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MONDAY REPORT

Big Healthcare Bills Stalled As Formal Session Ends

Large, healthcare-related bills in the Massachusetts legislature have stalled as time ran out in the 2023-2024 legislative session early Thursday morning last week.

A substance use addiction and disorder bill, S.2898, that the Senate passed last Monday could not be reconciled with a similar bill the House passed in June. Late last Monday, the Senate also passed an omnibus maternal health bill, S.2899, that the House had previously acted upon, but again there was not enough time before the session-ending deadline to work out a compromise. (The session officially ended at midnight on July 31, but the legislature suspended its rules allowing the session to continue until around 10 a.m. on August 1.)

Also set aside through lack of agreement between the chambers were the healthcare oversight bill that was a priority of House Speaker Ron Mariano (D-Quincy) and the prescription drug bill that was a Senate priority. In the final days, it appeared as though the two large bills would somehow be melded in conference with a new combined proposal emerging for a vote.

But on Thursday morning, addressing a scrum of reporters, Mariano said reaching a final package around the two topics had become difficult given the tight timeframe.

There was also lack of agreement on a long-term care bill that included a provision that required commercial insurers to speed up the prior authorization process for post-acute care services. Many other non-healthcare bills, including those relating climate/clean energy and economic development, did not pass and may come up for later deliberation.

Mariano and Senate President Karen Spilka (D-Ashland) did say last week that even though the formal session ended, deals could still be crafted during informal sessions. The risk there is that any one legislator objecting to any item during informal sessions could scuttle the entire proposal. Mariano noted last Thursday that the House and Senate hospital oversight and prescription drug bills passed their chambers either unanimously or with one or two negative votes, which he said is a hopeful sign that an agreement could be reached eventually on the bills.

“The legislature is taking on massive healthcare issues this session, all of which recognize the changing needs of today’s patients, providers, and regulators,” said MHA President & CEO Steve Walsh. “Getting these reforms right is far more important than rushing to a deadline – especially as the Steward bankruptcy changes the healthcare landscape and the future of patient care hangs in the balance.

“Members of the legislature have shown tremendous collaboration with the healthcare community as they address these complex topics, and we feel confident about the path forward in the months ahead. MHA and our members will continue to support bold policies to modernize healthcare oversight, protect patients from rising drug costs, and expand access to essential behavioral and maternal health services.”

Judge OKs Closure of 2 Hospitals; Negotiations Ongoing for Remaining 5

A federal bankruptcy court judge in Houston last Wednesday signed off on allowing the closure of Steward Health Care’s Carney Hospital in Dorchester and Nashoba Valley Hospital in Ayer.

A somber Judge Christopher Lopez of the United States Bankruptcy Court for the Southern District of Texas said in issuing his order, “Closing a hospital is real; it’s affecting the lives of people who are in it right now … It weighs on me.” As of last Wednesday, there were 45 inpatients at Carney, and 21 at Nashoba.

While there are “qualified” bids for five hospitals in Massachusetts, no one made such bids for Carney and Nashoba. Hugh McDonald, a lawyer from Pillsbury Winthrop Shaw Pittman, who was representing Massachusetts at the hearing, said the bids for the two hospitals were vetted by the state, Steward, and creditors and were found lacking; that is, no one thought the bidders would have been able to operate the facilities with the resources they offered.

The remaining Steward hospitals in Massachusetts are Good Samaritan Medical Center in Brockton, St. Elizabeth’s Medical Center in Brighton, Morton Hospital in Taunton, St. Anne’s Hospital in Fall River, and Holy Family Hospital in both Methuen and Haverhill. Steward Norwood Hospital that has been closed due to flooding and whose rebuilding has been halted is not part of the bankruptcy proceedings.

Last Wednesday, Judge Lopez also signed an order allowing Steward to break what is known as Master Lease II – its agreement with Medical Properties Trust (MPT) and Macquarie Asset Management, which owns the property beneath Steward’s hospitals. Bidders on the remaining hospitals in Massachusetts would have to renegotiate new leases with MPT/Macquarie or purchase the land outright. That new lease/purchase agreement appears to be the greatest stumbling block in completing the deals to transfer the Steward hospitals to new owners.

