27 Aug 2008 ... Promote Reform and Efficiency in the Health Care System. • Creates a Special
Commission on Health Payment Reform to investigate.
An Act to Promote Cost Containment, Transparency and Efficiency in the Delivery of Quality Health Care (Summary of MA S.2863 final version, signed as Chapter 305 of the Acts of 2008, 8/10/2008)
1. Promote Reform and Efficiency in the Health Care System • Creates a Special Commission on Health Payment Reform to investigate restructuring the current payment system to provide incentives for efficient and effective care. The 15-member Commission shall make its recommendations no later than April 1, 2009. • Strengthens the Determination of Need (DON) process for outpatient capital projects and ambulatory surgery centers to help maintain standards of quality, and ensure the efficient and equitable deployment of health care resources across the Commonwealth. • Authorizes MassHealth to establish a “Medical Home” demonstration program to promote coordinated, comprehensive patient care and strengthen the role of primary care providers. • Sets a statewide standard for uniform billing and coding among health care providers and insurance companies to reduce administrative costs. • Authorizes the Department of Public Health, to establish a list of so-called “never-events” to be updated annually, and prohibits health providers from billing for costs related to a “never-event”. • Reduces medical record storage requirements, changing the required number of years to retain records from 30 to 20 years. • Establishes a Pharmacy Academic Detailing Program to educate providers who prescribe expensive brand name drugs on the use of therapeutic alternatives in lower cost brand names and generic drugs.
2.) Improve Access to Health Care Services • Establishes a new Health Care Workforce Center within the Department of Public Health to improve access to health care services in the Commonwealth, with a particular emphasis primary care. The Center shall develop short-term and long-term policies to address workforce shortages. • Creates a new loan forgiveness program for doctors and nurses who commit to practicing certain specialties in medically underserved areas, administered by the Health Care Workforce Center • Expands enrollment at UMass Medical School for students committed to primary care specialties. • Creates an enhanced “learning contract” for UMass Medical students who commit to working four years in primary care in Massachusetts, providing a greater tuition incentive for those who participate, but also including a tougher penalty for students who don’t complete their commitment. • Creates an affordable housing model for health care professionals committed to providing care in underserved regions. • Requires health insurers to recognize and reimburse nurse practitioners as primary care providers. • Expands the number of physician assistants that a physician may supervise from 2 to 4 in medically underserved areas. • Establishes a Nursing and Allied Health Workforce Development Trust Fund to increase the nursing workforce and creates a loan forgiveness/incentive program for nursing graduates who commit to serve as nursing faculty for a specified number of years. • Directs the MassHealth Payment Policy Advisory Board to study methods of improving reimbursements or bonuses for those engaged in primary care.
3.) Enhanced Transparency of Health Care Costs and Quality • Authorizes the Division of Health Care Finance and Policy and the Attorney General to hold an annual public hearing with health care providers and health care insurers to investigate and report on health care cost drivers and make cost-reduction recommendations. • Directs the Division of Health Care Finance and Policy and Division of Insurance to review the regulation, oversight and disposition of the reserves and surpluses of health insurers and providers. • Requires reporting of “serious reportable events”, adverse drug events and hospital-acquired infections. • Regulates marketing practices to health care professionals from the pharmaceutical and medical device industry based on an industry-accepted code of conduct. • Requires disclosure of pharmaceutical and medical device companies’ training and compliance policies, as well as the value, nature, purpose and recipient of any payment or subsidy over $50 to any health care professional. 4. Encourage Adoption of Health Information Technology • Sets a goal of statewide adoption of electronic health records by the year 2015 to improve patient safety and lower costs. After this date, the use of an interoperable health record system would be required for hospital licensure. • Dedicates $25 million to the new Massachusetts e-Health Institute, under the Massachusetts Technology Collaborative, the Health Information Technology Council to facilitate the financing and deployment of the statewide, compatible system of electronic health records. • Sets a goal of 2012 for statewide adoption of Computerized Physician Order Entry systems (CPOE). After this date, the use of CPOE systems would be required for hospital licensure.
• Requires physician competency in health information technology for board registration by the year 2015. Other provisions of the legislation include: • Directs the Executive Office of Health and Human Services to examine the feasibility of an interstate independent entity to research the comparative effectiveness of medical procedures, drugs, devices, and biologics, so that research results can by used as a basis for health care purchasing decisions. • Authorizes a Medical Malpractice Study, directing the Division of Insurance to conduct an investigation into the high costs of medical malpractice coverage for health care providers and the possibility of prorating premiums for providers who practice less than full time. • Establishes patient and family advisory councils in all hospitals to ensure consumer involvement in health care delivery. • Requires disclosure by pharmacies of improper dispensing of drugs that result in serious injury or death. ### The full text is available at: http://www.mass.gov/legis/laws/seslaw08/sl080305.htm (Note and link added by NCSL, 8/27/08)
