HEALTH CARE QUALITY AND COST COUNCIL
[Document distributed at Council meeting 9-20-06]
APPLICABLE STATE LEGISLATION
Health Care Reform Act – Chapter 58 of the Acts of 1006. Adds new Section 16K and Section 16L to Chapter 6A of the General Laws ( G.L. c. 6A, §§ 16K, 16L )
Open Meetings law : G.L. c. 30A, §§ 11A, 11A½. All meetings of the Council shall comply with G.L. c. 30A. The Council may provide in its bylaws for executive sessions, but no action of the Council may be taken in executive session. ( G.L. c. 6A, § 16L(o)).
Conflict of Interest law : G.L. c. 268A. There is no exemption to the conflict of interest laws, and therefore the Council must comply with these provisions.
Public Records law : G.L. c. 4, § 7, cl. 26; G.L. c. 66. There is no exemption to the public records law, and therefore the Council must comply with these provisions.
State Procurement Law : G.L. c. 30B. The Council may procure equipment, office space, goods, and services pursuant to Chapter 30B ( G.L. c. 6A, § 16L(q)).
CHARGE AND PURPOSE
To set quality improvement and cost containment goals for the Commonwealth. The Council will collect cost and quality data from health care providers, pharmacies, payers, and insurers that will be maintained on a website for consumers and purchasers so that there is greater transparency and accountability on the part of providers and insurers to inform better decision-making.
COMPOSITION AND APPOINTMENT ( G.L. c. 6A, § 16K )
Secretary of EOHHS, Chair: Timothy Murphy
Auditor (or designee): Joseph DeNucci
Inspector General (or designee): Gregory Sullivan
Attorney General (or designee): Thomas Reilly
Commissioner of DOI: Julie Bowler
Executive Director of GIC: Dolores Mitchell
7 Gubernatorial Appointments from the following organizations:
• Health care quality improvement organization: Dr. Ken LaBresh, Masspro
• Institute for Health Care Improvement: James Conway, Dana Farber Cancer Institute
• Massachusetts Chapter of the National Association of Insurance and Financial Advisors:__________________________________
• Massachusetts Assoc of Health Underwriters: Christopher Delorey, Pres, Telamon Insurance and Financial Network
• Massachusetts Medicaid Policy Institute: Robert Seifert
• Expert in Health Policy: Dr. Thomas Lee, Partners
• Non-Governmental purchaser of insurance: Charles Baker, HPHC
POWERS AND DUTIES OF THE COUNCIL
? Hire staff or consultants as the Council deems necessary ( G.L. c. 6A, § 16K ).
? Develop goals to lower or contain the growth in health care costs, identify the steps required to reach each goal, estimate the cost of implementation , project the anticipated short-term or long-term financial savings achievable to the health care industry and the Commonwealth, and estimate the expected improvements in the health status of health care consumers ( G.L. c. 6A, § 16L(a)).
? Contract with an independent health care organization to provide technical assistance with developing health care quality goals, cost containment goals, performance measurement benchmarks, design and implementation of health quality interventions, construction of a consumer health information website, and the preparation of reports ( G.L. c. 6A, § 16L(b)).
? Collect data from insurers and health care providers, and levy fines on insurers or health care providers for failure to provide data ( G.L. c. 6A, § 16L(d) ).
? Promulgate rules and regulations relating to the type of data to be collected from insurers and health care providers ( G.L. c. 6A, § 16L(e)).
? Adopt by-laws for the Council and the advisory committee ( G.L. c. 6A, § 16L(f )).
? Establish performance measurements benchmarks for its goals, and publish the benchmarks annually ( G.L. c. 6A, § 16L(g)).
? Establish and maintain a consumer health information website that contains information comparing the cost and quality of health care services that is facility and provider specific, along with other health care related information (G.L. c. 6A, § 16L(h)).
? Update the website at least annually (G.L. c. 6A, § 16L(i)).
? Conduct annual public hearings to obtain input regarding the goals and performance measurement benchmarks (G.L. c. 6A, § 16L(j)).
? File a report not less than annually with the legislature summarizing the progress towards achieving the goals of improving quality and containing or reducing health care costs (G.L. c. 6A, § 16L(k)).
? Establish an advisory committee to involve the health care industry and other stakeholders (details included separately below ) (G.L. c. 6A, § 16L(l)).
? Recommend legislation or regulatory changes (G.L. c. 6A, § 16L (m)).
? Subject to appropriation, provide grants or loans to assist members in the health care industry in implementing the goals of the Council (G.L. c. 6A, § 16L(n)).
RESPONSIBILITIES OF EHS
EHS shall provide the Council with staff assistance (G.L. c. 6A, § 16K ).
ADVISORY COMMITTEE TO THE HEALTH CARE
QUALITY AND COST COUNCIL
APPLICABLE STATE LEGISLATION
Health Care Reform Act – Chapter 58 of the Acts of 1006. Adds new Section 16L to Chapter 6A of the General Laws (G.L. c. 6A, § 16L). The Advisory Committee is governed by by-laws established by the Council (G.L. c. 6A, § 16L(f)).
Open Meetings law : G.L. c. 30A, §§ 11A, 11A½. There is no exemption to the open meetings law, and therefore the Advisory Committee must comply with these provisions.
Conflict of Interest law : G.L. c. 268A. There is no exemption to the conflict of interest laws, and therefore the Advisory Committee must comply with these provisions.
Public Records law : G.L. c. 4, § 7, cl. 26; G.L. c. 66. There is no exemption to the public records law, and therefore the Advisory Committee must comply with these provisions.
CHARGE AND PURPOSE
To allow the broadest possible involvement of health care industry and other stakeholders in the Council's progress. (G.L. c. 6A, § 16L(l)).
To assist in establishment of goals and review the progress of the Council. (G.L. c. 6A, § 16L(g)).
COMPOSITION AND APPOINTMENT (G.L. c. 6A, § 16L(l))
• Representative of MMS
• Representative of MHA
• Representative of MAHP
• Representative of BCBS
• Representative of AFL-CIO
• Representative of Massachusetts League of CHCs
• Representative of HCFA
• Representative of Massachusetts Public Health Assoc
• Representative of Massachusetts Assoc of Behavioral Health Systems
• Representative of Massachusetts Extended Care Federation
• Representative of Massachusetts Council of Human Service Providers
• Representative of Home Care Alliance of Massachusetts
• Representative of AIM
• Representative of Massachusetts Business Roundtable
• Representative of MTF
• Representative of NFIB, MA Chapter
• Representative of Massachusetts Biotech
• Representative of BCBS Foundation
• Representative of AARP, Massachusetts Chapter
• Representative of Massachusetts Coalition of Taft Hartley Trust Funds
• Additional members to be appointed by Governor, including but not limited to:
• a. Representative of Mental health field: ________________________
• b. Representative of Pediatric health care: _______________________
• c. Representative of primary care: _____________________________
• d. Representative of medical education: _________________________
• e. Representative of racial or ethnic minority groups:______________
• f. Representative of Hospice Care: _____________________________
• g. Representative of Nursing profession: ________________________
• h. Representative of pharmaceutical field: _______________________
POWERS AND DUTIES OF THE COMMITTEE
? To consult with the Council regarding the Council's performance measurement benchmarks and the publication of the benchmarks (G.L. c. 6A, § 16L(g)).
? To review and comment on all reports before their public release (G.L .c 6A, § 16L(g)).
RESPONSIBILITIES OF EHS AND HCFP
None specified.