Hospitals would plan to prevent unnecessary repeat tests for patients

Hospitals would submit plans to share test results and decide whether earlier results can safely guide treatment. Every Massachusetts hospital would need a plan. State health officials would issue rules defining duplicate diagnostic services. State health officials would review plans for safety, costs, and likely success. Plans would count as approved if officials took no action within 45 days. Hospitals would have 30 days to revise rejected plans. Officials could fine hospitals up to $500,000 for willful failure to file, bad-faith filing or implementation, or knowingly withholding required information. Payers could deny duplicate-service charges unless hospitals showed the services were medically necessary and appropriate. Hospitals could not bill insured patients for those denied services. Hospitals would file within 30 days after their fiscal year starts. State health officials would notify hospitals of approval or rejection within 30 days after filing.

The secretary of health and human services would develop and maintain a secure online tool showing all licensed psychiatric and substance use treatment beds available for inpatient care. Providers, health facilities, and payers would use the tool to place patients older than 22 seeking admission from emergency departments or hospital medical floors. The tool would show bed locations, treatment specialties, and insurance requirements in real time. The tool and its information would be confidential and excluded from public-record disclosure.

Massachusetts public health officials would use state health planning findings when deciding whether to approve proposed health services. Officials could not approve services where the state health planning office finds that existing supply, distribution, and capacity exceed projected statewide need or need in the project’s region. Health planning would consider fair access, staffing, costs, and coordination of care. Focused assessments could identify shortages, excess capacity, barriers to care, and possible policy responses. Approval reviews would consider patients, nearby providers’ workers, and state agency findings. The written review record would include the health planning office’s report. Officials could set approval conditions and consider special needs of research or training projects unlikely to increase patient capacity or total patient charges. Application reviews would use the criteria in effect on the date the application was filed.

Massachusetts public health officials would require licensed facilities to handle admissions and discharges around the clock. The requirement would cover all facilities licensed under the health facility licensing section amended by Section 6.