On December 30, 2024, the Massachusetts General Assembly passed House No. 4653, “An Act to Strengthen the Health Care Marketplace Review Process.” The bill includes sweeping changes focused on increasing regulatory oversight and overhauling the health care market. Gov. Maura Healey is expected to sign the bill into law.
Main regulations
The health care bill expands the oversight functions of various state agencies, boards, and commissions, including the Health Policy Commission (HPC), the Department of Public Health (DPH), and the Center for Health Information and Analysis (CHIA). This bill makes a number of important changes.
Expands the scope of Health Policy Committee HPC cost trends hearings to include examination of pharmaceutical companies, pharmacy benefit managers, equity investors, real estate investment trusts (REITs), and managed services organizations. Requires registered provider organizations to disclose information about significant equity investors, REITs, and managed services organizations. Expands the types of HPC significant changes that require HPC review to include significant expansions in the capabilities of a provider or provider organization. Transactions involving significant equity investors that result in a change of ownership or control. significant acquisitions, including real estate sale-leaseback agreements; Conversion of providers from nonprofit to for-profit organizations. Creates a new Office of Health Resources and Planning, which will be responsible for developing a state health plan to predict the anticipated demand, production, supply, and allocation of health care resources across the state. The Department of Public Health amended the Determination of Necessity (DoN) Act to require DPH to review projects under the state health plan. Federal cost containment goals. The impact of the proposed project on patients, including considerations for health equity, the surrounding health care provider workforce, and other residents of the commonwealth. Data from CHIA and HPC, including cost and market impact review reports submitted by HPC. DPH may impose conditions on project approval to address these factors. Authorizes DPH to request from HPC an impact analysis of the closure of a hospital or essential health care service. Prohibits DPH from issuing or renewing licenses for acute care hospitals if the hospital's main campus is leased from a healthcare REIT. As a condition of accreditation, it requires acute care hospitals to continue to comply with reporting requirements to CHIA. Requires DPH to establish licensing and practice standards for office-based surgical centers and emergency medical providers. CHIA CHIA Expands the types of entities covered by CHIA reporting to include affiliated significant equity investors, managed services organizations, and healthcare REITs. Directs CHIA to require all hospitals to submit audited financial statements of the hospital's parent organization, major equity investors, health care REITs, and managed services organizations' out-of-state operations. Expands reporting requirements for registered provider organizations to include information about parent companies, out-of-state operations, and corporate affiliates, including significant equity investors, health care REITs, and managed services organizations. Update the standard quality measurement set. Increased penalties for providers and other organizations for failure to report in a timely manner.
Other amendments to the Massachusetts General Laws also apply to the Attorney General's Office's False Claims Act and MassHealth. Additionally, a Primary Care Payment and Delivery Task Force will be established to make recommendations to improve access, delivery, and financial stability of primary care.
what this means for you
These legislative changes expand the reporting requirements and compliance obligations placed on healthcare organizations. Once this is finalized, we will publish additional, more detailed information regarding some of the important changes.
inquiry
If you have any questions about this development or any other issues, please contact Bob Blaisdell, Crystal Bloom, Sean Ryan, Rebecca Rodman, or another member of our Massachusetts-based healthcare team.
