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S 904

Relates to the termination of certain utility services and to reports on investigatory proceedings relating to gas, electric, and steam service

2025 Regular Session Introduced by Jabari Brisport and 4 co-sponsors

HPC may require CHIA-identified health entities to file and implement performance improvement plans to curb spending, with timelines, monitoring, and public disclosure.

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Bill Summary · S 904

Summary — S.904 (Commonwealth of Massachusetts, 194th General Court)

Title: An Act to strengthen health spending accountability processes within the Health Policy Commission and the Center for Health Information and Analysis

Presented by: Senator Rebecca L. Rausch
Filed: 01/17/2025 (Senate Docket No. 2127)
Current status (as provided): Recommitted to Rules (multiple referrals and actions between Jan–Jun 2025)

Purpose

To strengthen the Health Policy Commission’s (HPC) authority and processes for holding large health care entities accountable for health spending performance, and to formalize requirements for performance improvement plans for entities identified by the Center for Health Information and Analysis (CHIA) under chapter 12C, section 18.

Key provisions

  • Definitions: “Health care entity” = any entity identified by CHIA under section 18 of chapter 12C.
  • Notice: HPC must notify all CHIA-identified entities that the commission may analyze their spending performance and require actions.
  • Performance improvement plans (PIPs):
    • HPC may require any CHIA-identified entity to file a PIP and must give written notice.
    • On receiving notice, the entity has 45 days to either (a) file a PIP or (b) apply to waive or extend the filing requirement.
    • The entity may submit supporting documentation; HPC can request additional information (which may be made public at HPC’s discretion).
  • Waiver/extension criteria: HPC may grant a waiver/delay based on consideration of factors including:
    1. Spending, price and utilization trends and demonstrated improvement
    2. Ongoing strategies or investments to improve long-term efficiency
    3. Whether increased spending resulted from unanticipated, uncontrollable factors (e.g., patient age/health status, pharmaceutical or device costs)
    4. Overall financial condition of the entity
    5. Differences between potential and actual gross state product growth (per chapter 29, §7H½)
    6. Other relevant factors
  • PIP content and timing:
    • Must identify causes of spending performance and include specific strategies, measurable expected outcomes, and an implementation timetable not to exceed 18 months.
    • HPC must approve PIPs it determines are reasonably likely to address underlying causes and are reasonably implementable.
    • If unacceptable/incomplete, HPC may provide consultation and allow up to an additional 30 days for resubmission.
  • Implementation and monitoring:
    • Upon approval, HPC will notify the entity to begin implementation and post public notice on its website.
    • Approved PIPs are subject to additional reporting and compliance monitoring; HPC shall assist implementation.
    • Entities may amend PIPs during implementation, subject to HPC approval.
  • Reporting on outcomes:
    • At the conclusion of the timetable, the entity must report outcomes to HPC.
    • If a PIP is found unsuccessful, the commission may (based on the available truncated text) extend the timetable, approve amendments, or require submission of a new PIP. (Full text of later enforcement/remedies was truncated in the provided version.)

Who is affected

  • Primary: Health care entities identified by CHIA under chapter 12C §18 — typically large providers, hospital systems, or other entities CHIA flags for spending/performance review.
  • Secondary: Payers, patients, and regulators — as HPC oversight could change provider behavior, reporting requirements, and transparency.

Procedural notes & timeline

  • Filed: 01/17/2025 (Senate docket). Multiple readings, committee referrals (Energy & Telecommunications; Corporations, Authorities & Commissions; Health Care Financing), amendments, and transfers between chambers are recorded between Jan–Jun 2025.
  • Hearing scheduled: 06/02/2025 (Gardner Auditorium) per record.
  • Latest status in record: RECOMMITTED TO RULES (06/13/2025).

Potential impacts

  • Increased regulatory oversight and transparency for high-spending health entities.
  • Additional administrative and reporting burden on affected entities.
  • Potential to accelerate implementation of cost-containment strategies if HPC-approved PIPs are effective.
  • The public posting requirement may pressure entities to demonstrate measurable spending improvements.

Note: The provided bill text was truncated after describing commission actions if a PIP is unsuccessful; the summary reflects all available provisions in the supplied text. Related measures include SD 2127 (replaces) and companion A.953.

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

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