Massachusetts § 2FFFFFFF - Managed Care Organization Services Reinvestment Fund

§ 2FFFFFFF. Managed Care Organization Services Reinvestment Fund

Section 2FFFFFFF. (a) There shall be a Managed Care Organization Services Reinvestment Fund which shall be a separate, nonbudgeted revenue fund to be administered by the secretary of health and human services. There shall be credited to the fund: (i) any transfers from the Health Safety Net Trust Fund established in section 66 of chapter 118E; (ii) an amount equal to any federal financial participation revenues claimed and received by the commonwealth for eligible expenditures made from the fund; (iii) any revenue from appropriations or other money authorized by the general court and specifically designated to be credited to the fund; and (iv) interest earned on any money in the fund. Amounts credited to the fund shall be expended, without further appropriation, to make payments to Medicaid managed care organizations, as defined in section 64 of chapter 118E.

(b) Money in the fund shall be expended for Medicaid payments under an approved state plan or federal waiver or for the administration of the assessment established in section 68 of chapter 118E; provided, however, that all Medicaid payments from the fund shall be: (i) subject to the availability of federal financial participation; (ii) made only under federally-approved payment methods; (iii) consistent with federal funding requirements and all applicable federal payment limits as determined by the secretary; and (iv) subject to the terms and conditions of applicable agreements between Medicaid managed care organizations and the executive office of health and human services. To accommodate timing discrepancies between the receipt of revenue and related expenditures, the comptroller may certify for payment amounts not to exceed the most recent revenue estimates as certified by the secretary to be transferred, credited or deposited under this section. The secretary shall, to the maximum extent possible, administer the fund to obtain federal financial participation for the expenditures of non-federal money from the fund. Money remaining in the fund at the end of a fiscal year shall not revert to the General Fund and shall be available for expenditure in subsequent fiscal years.

(c)(1) The secretary shall expend money in the fund, including all amounts credited to the fund, as provided in paragraphs (2) and (3).

(2) The secretary shall annually expend amounts from the fund for payments to Medicaid managed care organizations, as such term is defined in section 64 of chapter 118E, averaging, over a period of 5 years, not less than $246,000,000 per year; provided, however, that such expenditures shall be consistent with all approved federal waivers and state plan provisions.

(3) Notwithstanding the requirements of this section, the secretary shall transfer from the fund to the General Fund $57,000,000 in fiscal year 2025 and $114,000,000 annually thereafter.

(d) If the amount in the fund exceeds the amount sufficient to make the payments described in subsection (c), at any point in time, as determined by the secretary, the secretary may transfer the commonwealth's share of such amount to the General Fund, the Health Safety Net Trust Fund established in said section 66 of said chapter 118E or the Massachusetts Child Psychiatry Access Project Fund established in section 2EEEEEE of chapter 29; provided, however, that no such transfer shall cause a deficit in this fund.