Chapter 6D

Section 1. As used in this chapter, the following words shall, unless the context clearly requires otherwise, have the following meanings:— ''Actual costs'', all direct and indirect costs incurred by a hospital or a community health center in providing medically necessary care an…

Section 10. (a) For the purposes of this section, ''health care entity'' shall mean a clinic, hospital, ambulatory surgical center, physician organization, accountable care organization or payer; provided, however, that physician contracting units with a patient panel of 15,000 o…

Section 11. (a) The commission shall develop and administer a registration program for provider organizations. A provider organization shall be registered for a term of 2 years and renewable under like terms. The commission shall coordinate with state agencies including, but not …

Section 12. (a) No provider or provider organization may negotiate network contracts with any carrier or third-party administrator except for a provider or provider organizations which are registered under this chapter and regulations promulgated under this chapter; provided, how…

Section 13. (a) Every provider or provider organization shall, before making any material change to its operations or governance structure, submit notice to the commission, the center and the attorney general of such change, not fewer than 60 days before the date of the proposed …

Section 14. (a) By January 1, 2014, the commission, in consultation with the office of Medicaid, shall develop and implement standards of certification for patient-centered medical homes. In developing these standards, the commission shall consider existing standards by the Natio…

Section 15. (a) The commission shall establish a process for certain registered provider organizations to be certified as accountable care organizations, herein referred to as ACOs; provided that no provider organization is required to become an ACO. The ACO shall be certified fo…

Section 16. (a) There is hereby established within the commission an office of patient protection. The office shall:— (1) have the authority to administer and enforce the standards and procedures established by sections 13, 14, 15 and 16 of chapter 176O. The commission shall prom…

Section 17. The commission shall keep an accurate account of all its activities and of all its receipts and expenditures and shall annually make a report thereof as of the end of its fiscal year to its board, to the governor, to the general court, and to the state auditor, such r…

Section 18. The commission may adopt regulations to implement this chapter.

Section 2. (a) There shall be established within the executive office for administration and finance, but not under its control, a state agency known as the health policy commission. The commission shall be an independent public entity not subject to the supervision and control o…

Section 20. Every 3 years, the commission, in collaboration with the department of public health, the department of mental health and the department of developmental services, shall prepare a pediatric behavioral health planning report analyzing the status of pediatric behavioral…

Section 21. The commission shall develop a standard release form for exchanging confidential mental health and substance use disorder information. The standard release form shall be available in electronic and paper format and shall be accepted and used by all public and private …

Section 22. (a)(1) There shall be within the commission an office for health resource planning. The office shall develop a state health resource plan to identify: (i) the anticipated needs of the commonwealth for health care services, providers, programs and facilities; (ii) the …

Section 23. Every 2 years, the commission, in consultation with the center, the group insurance commission, the office of Medicaid and the division of insurance, shall evaluate the impact of section 17Z of chapter 32A, section 10Z of chapter 118E, section 47CCC of chapter 175, se…

Section 2A. The commission shall keep confidential all nonpublic clinical, financial, strategic or operational documents or information provided or reported to the commission in connection with any care delivery or quality improvement process or performance improvement plan activ…

Section 3. For the purposes of this chapter, the board shall be authorized and empowered as follows: (a) to develop a plan of operation for the commission. The plan of operation shall include, but not be limited to: (1) implementation of procedures for operations of the commissio…

Section 3A. (a) There shall be within the commission an office for pharmaceutical policy and analysis. The office shall: (i) analyze pharmaceutical spending data and information collected by the commission and other agencies of the commonwealth pursuant to subsection (b); (ii) pr…

Section 4. There shall be an advisory council to the commission. The council shall advise on the overall operation and policy of the commission. The council shall be chosen by the executive director and shall reflect a broad distribution of diverse perspectives on the health care…

Section 5. The commission shall monitor the reform of the health care delivery and payment system in the commonwealth under this chapter. The commission shall: (i) set health care cost growth goals for the commonwealth; (ii) enhance the transparency of provider organizations; (ii…

Section 6. (a) For the purposes of this section, ''non-hospital provider organization'' shall mean a provider organization required to register under section 11 that is: (i) a non-hospital-based physician practice with not less than $500,000,000 in annual gross patient service re…

Section 7. (a) The commission, in consultation with the advisory council, shall administer the Healthcare Payment Reform Fund, established under section 100 of chapter 194 of the acts of 2011. The fund shall be used for the following purposes: (1) to support the activities of the…

Section 8. (a) Not later than October 1 of every year, the commission shall hold public hearings based on the report submitted by the center for health information and analysis under section 16 of chapter 12C comparing the growth in total health care expenditures to the health ca…

Section 8A. (a) As used in this section, the following word shall, unless the context clearly requires otherwise, have the following meaning: ''Manufacturer'', an entity that manufactures a pharmaceutical drug covered by MassHealth. (b) The commission may require a manufacturer s…

Section 9. (a) Not later than April 15 of every year, the board shall establish a health care cost growth benchmark for the average growth in total health care expenditures in the commonwealth for the next calendar year. The commission shall establish procedures to prominently pu…