Bill > S711

This bill aims to ensure fair and consistent reimbursement rates for community health centers across various healthcare and insurance entities in Massachusetts. Specifically, the bill requires that any Federally Qualified Health Center (FQHC) - defined as an entity receiving a grant under 42 U.S.C. 254B - be reimbursed at a rate equivalent to the annual aggregate revenue they would receive from MassHealth, using a payment methodology that aligns with specific federal guidelines as of January 1, 2025. The bill applies this requirement to multiple types of healthcare entities, including state employee health insurance, MassHealth, insurance companies, medical service plans, dental service corporations, health maintenance organizations, and preferred provider organizations. The legislation also mandates that the Division of Insurance will issue regulations to implement these requirements, including consulting with MassHealth to establish proper payment rates, and requires licensed entities to submit annual reports demonstrating compliance with the reimbursement standard. This bill is designed to provide rate equity and financial stability for community health centers by ensuring they receive consistent and fair compensation across different healthcare payment systems.

Budget and Finance, Business and Industry, Health and Social Services

https://malegislature.gov/Bills/194/S711