State Releases 2020 MassHealth Contract

The state has released the 2020 RFA – the main contract between the MassHealth program and acute care hospitals serving Medicaid patients.
This year leading up to the RFA, and following rate reductions in 2019, hospitals and the state engaged in improved discussions about how Medicaid underpayments are affecting the delivery of care in Massachusetts. RFA stands for “Request for Applications.” The contract goes into effect on November 1.
The RFA payment changes in 2020 are projected to yield a $53.5 million improvement to acute care hospitals, both through reimbursement from MassHealth as well as from managed care entities, which reimburse hospitals using the RFA’s rates. Significant improvements in language related to the new 30-day readmission penalty are also included.
New in RY2020, MassHealth will provide $9 million in added financial support for inpatient behavioral health services provided at disproportionate share hospitals. (This is part of the total $53.5 improvement.)
MHA President & CEO Steve Walsh credited the state and hospital community for the recent discussions, adding, “Our goal is to further expand upon these improvements and we look forward to working collaboratively with the Executive Office of Health & Human Services and the Baker Administration as it develops a fiscal plan for 2021. We are committed to advocating for the resources needed to appropriately support hospitals and the MassHealth program.”