Bill > H1096

This bill aims to ensure fair and consistent reimbursement rates for Federally Qualified Health Centers (FQHCs) across various insurance and health care programs in Massachusetts. The bill defines FQHCs as entities receiving grants under a specific federal statute and establishes that these community health centers must be reimbursed at a rate equivalent to what they would receive from MassHealth (the state's Medicaid program), based on federal methodologies effective January 1, 2025. The legislation applies to multiple types of health insurance entities, including state-regulated insurers, medical service corporations, health maintenance organizations, preferred provider organizations, and student health insurance programs. The bill requires these entities to pay community health centers an annual aggregate revenue that matches MassHealth's reimbursement methodology, and mandates that the Division of Insurance create regulations to implement these requirements, with a deadline of January 1, 2027. Additionally, insurance entities must submit annual reports demonstrating compliance with these reimbursement standards. This comprehensive approach aims to provide financial stability and equity for community health centers by standardizing their payment rates across different insurance platforms.

Business and Industry

https://malegislature.gov/Bills/194/H1096