Bill > S661

This bill proposes several key changes: 1. It requires MassHealth (the state's Medicaid program) to set reimbursement rates for providers that are equal to or greater than the federal Medicare rates for the same services, and establishes a single reimbursement fee schedule for all MassHealth Accountable Care Organizations. 2. It mandates timely payment of claims by MassHealth, requiring payment within 45 days (or 15 days for electronic claims) and imposing interest penalties for late payments, unless the claim is under investigation for fraud. 3. It requires MassHealth to provide detailed guidelines to providers on the information and documentation needed for reimbursement claims, and prohibits retroactive denials or reductions of payments for services provided over a year ago without proper notice. 4. It expands the definition of "carrier" under the state's health insurance consumer protection law to include MassHealth and its managed care arrangements, ensuring consistent protections for both private and public health plan enrollees. Overall, the bill aims to improve the timeliness and fairness of MassHealth provider reimbursements, while extending certain consumer protections to the state's Medicaid program.

Health and Social Services

https://malegislature.gov/Bills/191/S661