REGULATORY ACTIVITY:

• Published notice of public hearing for rules 101 CMR 316.00 Surgery and Anesthesia; 101 CMR 317.00 Medicine, and 101 CMR 318.00 Radiology.
• Pursuant to the authority of M.G.L. c. 118E and in accordance with M.G.L. c. 30A, a public hearing was held at 9:30 a.m. on Tuesday, January 23, 2018, in the First Floor Conference Room, 100 Hancock Street, Quincy, MA 02171, relative to the adoption of amendments to: 101 CMR 345.00: Temporary Nursing Services. M.G.L. c. 118E, § 13D, requires the Executive Office of Health and Human Services (EOHHS) to annually establish by regulation the limit for the rates for services provided by temporary nursing agencies registered with the Department of Public Health (DPH) to licensed hospitals and nursing facilities. The proposed amendments to 101 CMR 345.00 are in accordance with this statutory requirement. The proposed amendments establish the rate limits for temporary nursing agency services for each geographic region as purchased by hospitals and nursing facilities effective May 1, 2018. The rate limits were developed through analysis of 2014 cost data provided by facilities for the wage component, and 2014 cost data provided by temporary nursing agencies for the administrative component and profit factor, and include rates for registered nurses, licensed practical nurses, and certified nursing assistants. The rate limits include an allowance for wages, payroll taxes, and fringe benefits, in accordance with statutory requirements. The wages incorporate a cost adjustment factor (CAF) of 6.18% based on the Massachusetts consumer price index and incorporate an adjustment to the shift differentials by a CAF of 5.84% for hospitals based on Massachusetts Hospital Association Hospital Salary Survey for 2015, and a CAF of 5.52% for nursing facilities based on Massachusetts Senior Care Association Annual Employment Survey for 2015. The final regional hourly rate limits for hospitals and nursing facilities were determined by combining the median wages with an administrative component of 35.43% and profit factor of 5.31%, as derived from cost data.
• Published Bulletin 18-2 regarding 101 CMR 206.00 Standard Payments to Nursing Facilities.  To view the bulletin, go to : http://www.mass.gov/eohhs/docs/eohhs/eohhs-regs/adminbull-2017/ab-18-02.pdf
• Published bulletin 18-03 regarding rule 101 CMR 512.00 Nursing Facility User Fees: Offset Procedures for Non-Payment of User Fees. The bulletin has a retro effective date of January 26, 2018.  To view a copy of the bulletin, go to: http://www.mass.gov/eohhs/docs/eohhs/eohhs-regs/adminbull-2017/ab-18-03.pdf.

FEE SCHEDULE NEWS:

• Hospital fee schedule has been updated as of July 1, 2017.
• The state has posted updates for the following modules:
  • 101 CMR 304.00 Community Health Centers on or after October 20, 2017
• The percentage of the Health Safety Net Uniform Assessment was revised from 0.80% to 0.73% for dates of service on or after October 1, 2017 in Administrative Bulletin 17-17.
•  

REGULATORY ACTIVITY:

• Issued Administrative Bulletin 17-18 regarding 101 CMR 304.00: Community Health Centers:  Clarification on the Methodology and Payment Schedule for 340B Transition Supplemental Payments.
• EOHHS has published notices of public hearings for the following regulations. You can view the notices and the corresponding regulations at http://www.mass.gov/eohhs/gov/laws-regs/hhs/public-hearings.html
  • 101 CMR 322.00:  Durable Medical Equipment, Oxygen, and Respiratory Therapy Equipment and the repeal of:  114.3 CMR 22.00:  Durable Medical Equipment, Oxygen, and Respiratory Therapy Equipment 101 CMR 350.00:  Home Health Services 101 CMR 353.00:  Payment for Primary Care Clinician Plan Services and the repeal of 114.3 CMR 53.00:  Payment for Primary Care Clinician Plan Services

REGULATORY ACTIVITY:

• A Health Care Services Board meeting was held Saturday September 16, 2017 9:30 AM at the Department of Industrial Accidents Conference room 10-140 1 Congress Street, Suite 100 Boston, Massachusetts 02114. The Board voted on the minutes of previous meeting and reviewed the Neck and Back treatment guideline draft.  There was a presentation on High Frequency Stimulation Treatment.
• BOSTON — The Department of Industrial Accident (DIA) launched a 2-year pilot program called the Opioid Alternative Treatment Pathway (OATP) which aims to be another tool to address the state’s opioid epidemic by giving attorneys, judges, and injured workers within the DIA system quicker access to medical professionals to make treatment decisions.  To assist in this process, specially qualified Care Coordinators with knowledge and experience in dealing with issues relating to the long-term use of opioids are needed to assist and direct the care for the injured worker.  In order to be considered as a Care Coordinator, please submit a resume and complete the following questionnaire. The questions are designed to help us gain insight as to your experience and professional approach as to how you best achieved pain control with the least opioids as well as your ability to foster a therapeutic alliance with the injured worker and restore the individual to the maximum functional level.   To find out more information go to: https://www.mass.gov/news/opioid-care-coordinator-information-and-questionnaire.

