment limits as determined by the secretary of health and human services. Federal financial participation shall be sought in a manner that achieves the maximum amount of federal revenue such that the assessment amount equals the state share of the qualifying Medicaid hospital payments related to this section.

(d) The schedule of payment amounts to be established and distributed by the executive office of health and human services under this section shall be developed in a manner that: (i) promotes the provider capacity, access and utilization management needs of the MassHealth program as those needs are determined by the secretary of health and human services; (ii) may consider the cost of services delivered by providers for which the providers are not fully reimbursed or otherwise compensated, including, but not limited to, inpatient, outpatient, and physician bad debt, free care and services delivered in good faith reliance on authorization; (iii) may consider existing Medicaid reimbursement rates above base rates including but not limited to those provided to chronic disease rehabilitation hospitals that serve solely children and adolescents; and (iv) is proportional, to the extent possible, to the respective assessed amounts paid by each class of hospitals relative to this section. The executive office shall consult with trade organizations representing rehabilitation hospital providers, chronic care hospital providers and psychiatric hospital providers in the development and implementation of the payments. In order to accommodate timing discrepancies between the receipt of 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 section. Money remaining in the fund at the end of a fiscal year shall not revert to the General Fund and shall be available for expenditure in subsequent fiscal years.

(e) Annually, not later than September 30, the executive office of health and human services shall file a report with the house and senate committees on ways and means which shall include: (i) a detailed accounting of all money transferred, credited or deposited into and from the fund; (ii) the reasons for any unspent amount in the fund; and (iii) an analysis of the respective assessed amounts paid by each class of hospitals and the respective payments received by each class of hospitals relative to this section.