Sleep Number, SC manufacturing and Assembly

2025-2026 Regular Session Introduced by Tameika Isaac Devine

MassHealth SCOs must reimburse contracted nursing homes at least the Medicaid FFS rate plus applicable add-ons for room, board, and access/transition supports.

Introduced and adopted

Summary — S.467 (Print 467B)

Title discrepancy: the bill file lists an unrelated title about rent-regulated property owners; the actual bill text (Senate No. 467) is a Massachusetts state bill presented by Senator Barry R. Finegold titled “An Act ensuring senior care organization quality and accountability.” This summary describes the bill text.

Purpose

Require MassHealth-contracted Senior Care Options (SCO) organizations that pay nursing homes on a capitated basis to reimburse nursing homes at no less than the applicable Medicaid fee‑for‑service (FFS) nursing facility payment rate, including room & board and specified rate add‑ons, to improve access to necessary services and support safe transitions from hospitals to nursing facilities.

Key provisions

Amends subsection (e) of G.L. c.118E, §9D by adding a new paragraph (7).

Requires any MassHealth SCO program (contracted to provide and coordinate services on a capitated basis) that contracts with a nursing home licensed under G.L. c.111, §71 to reimburse that nursing home at an amount not less than the current Medicaid fee‑for‑service payment rate established under 101 CMR 206.

Specifies that such reimbursement must include:

Room and board; and
All rate add‑ons set forth in 101 CMR 206 that are intended to ensure access to critical services and to facilitate hospital-to-nursing-facility transitions.

Who is affected

Nursing homes licensed under G.L. c.111, §71 that serve MassHealth members.

MassHealth Senior Care Options (SCO) plans and any entities contracting with the Commonwealth to provide capitated long‑term care services.

MassHealth members who require nursing facility care (may benefit from improved access/transition supports).

State budget/Medicaid program administrators (potential fiscal implications).

Potential impact

Financial: Raises the minimum reimbursement floor for nursing homes serving MassHealth SCO members to the Medicaid FFS rate plus applicable add‑ons. This may increase SCO plan costs or require adjustments to capitation payments or state funding.

Access/Quality: Intended to preserve or improve nursing facility capacity and care transitions by ensuring facilities receive adequate payment levels.

Administrative: Requires SCO contracts and payment arrangements to comply with 101 CMR 206 standards; may prompt renegotiation of provider contracts.

Legislative status and timeline (selected)

Filed: 1/17/2025 (Senate Docket No. 2260).

Introduced/Read twice: 2/6/2025; referred to Finance Committee (and earlier to Elder Affairs).

Print versions: 467A (2/20/2025) and 467B (5/6/2025).

Hearing scheduled: 6/24/2025 (House B‑1).

Other actions: multiple committee referrals and reassignments noted; House concurrence and several recommitments recorded.

Notes

The bill text and procedural history are for a Massachusetts state legislative proposal presented by Senator Barry R. Finegold. Some metadata provided (alternate title, sponsor list) appears inconsistent with the bill text and likely reflects data errors; this summary follows the bill text itself.