HOUSE . . . . . . . . No. 4620
The Commonwealth of Massachusetts
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HOUSE OF REPRESENTATIVES, May 2, 2024.
The committee on Health Care Financing, to whom were referred the
petition (accompanied by bill, Senate, No. 725) of Nick Collins for
legislation relative to shared responsibility for health care oversight
agencies, the petition (accompanied by bill, Senate, No. 728) of Cynthia
Stone Creem for legislation to make a technical changes to the Betsy
Lehman Center for Patient Safety and Medical Error Reduction enabling
statute, the petition (accompanied by bill, Senate, No. 734) of John J.
Cronin and Joanne M. Comerford for legislation to update high-cost
hospital and Health Policy Commission system accountability, the petition
(accompanied by bill, Senate, No. 736) of Julian Cyr, John C. Velis,
Michael D. Brady, Adam Scanlon and other members of the General
Court for legislation relative to the closing of hospital essential services,
the petition (accompanied by bill, Senate, No. 746) of Barry R. Finegold
for legislation relative to the operating budgets of health care oversight
agencies, the petition (accompanied by bill, Senate, No. 761) of John F.
Keenan for legislation relative to hospital closures and health planning, the
petition (accompanied by bill, Senate, No. 777) of Paul W. Mark for
legislation relative to hospital billing and licensure, the petition
(accompanied by bill, Senate, No. 785) of Mark C. Montigny for
legislation to ensure timely health care cost reporting, the petition
(accompanied by bill, Senate, No. 788) of Michael O. Moore for
legislation to prohibit inappropriate use of the health care cost growth
benchmark, the petition (accompanied by bill, Senate, No. 789) of Michael
O. Moore for legislation relative to hospital price transparency, the
petition (accompanied by bill, Senate, No. 790) of Michael O. Moore, Jack
Patrick Lewis, Paul R. Feeney and James B. Eldridge for legislation
relative to hospital profit and fairness, the petition (accompanied by bill,
Senate, No. 801) of Rebecca L. Rausch for legislation to strengthen health
spending accountability processes within the health policy commission
and the center for health information and analysis, the petition
(accompanied by bill, Senate, No. 802) of Michael F. Rush, Vanna
Howard and Paul McMurtry for legislation to improve health care cost
accountability, the petition (accompanied by bill, Senate, No. 810) of
Bruce E. Tarr for legislation to ensure temporary nursing service agency
quality, the petition (accompanied by bill, House, No. 1165) of Ruth B.
Balser for legislation to make technical changes to the Betsy Lehman
Center for patient safety and medical error reduction enabling statute, the
petition (accompanied by bill, House, No. 1174) of Gerard J. Cassidy and
others for legislation to ensure temporary nursing service agency quality
and accountability, the petition (accompanied by bill, House, No. 1175)
of Edward F. Coppinger and others relative to the closing of hospital
essential services, the petition (accompanied by bill, House, No. 1179) of
Josh S. Cutler and others relative to hospital profit transparency and
fairness and the establishment of a Medicaid reimbursement enhancement
fund, the petition (accompanied by bill, House, No. 1181) of Michael S.
Day for legislation relative to shared responsibility for funding of health
care oversight agencies, the petition (accompanied by bill, House, No.
1185) of Paul J. Donato relative to market oversight in health care, the
petition (accompanied by bill, House, No. 1189) of Patricia A. Duffy
relative to high-cost hospitals and Health Policy Commission system
accountability, the petition (accompanied by bill, House, No. 1203) of
Kevin G. Honan and Vanna Howard for legislation to improve health care
cost accountability, the petition (accompanied by bill, House, No. 1209) of
Hannah Kane relative to the operating budgets of health care oversight
agencies, the petition (accompanied by bill, House, No. 1212) of Meghan
Kilcoyne relative to determination of need of new health care related
technology, the petition (accompanied by bill, House, No. 1219) of John J.
Lawn, Jr., and others for legislation to enhance the market review process,
and the petition (accompanied by bill, House, No. 1228) of Frank A.
Moran and Estela A. Reyes relative to the ability of the healthcare
providers to negotiate rate increases with carriers, reports recommending
that the accompanying bill (House, No. 4620) ought to pass. [Cost:
Greater than $100,000.00].
For the committee,
JOHN J. LAWN, JR..
 FILED ON: 4/30/2024
HOUSE . . . . . . . . . . . . . . . No. 4620
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act enhancing the market review process.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 16 of chapter 6A of the General Laws, as appearing in the 2022
2 Official Edition, is hereby amended by striking out, in lines 24 to 26, inclusive, the words “, the
3 division of medical assistance and the Betsy Lehman center for patient safety and medical error
4 reduction” and inserting in place thereof the following words:- and the division of medical
5 assistance.
