Healthcare (Long-Term Care)

This bill adjusts how Massachusetts Medicaid pays nursing homes to stabilize funding. It requires annual inflation adjustments using the Medicare Market Basket Update, sets base costs to the most recent two-year period, and mandates a 10% above-average Nursing Cost Per Diem. Facilities serving 75%+ Medicaid residents receive a minimum 5% rate increase. Additionally, it preserves capital funding rates for facility upgrades completed after 2020. These changes directly affect nursing homes receiving Medicaid payments, aiming to better cover rising labor and care costs.

HD 3406 aims to improve access to post-acute care services for MassHealth patients in Massachusetts by streamlining administrative processes and expanding community resources. The bill requires the Office of Medicaid to revise beneficiary notices, adopt transparent appeal procedures, and develop community discharge pathways for patients with chronic, medically complex conditions. It also establishes a complex care ombudsman program to assist hospitals with discharges and a pilot program to increase skilled nursing facility capacity for dementia, psychiatric, and geriatric patients. These changes target delays in transferring medically ready patients from hospitals to community-based care, freeing up acute care beds and improving care coordination.

This bill requires Massachusetts to increase funding for continuous skilled nursing care for medically fragile children covered by MassHealth (state Medicaid). It mandates specific staffing targets: filling at least 75% of authorized nursing hours by 2025, 80% by 2026, and 85% by 2027 onward, with provisions to boost nurse wages. The state must also require MassHealth to submit annual reports tracking staffing levels, appeals for denied care, and reductions in authorized hours. The bill aims to improve access to consistent nursing care for vulnerable children by ensuring funding meets these targets and reviewing wage rates paid to providers.

By Mr. Payano, a petition (accompanied by bill, Senate, No. 903) of Pavel M. Payano for legislation to improve the ability for patients to receive specialized medical care after an acute illness or surgery. Health Care Financing.

By Mr. Cyr, a petition (accompanied by bill, Senate, No. 850) of Julian Cyr for legislation to ensure that students who are enrolled in and pursuing a nursing career program of higher education shall be eligible for career pathway financial assistance. Health Care Financing.