Massachusetts § 2UUUUU - Population Health Investment Trust Fund

§ 2UUUUU. Population Health Investment Trust Fund

  Section 2UUUUU. (a) There shall be a Population Health Investment Trust Fund. The secretary of health and human services shall be the trustee of the fund and shall expend money in the fund to make payments to providers or care organizations under contract to provide MassHealth services pursuant to an approved state plan or federal waiver. 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.

  (b) Money in the fund may be expended for Medicaid payments under an approved state plan or federal waiver; provided, however, that all 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 providers or 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. The payments from the fund shall supplement and not supplant Medicaid payments that would be made to hospitals in the absence of such payments.

[ Subsection (c) effective until October 1, 2027. For text effective October 1, 2027, see below.]

  (c)(1) The secretary shall annually expend money in the fund for payments to qualifying providers or care organizations under contract with the executive office as further provided in paragraph (2).

  (2) The secretary shall annually expend amounts from the fund averaging, over a period of 5 years, not less than $255,000,000 per year; provided, however, that such payments shall promote the continued implementation of certain federally-approved delivery system reform activities, including to support primary care and complex care management and to address health-related social needs.

[ Clause (3), of subsection (c), added by 2025, 73, Sec. 17 effective upon the later of: (i) the date for which the secretary receives all federal approvals deemed necessary to implement said sections; or (ii) October 1, 2025. See 2025, 73, Sec. 198. ]

  (3) If, in any fiscal year, the commonwealth fails to secure federal financial participation necessary to make expenditures described in this section, or if the total hospital assessment amount described in section 67 of chapter 118E is insufficient to support the distributions to the fund required to be made from the Health Safety Net Trust Fund established in section 66 of said chapter 118E, or if such distributions are otherwise not made due to limitations on federal matching, applicable payment ceilings, or other restrictions under state or federal law, then the expenditures otherwise required to be made from the fund shall be reduced proportionally based on the total amount available for expenditure.

[ Subsection (c) as amended by 2022, 126, Sec. 24 effective October 1, 2027 applicable as provided by 2022, 126, Sec. 186 and 2024, 140, Sec. 239. For text effective until October 1, 2027, see above.]

  (c) [reserved].