6 SECTION 2. Section 16D of said chapter 6A, as so appearing, is hereby amended by
7 striking out, in lines 4 and 5, the words “commissioner of insurance” and inserting in place
8 thereof the following words:- commissioner of health insurance.
9 SECTION 3. Said section 16D of said chapter 6A, as so appearing, is hereby further
10 amended by striking out, in lines 22 and 23, the words “department of public health established
11 by section 217 of chapter 111, and the managed care bureau in the division of insurance” and
12 inserting in place thereof the following words:- health policy commission established by section
13 2 of chapter 6D, and the managed care bureau in the division of health insurance.
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14 SECTION 4. Section 16G of said chapter 6A, as amended by section 16 of chapter 7 of
15 the acts of 2023, is hereby amended by striking out subsection (b) and inserting in place thereof
16 the following subsection:-
17 (b) The following divisions and agencies shall be within the department of consumer
18 affairs and business regulation: the division of banks, the division of insurance, the division of
19 health insurance, the division of standards, the division of occupational licensure, and the
20 department of telecommunications and cable.
21 SECTION 5. Section 16N of chapter 6A of the General Laws is hereby repealed.
22 SECTION 6. Section 16Q of said chapter 6A of the General Laws, as so appearing, is
23 hereby amended by striking out, in line 13, the words “commissioner of insurance” and inserting
24 in place thereof the following words:- commissioner of health insurance.
25 SECTION 7. Section 16T of chapter 6A of the General Laws is hereby repealed.
26 SECTION 8. Section 16Z of said chapter 6Z, as so appearing, is hereby amended by
27 striking out, in lines 6 and 7, the words “commissioner of insurance” and inserting in place
28 thereof the following words:- commissioner of health insurance.
29 SECTION 9. Section 1 of chapter 6D of the General Laws, as so appearing, is hereby
30 amended by inserting after the definition of “Alternative payment methodologies or methods”
31 the following definition:-
32 “Benchmark cycle”, a fixed, predetermined period of 3 consecutive calendar years during
33 which the projected average annual percentage change in total health care expenditures in the
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34 commonwealth is calculated pursuant to section 9, and monitored for compliance pursuant to
35 section 10.
36 SECTION 10. Said section 1 of said chapter 6D, as so appearing, is hereby further
37 amended by striking out the definition of “Health care cost growth benchmark” and inserting in
38 place thereof the following definition:-
39 “Health care cost growth benchmark”, the projected average annual percentage change in
40 total health care expenditures in the commonwealth during a benchmark cycle, as established in
41 section 9.
42 SECTION 11. Said section 1 of said chapter 6D, as so appearing, is hereby further
43 amended by inserting after the definition of “Health care provider” the following definition:-
44 “Health care real estate investment trust”, a real estate investment trust, as defined by 28
45 U.S.C section 856, whose assets consist of real property held in connection with the use or
46 operations of a provider or provider organization.
47 SECTION 12. Said section 1 of said chapter 6D, as so appearing, is hereby further
48 amended by inserting after the definition of “Health care provider” the following definition:-
49 “Health care resource”, any resource, whether personal or institutional in nature and
50 whether owned or operated by any person, the commonwealth or political subdivision thereof,
51 the principal purpose of which is to provide, or facilitate the provision of, services for the
52 prevention, detection, diagnosis or treatment of those physical and mental conditions
53 experienced by humans which usually are the result of, or result in, disease, injury, deformity or
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54 pain; provided, that the term “treatment” shall include custodial and rehabilitative care incident
55 to infirmity, developmental disability or old age.
56 SECTION 13. Said section 1 of said chapter 6D, as so appearing, is hereby further
57 amended by inserting after the definition of “Health care services” the following 2 definitions:-
58 “Health disparities”, preventable differences in the opportunities to achieve optimal
59 health experienced by socially disadvantaged racial, ethnic, and other population groups and
60 communities, including, but not limited to, preventable differences between groups in health
61 insurance coverage, affordability, and access to quality health care services.
62 “Health equity”, the state in which a health system offers the infrastructure, facilities,
63 services, geographic coverage, affordability and all other relevant features, conditions and
64 capabilities that will provide all people with the opportunity and reasonable expectation that they
65 can reach their full health potential and well-being and are not disadvantaged in access to health
66 care by their race, ethnicity, language, disability, age, gender, gender identity, sexual orientation,
67 social class, intersections among these communities or identities, or their socially determined
68 circumstances.
69 SECTION 14. Said section 1 of said chapter 6D, as so appearing, is hereby further
70 amended by inserting after the definition of “Hospital service corporation” the following
71 definition:-
72 “Management services organization”, any organization that is contracted by a provider or
73 provider organization to perform management or administrative services relating to, supporting,
74 or facilitating the provision of patient care.
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75 SECTION 15. Said section 1 of said chapter 6D, as so appearing, is hereby further
76 amended by striking out, in lines 168 and 169, the words “division of insurance” and inserting in
77 place thereof the following words:- division of health insurance.
