SPRINGFIELD, Mass. (WWLP/State House News Service) – A proposed MassHealth cap set to take effect October 1st could result in a $150 loss in reimbursements to hospitals, according to the Massachusetts Hospital Association.
The Executive Office of Health and Human Services’ proposal would ban MassHealth managed care organizations from reimbursing hospitals more than 105% of the MassHealth fee for service rates paid for hospital services.
The hospital association said that hospitals are already being paid 76 cents for each dollar of care provided under the existing fee for service rates, so the cap “would result in hospitals being paid 20% below the cost of care.”
The organization is calling on the Baker Administration to rescind the proposal. 22News spoke with Baystate Health about the possible impact on their healthcare system.
“We don’t have a sense yet of specific impact, but it is certainly concerning at a time when Baystate Health is already experiencing about $40 million a year in losses due to underpayments through Medicaid services, added to the fact that we just had a $23 million hit from the wage data issue,” Baystate Health spokesperson Ben Craft said.
MassHealth is the largest program in the state budget, and the largest insurer in Massachusetts. The Baker Administration is looking for ways to control spending on MassHealth, which is taking up available revenues.