FEE SCHEDULE NEWS:

• Hospital fee schedule has been updated as of July 1, 2017.

REGULATORY ACTIVITY:

• Massachusetts Health and Human Services has published two new bulletins 17-12 and 17-13.  The bulletins are regarding 114.3 CMR 47.00 Free Standing Ambulatory Surgical Facilities:  CPT/HCPCS Coding Updates and 114.3 CMR 22.00 Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment Rate Updates and Insulin Pump Supplies.

REGULATORY ACTIVITY:

• Posted Bulletin17-8 regarding 101 CMR 701.00 Community Hospital Reinvestment Trust Fund Payments and Funding effective June 2, 2017.
• The division has posted a power point entitled Opioid Alternative Treatment Pathway. The document was released on June 12, 2017 and is authored by Senior Judge Omar Hernandez.
• Published a power point titled "Introducing the DIA's Document Upload Module for submitting Conference Medical and Non-Medical Packets.
• The state has published a revised bulletin 17-09 and a new bulletin 17-10.  The revised bulletin was published on June 14, 2017 and the new bulletin is effective July 1, 2017.
• The division of Workers' Compensation has issued the Advisory Council's FY 16 Annual Report.

REGULATORY ACTIVITY:

• The Department of Industrial Accidents has made a revision to the Form 105 – Agreement to Extend 180 Day Pay Without Prejudice Period.  The revision appears in the notice just below the employee’s signature and is intended to clarify the purpose and scope of the agreement to extend benefits under the pay without prejudice clause in M.G.L. c. 152, Sec. 8.  The new form 105 took effect on March 31, 2017.
• The state published two new bulletins: Bulletin 17-06 and 17-07.  Bulletin 17-06 addresses 114.3 CMR 22: Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment providing Updates and Corrections to HCPCS codes effective January 1, 2017/  Bulletin 17-07 addresses 101 CMR 334.00: Prostheses, Prosthetic Devices and Orthotic Devises providing HCPCS updates and corrections effective January  1, 2017.

FEE SCHEDULE NEWS:

• Hospital fee schedule has been updated as of January 1, 2017.
• The state has posted updates for the following modules:
  • 101 CMR 346.00: Increased rates for certain substance-related and addictive disorder programs retroactive to January 1, 2017.
  • 101 CMR 350.00: Home Health Services, retroactive to January 1, 2017
  • 101 CMR 323.00: Hearing Services, effective for dates of service provided on or after April 7, 2017.
  • 101 CMR 331.00: Prescribed Drugs (emergency adoption), effective April 1, 2017.

• The percentage of the Health Safety Net Uniform Assessment was revised from 0.82% to 0.80% for dates of service on or after October 1, 2016 in Administrative Bulletin 17-02.

REGULATORY ACTIVITY:

• The Department of Industrial Accidents has made a revision to the Form 105 – Agreement to Extend 180 Day Pay Without Prejudice Period.  The revision appears in the notice just below the employee’s signature and is intended to clarify the purpose and scope of the agreement to extend benefits under the pay without prejudice clause in M.G.L. c. 152, Sec. 8.  The new form 105 shall take effect on March 31, 2017.
• The following regulations have been recently adopted:
  • 101 CMR 206.00:  Standard Payments to Nursing Facilities
    http://www.mass.gov/eohhs/gov/laws-regs/hhs/hospitals-nursing-homes-and-rest-homes.html#114_2_6
  • 101 CMR 350.00:  Home Health Services
    http://www.mass.gov/eohhs/gov/laws-regs/hhs/community-health-care-providers-ambulatory-care.html#101cmr350
  • Massachusetts has posted two new rules and two new bulletins.  Bulletins 17-04 and 17-05 and Rules 101-cmr-323 Hearing Services and 101-cmr-Restorative Services.  The bulletins although just published are effective January 1, 2017.  The two rules are adopted and become effective April 7, 2017.

