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H 2232

An Act to require equitable payment from the Commonwealth

194th Legislature (2025-2026) Introduced by Adam Scanlon

Requires the Commonwealth to pay network hospitals full negotiated rates for certain behavioral health services to MassHealth patients served via EOHHS agencies when no appropriate

Hearing scheduled for 11/03/2025 from 01:00 PM-05:00 PM in A-2
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Bill Summary · H 2232

Summary: H.2232 – An Act to require equitable payment from the Commonwealth

Overview

H.2232, introduced February 27, 2025 by Rep. Adam J. Scanlon (14th Bristol), is a bill that requires the Commonwealth to compensate network hospitals at their full negotiated rate for certain behavioral health services provided to MassHealth patients who are also clients of agencies within the Executive Office of Health and Human Services (EOHHS), but only when no appropriate alternative placement is available. The bill’s stated purpose is to ensure equitable payment to hospitals for behavioral health care delivered to MassHealth clients served through EOHHS agencies.

Status and process:
- Hearing scheduled: November 3, 2025, 1:00 PM–5:00 PM, in Committee Room A-2.
- Referred to the Joint Committee on Mental Health, Substance Use and Recovery on February 27, 2025.
- House docket: No. 2232 (Filed January 6, 2025).
- Primary sponsor: Rep. Adam J. Scanlon.
- Related item: HD 99 (replaces).

Key provisions

  • Amended statute: Section 16 of Chapter 6A (as of the 2008 Official Edition) is expanded with a new paragraph at the end.
  • New requirement: The secretary of the Executive Office of Health and Human Services (EOHHS) must ensure network hospitals are compensated at their full negotiated rate for behavioral health services provided to MassHealth patients who are also clients of EOHHS agencies and for whom no appropriate alternative placement is available.
  • Conditional payment: Such equitable payment is contingent on the hospital documenting that it has engaged in good faith efforts to place the MassHealth/EOHHS clients in any appropriate alternative setting.

Who is affected

  • Primary beneficiaries: Network hospitals that provide behavioral health services to MassHealth patients who are clients of EOHHS agencies.
  • MassHealth/EOHHS: Responsible for implementing the requirement and documenting placement attempts.
  • Patients: MassHealth beneficiaries who are also clients of EOHHS agencies and who lack appropriate alternative placement options.
  • Implications for hospital reimbursement: Hospitals would receive full negotiated rates for targeted services under defined placement constraints, potentially altering typical rate structures.

Fiscal and policy implications

  • Budgetary impact: Likely increase in Commonwealth expenditures for behavioral health services repaid at full negotiated rates when the specified placement conditions are met.
  • Administrative requirements: Hospitals must maintain documentation of good-faith placement efforts; EOHHS must verify adherence and timeliness.
  • Incentives: The provision aims to balance access to network hospital BH services with responsible placement planning, reducing the likelihood that clients remain in higher-cost or unsuitable settings due to funding constraints.

Timeline and procedural notes

  • Intro and filing: January 6, 2025.
  • First action: Referred to the Mental Health, Substance Use and Recovery committee on February 27, 2025.
  • Hearing: Scheduled for November 3, 2025, in A-2.
  • Legislative context: In the 194th General Court (2025–2026 session).

Notes for readers

  • The core concept is to ensure payment parity (full negotiated rates) for specific behavioral health services in situations where MassHealth patients are served through EOHHS agencies and no alternative placement is available, provided hospitals document good-faith placement efforts.
  • The bill reflects a focus on both equitable reimbursement and responsible placement practices within the Commonwealth’s health and human services framework.

Compiled from official sources — confirm details with the bill’s official record.

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