Massachusetts HD 3798: An Act updating the health care cost growth benchmark and associated market oversight activities

Bill Text

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HOUSE DOCKET, NO. 3798 FILED ON: 1/17/2025
HOUSE . . . . . . . . . . . . . . . No. 1384

The Commonwealth of Massachusetts
_________________
PRESENTED BY:
John J. Lawn, Jr.
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act updating the health care cost growth benchmark and associated market oversight
activities.
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PETITION OF:

NAME: DISTRICT/ADDRESS: DATE ADDED:
John J. Lawn, Jr. 10th Middlesex 1/17/2025

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HOUSE DOCKET, NO. 3798 FILED ON: 1/17/2025
HOUSE . . . . . . . . . . . . . . . No. 1384
By Representative Lawn of Watertown, a petition (accompanied by bill, House, No. 1384) of
John J. Lawn, Jr. relative to health care cost growth benchmark and associated market oversight
activities. Health Care Financing.

The Commonwealth of Massachusetts

_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________

An Act updating the health care cost growth benchmark and associated market oversight
activities.

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 1 of chapter 6D of the General Laws, most recently amended by
2 sections 5 through 11, inclusive, of chapter 343 of the acts of 2024, is hereby further amended by
3 inserting after the definition of “Alternative payment methodologies or methods” the following
4 definition:-
5 “Benchmark cycle”, a fixed, predetermined period of 3 consecutive calendar years during
6 which the projected average annual percentage change in total health care expenditures in the
7 commonwealth is calculated pursuant to section 9 and monitored pursuant to section 10.
8 SECTION 2. Said section 1 of said chapter 6D, as so amended, is hereby further amended
9 by striking out the definition of “Health care cost growth benchmark” and inserting in place
10 thereof the following definition:-

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11 “Health care cost growth benchmark”, the projected average annual percentage change in
12 total health care expenditures in the commonwealth during a benchmark cycle, as established in
13 section 9.
14 SECTION 3. Said section 1 of said chapter 6D, as so amended, is hereby further amended
15 by inserting after the definition of “Surcharge payor” the following definition:-
16 “Technical advisory committee”, the technical advisory committee of the health policy
17 commission established by section 4A.
18 SECTION 4. Said chapter 6D is hereby further amended by inserting after section 4 the
19 following section:-
20 Section 4A. (a) There is hereby established a technical advisory committee consisting of
21 appointed members with demonstrated experience in a broad range of provider sectors and
22 public and private health care payers. The technical advisory committee shall: (i) establish the
23 adjustment factor as part of the health care cost growth benchmark setting process pursuant to
24 subsection (c) of section 9; (ii) provide technical advice to the commission upon request; (iii)
25 provide the commission with operational, policy, regulatory or legislative recommendations for
26 the commission’s consideration; and (iv) produce an annual report and other reports pursuant to
27 subsection (c).
28 (b) The technical advisory committee shall consist of the following 16 members: the
29 executive director of the commission, who shall serve as non-voting chairperson; the assistant
30 secretary for MassHealth, or a designee; the executive director of the commonwealth health
31 insurance connector authority, or a designee; the executive director of the group insurance
32 commission, or a designee; and 12 members appointed by the executive director of the

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33 commission for their technical experience in specific health care sectors, 1 of whom shall be
34 selected from a list of 3 nominees submitted by the Massachusetts Hospital Association, Inc., 1
35 of whom shall be selected from a list of 3 nominees submitted by the Massachusetts Senior Care
36 Association, Inc., 1 of whom shall be selected from a list of 3 nominees submitted by the
37 Massachusetts Medical Society, 1 of whom shall be selected from a list of 3 nominees submitted
38 by the Massachusetts League of Community Health Centers, Inc., 1 of whom shall be selected
39 from a list of 3 nominees submitted by the Massachusetts Biotechnology Council, Inc., 1 of
40 whom shall be selected from a list of 3 nominees submitted by the Massachusetts Association of
41 Health Plans, Inc., 1 of whom shall be selected from a list of 3 nominees submitted by Blue
42 Cross Blue Shield of Massachusetts, Inc., and 5 of whom shall be selected by the executive
43 director from applications submitted by candidates with demonstrated experience in health care
44 delivery, health equity advocacy, hea