Agencies and Programs

Provides Health Care Quality and Cost Council - definitions of terms used in QCC statute.

Creates the Health Care Quality and Cost Council that will promote health care quality improvement and cost containment.

M.G.L. c. 6A, § 6J-L: Creates a Health Care Quality and Cost Council to promote health care quality improvement and cost containment.

Creates a MassHealth Payment Policy Advisory Board to review and evaluate Medicaid rates and rate methodologies, especially rates paid to Community Health Centers.

Creates a special commission to study reducing or eliminating the payor assessment paid by insurers and self-insured employers for the Health Safety Net.

Creates a Health Disparities Council within EOHHS to make recommendations to reduce racial and ethnic health disparities in the Commonwealth and to increase diversity among healthcare workers.

Changes composition of Public Health Council to include members from public health schools, providers, and health advocates.

Creates a new Health Care Access Bureau within the Division of Insurance with responsibility for oversight of the small group and individual health insurance market and affordable health plans, funded by a $600,000 annual assessment on insurance carriers.

Creates an Essential Community Provider Trust Fund. Funds will be used to make grant payments to hospitals and community health centers in accordance with criteria established by the new Health Safety Net Office.

Allows staff of the Connector to receive pension benefits.

Establishes a pediatric palliative care program, administered by the Department of Public Health, to serve children, and the families of children, with life-threatening illnesses.

Individuals may appeal an adverse decision of eligibility or affordability through an appeals process established by the Connector.

Establishes the procedure for implementation of the individual mandate. Qualifying individuals for whom "creditable coverage" is deemed affordable must have "creditable coverage" in place. Individuals must include information about health insurance status on their tax forms. Failure to meet the insurance requirement will result in a penalty, assessed by the department of revenue. All penalties will be deposited in the Commonwealth Care Trust Fund that will contribute to state subsidies for the Commonwealth Care program. • Creates a penalty for non-compliance with the individual mandate as equal to 50% of the lowest premium available for each month the individual did not have creditable insurance, as determined by the Connector.

Expands employee eligibility for participation in the Insurance Partnership Program to 300% of the Federal Poverty Level. • Ensures that Insurance Partnership subsidies are consistent with those provided under the Commonwealth Care program. • Specifies that self-employed individuals enrolled in the Insurance Partnership Program are eligible for employee subsidies only.

Creates Health Safety Net Office to replace current Uncompensated Care Pool administration. The Health Safety Net pays acute care hospitals and community health centers for certain essential services provided to uninsured and underinsured Massachusetts residents.

Establishes the Health Safety Net Office which administers the Health Safety Net program and the Health Safety Net Trust Fund.

Establishes the Health Safety Net Trust Fund.

Amends the Division of Health Care Finance and Policy statute to include references to Health Care Quality and Cost Council and the provider and payer cost trends hearings.

Amended powers of the Division of Health Care Finance and Policy to delete reference to Uncompensated Care Pool.

Sets out provisions to determine an acute hospital's annual assessment to cover a portion of estimated expenses of the Division of Health Care Finance and Policy and the Health Safety Net office.