Bill > H963

This bill proposes to amend existing Massachusetts General Laws to allow certain healthcare provider organizations participating in accountable care organizations (ACOs) to expand their outpatient surgery capacity without needing a "Determination of Need" (DON) approval, which is typically required for major healthcare facility changes. An ACO is a model where healthcare providers coordinate care for patients, aiming to improve quality and reduce costs. Specifically, this exemption would apply to organizations involved in the Medicare Pioneer ACO program, the Medicare Shared Savings Plan ACO, or those with an ACO arrangement with MassHealth (Massachusetts' Medicaid program), or those receiving a significant portion of their revenue from contracts with substantial financial risk. The expansion must be located either on the main hospital campus or within 10 miles of it. The Department of Public Health would still review these expansions, but they could only be prohibited if they are deemed to have an excessive cost impact on the state's overall medical expenses and its ability to meet healthcare cost growth targets, as defined by Chapter 6D of the General Laws.