The Massachusetts House of Representatives today begins debate on the proposed FY2020 state budget, and the nearly 1,400 amendments to it that have been filed.
The budget draft that emerged from the House Ways & Means Committee on April 10 envisions $42.7 billion in spending, but left relatively unchanged MassHealth reimbursement rates from the previous year.
MHA’s six priority amendments focus on restoring funding to support services provided to MassHealth and Health Safety Net patients, as well as initiatives to strengthen treatment and payment for care for those with opioid use disorder. Here are summaries of those amendments (with their sponsor in parenthesis):
Amendment #1261 (Rep. Michael Finn (D-West Springfield)) would provide additional funding for Disproportionate Share Hospitals (DSH). The number of MassHealth patients and the cost of providing care to them have grown, as has the number of hospitals that qualify for DSH status. Yet the funding over the last five years has dropped from $51 million to $13 million. MHA seeks $20 million in FY2020, and an additional supplemental payment of $10 million for those hospitals that provide a significant amount of behavioral health services.
Amendment #438 (Rep. Dan Cahill (D-Lynn)) would set MassHealth outlier payments at 75% of the cost of care. In FY2019, MassHealth reduced from 80% to 50% the additional payments it provides acute hospitals for services provided to the most complex and sickest MassHealth patients. In arguing for the payment update, MHA wrote, “Extraordinary care provided to the most complex MassHealth patients carries with it the need for extraordinary support. Hospitals should not have to assume nearly 50% of the cost of these types of cases through a financial loss.”
Amendment #1100 (Rep. Mike Moran (D-Boston)) would ensure a full $15 million state transfer to the Health Safety Net and offer protections so that funding for the program is not diverted to other uses. The state regularly declines to contribute its legally mandated $30 million share of funding for the safety net. (Hospitals and insurers each contribute $165 million annually.) In recent years, the legislature has included language in the state budget requiring that Massachusetts transfer “up to” $15 million into the safety net fund to help pay for care to the uninsured. However, the “up to” language has been interpreted by the administration to mean no transfer of any funding at all. The FY2020 House Ways & Means budget assumes a $15 million transfer; however, it also continues the problematic “up to” language. Amendment #1100 seeks to ensure the legislature’s intent to provide a $15 million transfer is fulfilled.
Amendment #1071 (Rep. Danielle Gregoire (D-Marlborough)) directs MassHealth to offer coverage for tele-behavioral health services for fee-for-service patients, similar to the coverage afforded to patients who participate in MassHealth managed care programs.
Amendment #1142 (Rep. Marjorie Decker (D-Cambridge)) would require payers to provide payment for the provision of nasal naloxone rescue kits in hospital emergency departments and outpatient and community-based settings in order to mitigate future overdose risk for those with opioid use disorder.
And Amendment #1153 (Rep. Decker) directs $500,000 to the Massachusetts Consultation Service for Treatment of Addiction and Pain (MCSTAP) so that, in addition to providing clinical support, MCSTAP would also offer case management and care navigation services to assist providers as they help patients access community-based treatment for opioid use disorder.