Debate on the Massachusetts Senate’s budget proposal begins tomorrow and MHA has two priority amendments among the nearly 1,200 that were filed.
One amendment, filed by Sen. Jim Welch (D-West Springfield), seeks to reinstate payment adjustments to the actual MassHealth reimbursement rates for Disproportionate Share Hospitals (DSH).
One amendment, filed by Sen. Jim Welch (D-West Springfield), seeks to reinstate payment adjustments to the actual MassHealth reimbursement rates for Disproportionate Share Hospitals (DSH). For many years, MassHealth provided an enhanced reimbursement rate to DSH as the legislature directed in various state budgets. Recently, MassHealth has instead used a supplemental payment that is paid only in the subsequent fiscal year and has been susceptible to mid-year state budget cuts. This amendment will return the DSH adjustment to the actual reimbursement rates, providing greater predictability and reliability so that hospitals can factor the adjustment into current operations. The amendment additionally provides $5 million to the DSH to support mental health and substance use disorder treatment provided to MassHealth patients, especially young patients.
MHA’s other priority amendment, filed by Sen. Michael Moore (D-Millbury), would put in place protections to allow providers to freely negotiate with Medicaid Managed Care Organizations (MCOs) rather than have the state cap the MCOs’ reimbursement rates. The ability of hospitals to negotiate with MCOs is critical to ensure the added value of a hospital is recognized in the care management provided to plan enrollees. The ability to negotiate is also essential in minimizing the likelihood that hospitals will be taken advantage of financially by non-network MCOs.