Because there were not any inked deals as of the hearing last Wednesday, the Commonwealth of Massachusetts took off the table its offer to provide $30 million to keep the Steward hospitals afloat until the new owners were in place. The state said it would not provide the funding until asset purchase agreements were signed. “We’re not going to fund it until it is clear there is a path to new operators,” the state’s attorney told the judge.

To get an agreement, the still-unnamed bidders, Steward, MPT/Macquarie, the large lender Apollo Global Management, as well as other parties were scheduled to meet in New York City on August 1 to work out final details of the deals. Steward’s attorney said he told the parties “to bring a change of clothes” because they could be at the negotiating table for awhile.

All the parties are due back in court tomorrow, August 6 at 2 p.m. where they are expected to discuss the details of the $30 million payment. But those details and the hearing itself appear to be contingent on agreements being reached on the sale of the remaining Steward hospitals.

New Federal Designation of Great Importance to North Adams Regional

Berkshire Health System’s North Adams Regional Hospital has achieved Critical Access Hospital (CAH) designation from the Centers for Medicare and Medicaid Services (CMS). Being a CAH allows North Adams to receive increased Medicare reimbursement for the care it provides. One of the reasons North Adams closed in 2014 under its previous ownership was because it could not get the CAH designation, which would have helped keep it afloat. Since then, the CAH rules have changed.

Critical Access Hospital designation by CMS is limited to small, rural facilities that meet criteria to qualify for federal support in maintaining services that would otherwise not be financially and/or operationally viable. Berkshire Health Systems reopened North Adams in March 2024, and has been pursuing the CAH designation.

“The enormous support of Congressman Richard Neal, his colleagues in the US House and Senate, our Berkshire state legislative delegation, the municipal leaders in the region, and members of the community at large helped to make this designation possible, and we are honored and grateful that they have entrusted us with the important responsibility of bringing inpatient care back to the Northern Berkshire region,” said Darlene Rodowicz, president and CEO of Berkshire Health System and a member of the MHA Board of Trustees.

Neal, who has been a staunch advocate for the Massachusetts and national hospital community said, “This designation works to resolve stark inequities in rural and underserved communities as it relates to our nation’s health system. I have long advocated for legislation that addresses health equity, allowing everyone to have a fair and just opportunity to achieve their highest level of health, regardless of who they are or where they live. I am pleased that the work of my colleagues in Congress working with the Biden/Harris administration has led to this Critical Access Hospital designation for North Adams Regional Hospital.”

Community Health Worker Certification Training

The Greater Boston Regional Workforce Boards have received funding from the state to offer free workforce training and related support that will help people prepare for entry level positions in healthcare/behavioral health jobs. Classes for the Community Health Worker Certification training with a concentration in behavioral health begin September 4.

The certification opens opportunities in community-based and hospital settings for roles such as resource navigators, therapeutic mentors, residential counselors, behavioral health technicians, among others. The program requires no prior healthcare experience and values diverse cultural backgrounds and community knowledge.

Eligible participants must be 18 years or older, with a high school diploma or equivalent, and live or work in the greater Boston area, including MetroWest and north and south of Boston. Full details are here.

State Seeks Providers for Refugee Program

The state’s Refugee Health Assessment Program (RHAP), which ensures swift access to medical services for refugees and immigrants newly arriving in the commonwealth, is seeking qualified licensed healthcare providers with expertise in serving refugee populations for the next round of grants.

While RHAP services are primarily focused in areas with high concentrations of newcomers, such as Boston, Brockton, Holyoke, Lawrence, Lowell, Lynn, Springfield, West Springfield, and Worcester, the program is also encouraging eligible organizations in northwestern and southeastern Massachusetts to apply, acknowledging the potential for resettlement in those areas. The state is seeking bidders who can “adapt and respond to rapid increases in new arrivals, including those under dynamic resettlement landscapes and immigration pathways such as Haitian Humanitarian Parole and private sponsorship.”

Full details of the state’s request for responses are available here.

John LoDico, Editor