Confronting a $635 million budget gap and steep spending increases in several areas, including MassHealth, Governor Charlie Baker’s administration released a $39.5 billion budget plan that aims to reduce growth while investing in more efficient programs.
On a conference call with stakeholders, state Health and Human Services Secretary Marylou Sudders thanked the Home Care Alliance for collaboration on a package of proposed solutions that are slated to go into effect by March 1st. As noted in previous newsletters and emails to HCA members, MassHealth is seeking to establish a prior authorization process, a moratorium on new home health providers, and a conflict-free physician referral process. This includes a closer scrutiny on medication administration visits and clients with a high utilization rate of home health aides.
Secretary Sudders reported on the call that audits will be conducted effective immediately. She also explained that there are currently 195 certified home health agencies in the Commonwealth and 12 were referred to the MassHealth Fraud Unit under the state’s Attorney General’s Office. The HCA will continue to monitor audit activity and provide pertinent updates.
More generally in the Health and Human Services budget, MassHealth Managed Care and MassHealth Senior Care are receiving funding increases while the Fee-for-Service line item continues to decrease reflecting a move to programs like Senior Care Options (SCO), OneCare and other managed care services.
In the elder services line items, the Enhanced Home Care or ECOP program was consolidated into several line items by the Baker administration. The bulk of what was a $70 million line item went to Home Care Purchased Services and Case Management under the Aging Service Access Points (ASAPs).
Below are some other notable items related to home care in the Governor’s FY17 budget:
- Nursing Home Supplemental Rates increased by $30 million. This is due to an increase to assessments on SNFs.
- The line item for MassHealth Managed Care increases $149.1 million and the MassHealth Senior Care account rises by $160.4 million, while the MassHealth Fee-for-service item goes down by $113.7 million.
- Elder Protective Services funding was increased by $4.9 million.
- DPH’s Pediatric Palliative Care Network was essentially level-funded at $1.8 million.
- Elder Nutrition (Meals on Wheels) was also nearly level funded at $7.2 million.
- The Nursing and Allied Health Education Workforce Development item was eliminated. Last year it was funded at $200,000 by the legislature after being zeroed out by the Governor.
The budget process moves on to the House and Senate and further updates – on both the budget as well as the HCA’s work with MassHealth on program changes to home health services – will be shared as information becomes available.
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