Massachusetts Legislature Returns from Recess, Healthcare Top Priority for Hearings in September
With the August recess coming to an end, the Massachusetts legislature returns with a busy schedule in September. With the state’s budget signed into law, the legislature is shifting focus to another important debate: health care. While health care reform in Massachusetts is widely credited as the model for the Affordable Care Act, the Commonwealth has failed to pass a large compromise bill on the issue in recent years. In 2018, the omnibus health care bill (HB4639/SB2573) died in conference, and would have impacted numerous sectors of the health care industry. If passed, the bill would have expanded the Center for Health Information and Analysis’ (CHIA) authority to cover the analysis, dissemination, and collection of data regarding pharmaceutical manufacturing companies. While the pandemic changed the agenda in 2020, the legislature passed a narrower compromise on health care (SB2984). SB2984 protects individuals from surprise billing, expands access to telehealth services, and expands the scope of practice for nurse practitioners in the Commonwealth.
During the 2021-2022 session, each chamber had different focuses in the health care debate. In the Senate, the core of the bill (SB2695) was managing prices of prescriptions, the most notable being the cap on the price of insulin. Community hospital protection was at the center of the House’s health care bill (HB4262), which would have allowed for these establishments to block capital expenditures at hospitals with overlapping service areas. Both of these bills failed to move through the legislature.
With this in mind, the legislature faces an uphill battle to pass significant legislation on health care. In the month of September, the legislature will hold hearings on a vast array of bills related to healthcare in the Commonwealth:
September 12th: Joint Committee on Health Care Financing
One of the first hearings scheduled on health care faces the issue of hospital funding and the health cost benchmark. HB1190 addresses the continuation of the Medicaid payments that would be received by nonprofit and acute outpatient care hospitals. This comes at a time when Massachusetts hospitals are fighting $630 million in federal aid cuts that were originally enacted with the passage of the Affordable Care Act in 2010. While these cuts have been delayed many times, they are set to take effect on October 1, 2023.
Another topic of debate is the health cost benchmark, which the Health Policy Commission (HPC) set for 2024 at 3.6%. The benchmark program was established in Massachusetts in 2012 to contain costs for patients and providers alike, and has since been adopted by a number of states. If the Commission finds that an entity has “an unwarranted pattern of contributing to excessive health care spending,” it can vote to have the entity submit a plan that would outline specified cost-savings. HB1228 would prohibit the inappropriate use of the Commonwealth’s health benchmark by limiting the ability of healthcare providers to negotiate a rate increase with a carrier that is over the benchmark. This comes two months before the HPC is set to have their annual hearing on November 8th, 2023. It will examine the factors of health care costs and feature testimony from health care executives and other industry experts.
The committee will also hear on HB1222, which would establish a centralized reporting system for medical debt data. The reporting system would serve as a “prerequisite condition” for advancing overdue medical bills to a debt collection agency. This bill will be on the docket almost a month after more than 134,000 Massachusetts residents were part of a data breach at UMass Chan Medical School on August 15th, 2023. The breach involved the name of the individuals along with sensitive information such as their Social Security number, provider name and other insurance-related data, and financial account information.
September 12th: Joint Committee on Financial Services
Mental health care and expansion of services is also up for debate, and will be heard on September 12th during the Joint Committee on Financial Services hearing. HB4058, sponsored by Rep. Marjorie Decker (D-25th Middlesex), would expand protections for those in the care of a mental health facility and offer new requirements for medical officials. If passed, the bill would require that the use of restraints used in transporting an individual only be used in cases of emergency and that these individuals have a “practicable and safe” means of transport. The bill would also remove application and registration fees for Mobile Integrated Health (MIH) programs that are focused on behavioral health services. MIH programs use mobile resources in coordination with healthcare facilities to deliver care to individuals.
Along with mental health care, the Committee will hear about legislation surrounding telehealth and digital healthcare equality. HB3585 would cover the expansion of services and protections, including the reimbursement of interpreter services for individuals with limited English proficiency and those who are hard of hearing or deaf. The proposed bill would also give the Health Policy Commission authority to establish a Digital Bridge Pilot Program, which would “provide funding for healthcare and human service providers and their patients and clients to support the purchase of telecommunications, information services and connected devices necessary to provide telehealth services to patients and clients.”
September 20th: Joint Committee on Health Care Financing
On September 20th, the Joint Committee on Health Care Financing will hear an array of bills on health care. HB1250, also known as an Act to Advance Health Equity, would establish an Executive Office of Equality to tackle issues regarding diversity, equity, and inclusion in the state government and Commonwealth. The Office would establish methodologies to collect demographic data to further equity within the other executive offices The bill would also establish regulations for accountable care centers under MassHealth to standardize reporting measures for social risk factor data such as race, language, sexual orientation, and others.
ConnectorCare expansion will also be discussed during the Joint Committee on Health Care Financing meeting. SB733 would establish a 5-year pilot program for expanded point-of-service cost-sharing premium payment eligibility for applicants at or below 500% of the federal poverty guideline. This comes at a time when an estimated 50,000 people in Massachusetts became newly eligible for ConnectorCare with the passage of the FY2024 budget.
National Healthcare Conversation
Health care and medical costs have been in the national spotlight in recent months, as President Biden has taken steps to reduce costs and expand financial protections for individuals. The administration released guidelines to reduce surprise billing for individuals who visited hospitals or facilities that were out-of-network. The guidance comes after a 2021 bill known as the No Surprises Act went into effect in 2022, which protects individuals from surprise billing that occurred from emergency visits to out-of-network hospitals.
The administration has also taken steps to address mental health services. In August, the U.S. Department of Health and Human Services announced that $64 million will be awarded through grants to fund mental health services and response training. The Community Mental Health Services Block Grant program awarded $59.4 million to states and territories through funding provided by the Bipartisan Safer Communities Act signed by President Biden in 2022. Massachusetts received $1,433,368 from the funding to put towards mental health services.
There is a lot happening when it comes to health care policy, and it can be difficult to stay updated at the local and national level. InstaTrac makes it easy to compare legislation from the Massachusetts legislature with other bills across the country. Simply search “health care,” and InstaTrac will generate all of the bills in the State House related to health care issues. From there, you can select a bill and InstaTrac will even inform you if there are similar bills in other state legislatures. To learn more, email us at info@instatrac.com and follow us on Instagram, Twitter, Facebook, Youtube, Medium, and Substack!