Boston– The Senate on Thursday passed the next phase of the Commonwealth’s two-year-old landmark health care reform with a package of new initiatives aimed at bringing down escalating health care costs and creating greater access to primary care.
“Health care cost drivers have been in place long before the passage of health care reform two years ago,” Downing said. “We must focus on reigning in the cost drivers throughout the health care delivery system. This legislation will help us reach the goal of sustainable, affordable health care for all Massachusetts residents.”
The legislation promotes the modernization of the health care system to reduce waste and inefficiencies and improve quality care, setting Massachusetts as a national leader in the statewide adoption of electronic medical records and uniform billing among health care providers and insurance companies, which together could save hundreds of millions of dollars.
“This legislation is crucial to the future vitality of our health care system and our economy,” Senate President Therese Murray (D-Plymouth) said. “We need to get this legislation to the governor’s desk as soon as possible, and I look forward to working with our friends in the House to get this done quickly. The cost of inaction is too great.”
Health care costs are straining state finances and cutting into resources for education, public safety and transportation, making it increasingly difficult for young people, families and businesses to make ends meet. This growth in health care costs is out-pacing the increase in workers’ wages and the overall inflation rate.
There are significant changes to the legislation since it was first announced in March. These changes include the following:
- The gift ban criminal penalty has been removed. The civil fine of up to $5,000 remains.
- The gift ban proposal will require pharmaceutical representatives to be licensed by the Department of Public Health (DPH), and require disclosure to DPH about the value, nature and purpose of anything not prohibited by the ban.
- All major health plans, regardless of their annual rates of premium increase, are required to break down the components of increasing costs at a public hearing conducted by the Division of Insurance and the Attorney General. (The 7% trigger has been removed.)
- The state’s determination of need process is strengthened by requiring a determination of need for new outpatient capital expenditures in excess of $25 million, where previously it did not apply at all to outpatient capital expenditures.
- Revised language ensures that health facilities do not charge for services associated with a serious reportable event, or “never-event” (for example, surgery performed on the wrong body part).
- A new section authorizes the Attorney General to allow anti-trust immunity to health insurers and providers for the purpose of discussing methods to standardize or simplify administrative practices to reduce costs and improve quality and access.
- Another new section directs the Secretary of Health and Human Services and the Secretary of Administration and Finance to conduct a review of state-funded hospitals and managed-care organizations and make recommendations for greater accountability and oversight of state resources.
The ban on gifts to physicians does NOT interfere with the efforts of pharmaceutical companies to educate doctors about new medical drugs and devices.
Other highlights of the bill include:
- An increase in the workforce capacity of nurses and primary care physicians through loan forgiveness programs and expanded enrollment at the state medical school. The bill also allows patients to choose nurse practitioners as their primary care providers.
- Sets a deadline of 2012 for statewide adoption of Computerized Physician Order Entry systems (CPOE).
- A Purchasing Reform initiative to coordinate public and private “pay-for-performance” efforts to drive quality and efficiency in the market.
- Authorization of the Department of Insurance to investigate the costs of medical malpractice coverage for health care providers.
The bill now goes to the House of Representatives.