Three Hospital Priorities for FY2019 House Budget Debate

Debate begins today on the Massachusetts House Ways & Means Committee’s state budget proposal for FY 2019. The committee released its $41 billion budget plan on Wednesday, April 11 and within two days, 1,400 amendments had been filed.

Three of those amendments were filed on behalf of MHA.  Hospitals reacted generally favorably to the Ways & Means budget, noting that it strengthened both the Health Safety Net program as well as assuring MassHealth reimbursement relief to disproportionate share hospitals (DSH).

One MHA amendment – #940 filed by Rep. Michael Finn (D-West Springfield) – seeks to further assist the DSH by directing MassHealth to expend $12.3 million specifically for DSH inpatient and outpatient behavioral health and substance use disorder services, with a  priority on care provided to children and adolescents.

Another MHA amendment (#280 filed by Reps. David Linsky (D-Natick) and Jim O’Day (D-West Boylston) would allow providers to freely negotiate with MassHealth Managed Care Organizations (MCOs) for in-network services and out-of-network non-emergency services.  Under new state policies, MassHealth MCO reimbursements have been capped at 100% of the MassHealth fee-for-service rates. That cap and the inability to negotiate it is putting immense financial pressure on hospitals that are, in many cases, the key elements of the new Accountable Care Organization models guiding healthcare. As the ACOs – with hospitals at their center – take on more risk they need the ability to freely negotiate with the MCOs.

Finally, amendment #725 filed by Kate Hogan (D-Stow) would allow hospitals streamlined, integrated access to the state’s prescription monitoring program, also known as MassPAT. Specifically, the amendment would allow hospitals to directly access MassPAT data in real time to allow for timely decision-making so that providers get the full picture of all the treatment that a patient has been receiving. The amendment doesn’t compromise compliance with strict federal and state privacy and security rules.