▸Intro / Preamble
Notwithstanding any general or special law to the contrary, the health policy commission shall, in consultation with the center for health information and analysis, the commonwealth health insurance connector authority, and the division of insurance, conduct a review and issue a report related to establishing a public health insurance option in the commonwealth. The report shall include, but not be limited to: (i) an analysis of public health options in other states and jurisdictions; (ii) an analysis of public health insurance option models; (iii) an estimated cost of establishing a public health option under the researched models; and (iv) a comparison of private health insurance payment rates to Medicare Parts A and B payment rates. The report shall include recommendations regarding: (i) a public health insurance option model; (ii) identification of the appropriate state agency to administer a public health option in the commonwealth; (iii) the estimated annual administrative costs to operate a public health option and proposed funding mechanisms under the recommended model; (iv) proposed eligibility requirements for a public health option under the recommended model; (v) the estimated premium rates for a public health option at a level sufficient to fully finance the costs of such a public health option under the recommended model; (vi) proposed payment rates for a public health option for services and providers under the recommended model; (vii) health care provider participation guidelines and processes for a public health option under the recommended model; and (viii) any other available information that the commission considers necessary to fulfill its duties under this section; provided, if the report indicates that a public health option under the recommended model will outperform the average cost of a private health insurance plan in terms of cost-savings and spending growth in the commonwealth, the report shall include draft legislation necessary to implement said recommendations for the legislature’s consideration. The report shall be filed with the clerks of the house of representative and the senate, the house and senate committees on ways and means, and the joint committee on health care financing 12 months after the effective date of this act.
Show raw text
Notwithstanding any general or special law to the contrary, the health policy commission shall, in consultation with the center for health information and analysis, the commonwealth health insurance connector authority, and the division of insurance, conduct a review and issue a report related to establishing a public health insurance option in the commonwealth. The report shall include, but not be limited to: (i) an analysis of public health options in other states and jurisdictions; (ii) an analysis of public health insurance option models; (iii) an estimated cost of establishing a public health option under the researched models; and (iv) a comparison of private health insurance payment rates to Medicare Parts A and B payment rates. The report shall include recommendations regarding: (i) a public health insurance option model; (ii) identification of the appropriate state agency to administer a public health option in the commonwealth; (iii) the estimated annual administrative costs to operate a public health option and proposed funding mechanisms under the recommended model; (iv) proposed eligibility requirements for a public health option under the recommended model; (v) the estimated premium rates for a public health option at a level sufficient to fully finance the costs of such a public health option under the recommended model; (vi) proposed payment rates for a public health option for services and providers under the recommended model; (vii) health care provider participation guidelines and processes for a public health option under the recommended model; and (viii) any other available information that the commission considers necessary to fulfill its duties under this section; provided, if the report indicates that a public health option under the recommended model will outperform the average cost of a private health insurance plan in terms of cost-savings and spending growth in the commonwealth, the report shall include draft legislation necessary to implement said recommendations for the legislature’s consideration. The report shall be filed with the clerks of the house of representative and the senate, the house and senate committees on ways and means, and the joint committee on health care financing 12 months after the effective date of this act.