78 SECTION 16. Said section 1 of said chapter 6D, as so appearing, is hereby further
79 amended, in line 189, by striking out the word “excludes”.
80 SECTION 17. Said section 1 of said chapter 6D, as so appearing, is hereby further
81 amended by inserting after the definition of “Primary care provider” the following 2 definitions:-
82 “Priority patient population”, a patient population that is disproportionately impacted by
83 health disparities.
84 “Private equity company”, a publicly traded or non-publicly traded company that collects
85 capital investments from individuals or entities and purchases a direct or indirect ownership
86 share of a provider or provider organization.
87 SECTION 18. Said section 1 of said chapter 6D, as so appearing, is hereby further
88 amended by inserting after the definition of “Shared decision-making” the following definition:-
89 “Significant equity investor”, (i) any private equity company with a financial interest in a
90 provider or provider organization, or (ii) an investor, group of investors or other entity with a
91 direct or indirect possession of equity in the capital, stock or profits totaling more than 10 per
92 cent of a provider or provider organization.
93 SECTION 19. Said section 1 of said chapter 6D, as so appearing, is hereby further
94 amended by inserting after the definition of “Surcharge payor” the following definition:-
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 95 “Technical advisory committee”, the technical advisory committee of the health policy
96 commission established by section 4A.
97 SECTION 20. Section 2 of said chapter 6D is hereby amended by striking out
98 subsections (b) and (c) and inserting in place thereof the following subsections:-
99 (b) (1) There shall be a board, with duties and powers established by this chapter, which
100 shall govern the commission. The board shall consist of 9 members: 1 of whom shall be the
101 secretary of health and human services, or a designee; 1 of whom shall be the commissioner of
102 the division of health insurance, or a designee; 5 of whom shall be appointed by the governor, 1
103 of whom shall serve as chairperson, 1 of whom shall be selected from a list of 3 nominees
104 submitted by the president of the senate and 1 of whom shall be selected from a list of 3
105 nominees submitted by the speaker of the house or representatives; and 2 of whom shall be
106 appointed by the attorney general. All appointed members shall serve for a term of 5 years, but a
107 person appointed to fill a vacancy shall serve only for the unexpired term. An appointed member
108 of the board shall be eligible for reappointment; however, no appointed member shall hold full or
109 part-time employment in the executive branch of state government. The board shall annually
110 elect 1 of its members to serve as vice-chairperson. Each member of the board shall be a resident
111 of the commonwealth.
112 (2) The person appointed by the governor to serve as chairperson shall have demonstrated
113 expertise in health care administration, finance, and management at a senior level. The second
114 person appointed by the governor, shall have demonstrated expertise in health systems or
115 ambulatory care settings. The third person appointed by the governor shall have demonstrated
116 expertise in health plan administration or benefits management. The fourth person appointed by
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117 the governor, from the list of nominees submitted by the president of the senate, shall have
118 demonstrated expertise in representing the health care workforce as a leader in a labor
119 organization. The fifth person appointed by the governor, from the list of nominees submitted by
120 the speaker of the house of representatives, shall have demonstrated expertise in health care
121 innovation, including pharmaceuticals, biotechnology, or medical devices. The first person
122 appointed by the attorney general shall be a health economist. The second person appointed by
123 the attorney general shall have demonstrated expertise in health care consumer advocacy or
124 population health.
125 (c) Five members of the board shall constitute a quorum, and the affirmative vote of 5
126 members of the board shall be necessary and sufficient for any action taken by the board. No
127 vacancy in the membership of the board shall impair the right of a quorum to exercise all the
128 rights and duties of the commission. Members of the board shall receive a stipend in an amount
129 not greater than 10 per cent of the salary of the secretary of administration and finance under
130 section 4 of chapter 7; provided, however, that the chairperson shall receive a stipend in an
131 amount not greater than 12 per cent of the salary of the secretary. No member of the board
132 serving ex officio shall receive an additional stipend for their service as a board member.
133 SECTION 21. Said chapter 6D is hereby further amended by inserting after section 4 the
134 following section:-
135 Section 4A. (a) There is hereby established a technical advisory committee consisting of
136 appointed members with demonstrated experience in a broad range of provider sectors and
137 public and private health care payers. The technical advisory committee shall: (i) establish the
138 adjustment factor as part of the health care cost growth benchmark setting process pursuant to
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139 subsection (c) of section 9; (ii) provide technical advice to the commission upon request; (iii)
140 provide the commission with operational, policy, regulatory or legislative recommendations for
141 the commission’s consideration; and (iv) produce an annual report and other reports pursuant to
142 subsection (c).
143 (b) The technical advisory committee shall consist of 16 members: 1 of whom shall be
144 the executive director of the commission, who shal