Patrick’s Budget- Health Provisions Detail
Cost Sharing for Members
The budget proposal would increase pharmacy co-payments from $3 to $4 for brand name drugs for MassHealth members with incomes below 150 percent of the federal poverty level. For members with incomes over 150 percent of the federal poverty level co-payments for generics would increase from $3 to $4 and for brand name drugs from $3 to $5. Those drug co-pays now at $1 would not change*. These increased pharmacy co-payments also apply to Commonwealth Care members with incomes below 100 percent of the federal poverty level.
The Governor’s budget also proposes a new $2 co-pay for non-emergency transportation.
* Includes antihyperglycemics, antihypertensives, and antihyperlipidemics.
Provider and Managed Care Organization Rates
The Budget would reduce rates or payments to health care providers.
These cuts would include:
- not paying hospitals for “preventable” readmissions that occur within 30 days
- eliminating special payments to community health centers to support increased dental capacity
- eliminating payments to nursing facilities to hold a patient’s bed for up to 10 days while the patient receives care in a hospital and
- reducing hospital rate “add-ons” for hospitals that serve a disproportionate share of publicly funded patients.
-From “Budget Brief: Fiscal Year 2012: The Governor’s House 1 Budget Proposal”, Mass Budget. F irst in a series of fact sheets that will be published by the Massachusetts Medicaid Policy Institute (MMPI) and produced by the Massachusetts Budget and Policy Center in partnership with the Massachusetts Law Reform Institute; at http://www.massbudget.org/file_storage/documents/FY-2012%20House%201%20Budget%20Brief.pdf, retrieved 2/10/11.
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