Instructs the Division of Health Care Finance and Policy (DHCFP), in consultation with the Division of Insurance, to establish regulations directing health insurance carriers to calculate and report relative prices paid to health care facilities and providers. In the regulations, DHCFP must specify a method to account for a uniform mix of products and services and all non-claims related payments to providers.
Instructs the Division of Health Care Finance and Policy (DHCFP), in consultation with the Division of Insurance, to establish regulations directing health insurance carriers to calculate and report health status adjusted total medical expenses for provider groups determined by zip code. In the regulations, DHCFP must specify a uniform method for calculating total medical expenses among each provider group, determine which non-claim related payments must be included in the calculations, account for health status and number of patients within each group, and specify reporting requirements.
Instructs the Division of Insurance (DOI), in consultation with the Division of Health Care Finance and Policy, to establish regulations directing health insurance carriers to calculate and report medical loss ratios of health benefit plans. The regulations must provide definitions for carriers to distinguish between medical claims expenditures and administrative cost expenditures. Before adopting final regulations, DOI must consult with designated stakeholders.
Requires the Group Insurance Commission to develop a wellness program for enrollees and to offer reductions in premiums or co-payments, or other incentives to encourage enrollees to comply with the wellness program goals. After 1 year of implementation, the GIC must issue a report to the legislature noting collective data, including level of participation and health services participants received and the savings incurred as a result of the program.
Prevents the Commonwealth from raising taxes for the purpose of financing Community Hospital and Community Health Center Capital Reserve Funds. Section 188 of chapter 240 of the acts of 2010 dissolved HEFA and merged its functions into MassDevelopment.
Creates Community Hospital and Community Health Center Capital Reserve Funds for the benefit of nonprofit community hospitals and nonprofit community health centers licensed by the Department of Public Health. These funds are to be used solely for the payment of the principal of Health and Education Facilities Authority (HEFA) bonds. Fund beneficiaries include only facilities where the ratio of the number of physician residents-in-training to the number of inpatient beds does not exceed 0.25. The Office of Health and Human Services and the Office of Administration and Finance may require that fund beneficiaries submit financial records to verify eligibility and agree to certain terms of lending, including reimbursement to the fund in the event a facility defaults on repayment of a loan. Section 188 of chapter 240 of the acts of 2010 subsequently dissolved HEFA and merged its functions into MassDevelopment.
Authorizes the Health and Educational Facilities Authority (HEFA) to allocate capital reserve funds to Community Hospital and Community Health Center Capital Reserve Funds created in Section 48 of this Act. These funds will support community hospitals and community health centers through loans and grant programs according to terms in Section 48 of this Act. Section 188 of chapter 240 of the acts of 2010 subsequently dissolved HEFA and merged its functions into MassDevelopment.
Authorizes the Health and Educational Facilities Authority (HEFA) to collect fees and administrative costs associated with the delegation of funds to various programs.
Section 188 of chapter 240 of the acts of 2010 subsequently dissolved HEFA and merged its functions into MassDevelopment.
Prohibits the Health Connector from using any of the data obtained from the Department of Revenue for solicitations or advertising.
Directs the Health Connector, in coordination with the Department of Public Health, to create a small group wellness pilot program to encourage small businesses to implement employee wellness incentive programs. The Health Connector shall provide funding and technical assistance to eligible qualified small businesses for program implementation. Funding for the subsidy program is limited and subject to state appropriation, so the Health Connector may cap enrollment in the program if funds are insufficient to meet the costs of enrolling new employers.
The Health Connector must establish regulations necessary to implement this program and annually report to the legislature on the enrollment and impact of small group wellness incentive programs.