REGULATORY ACTIVITY:

• Massachusetts is one of the first states to launch a ground­breaking program for workers’ compensation cases involving long-term opioid use which offers viable alternatives to fight the opioid epidemic. The MBA’s Workers’ Compensation Section invites you to attend this training session, featuring guest speaker Senior Judge Omar Hernandez of the Department of Industrial Ac­cidents (DIA). Topics will include:
  • A discussion of the opioid epidemic and its impact on the DIA;
  • An overview of the voluntary two-year pilot program;
  • A discussion of the types of cases suitable for the program;
  • The new DIA forms and their implementation;
  • An explanation of the “fast-track” court proceeding;
  • The role of care coordinators, insurers, attorneys, medical providers and injured workers
  • A question and answer session.
• The state issued a memo regarding assessment filings. Submission of the revised Form 50/51 assessment reporting template will become mandatory effective the quarter ending 9/30/17.  When submitting invoices for the period beginning 10/1/17 (policies effective July, August and September) the new standardized template will be required as supporting documentation for all quarterly filings.  Please note, when using the new template, do not make any changes to the original format of the document.  Rows may be added to the template to ensure all data is reported, but additional columns may not. For any questions, please contact:  Aalana Feaster (617) 626-5468 Director of Insurance or Nancy Moran (617) 626-5469 Program Coordinator I.
• Published a reminder in an administrative bulletin. The reminder was regarding courtroom protocols and procedures.

REGULATORY ACTIVITY:

• Massachusetts has released two administrative bulletins:
  • Administrative Bulletin 16-20: 101 CMR 343.00: Hospice Rates: Update to the Hospice Rates
  • Administrative Bulletin 16-19: 114.3 CMR 14.00: Dental Services: Updated CDT Dental Codes.
• The hospice rates were released January 6 but have an effective date of October 2016.  The Dental Codes have an effective date of January 1, 2017.

FEE SCHEDULE NEWS:

• Hospital fee schedule has been updated as of July 1, 2016.
• The state has adopted changes to professional service rates at community health and mental health centers as of January 1, 2015.

REGULATORY ACTIVITY:

• Governor Charlie Baker joined Secretary of Labor and Workforce Development Ronald L. Walker, II and Secretary of Health and Human Services Marylou Sudders to announce a new voluntary program to assist injured workers who have settled workers’ compensation claims get treatment for pain management, aimed at limiting the use of opioids or other narcotics. “Coordinating alternative viable chronic pain management options between an injured worker and their insurance company can reduce the chance of addiction to prescription opioids,” said Governor Baker. “Judges have seen a rising number of overdoses and deaths as these proceedings play out in the courts and this pilot will help resolve cases more swiftly as another tool for fighting the opioid epidemic.” The program seeks to resolve court cases more swiftly by assigning a care coordinator to mediate treatment options between an injured worker and the insurance company paying for medical care.

LEGISLATIVE ACTIONS:

• House Bill 4056
  Is not specifically written for the workers’ compensation system in the state.  The legislation actually amends a number of existing Massachusetts rules that address the issue of substance abuse more specifically opioid abuse.  The bill addresses law enforcement, treatment facilities, rehabilitation facilities, hospitals and physicians.  Section 23 and 24 of the legislation provide specific actions that providers are required to accomplish prior to prescribing opioids. In particular, the legislation provides: A registered pharmacist filling a prescription for an opioid substance in schedule II of section 3 may dispense the prescribed substance in a lesser quantity than the recommended full quantity indicated on the prescription if requested by the patient provided that the prescription complies with subsection (c) of section 22. The remaining quantity in excess of the quantity requested by the patient shall be void.  In the event that a practitioner recommends that an extended-release long-acting opioid be utilized during the course of long-term pain management, the practitioner registered under section 7 shall enter into a written pain management treatment agreement with the patient that appropriately addresses the benefits as well as the risk factors for abuse or misuse of the prescribed substance under guidelines published by the department. Such an agreement shall be filed in the patient’s medical record or included in the patient’s electronic health record; and when issuing a prescription for an opiate to an adult patient for outpatient use for the first time, a practitioner shall not issue a prescription for more than a 7-day supply. A practitioner shall not issue an opiate prescription to a minor for more than a 7-day supply at any time and shall discuss with the parent or guardian of the minor the risks associated with opiate use and the reasons why the prescription is necessary.  It should be noted that these sections are general law applicable to all patients in Massachusetts and not just workers’ compensation patients. There are numerous effective dates regarding the legislation based on the sections.  Effective Dates:  Section 29 no later than March 1, 2017; Sections 8, 9, 32, 43-51 July 1, 2016; Section 4 September 1, 2016; Section 27 October 15, 2016; Section 23 December 1, 2016; Sections 7, 29 and 69 December 1, 2016; Section 31 January 1, 2017, 55 December 31, 2021; The balance of the sections become effective June 14, 2016.