Lawmakers rushed a hospital oversight invoice to Gov. Maura Healey on Monday, agreeing on coverage responses to the Steward Well being Care disaster that goal to higher regulate non-public fairness companies and stiffen penalties for entities that fail to submit required info.
The well being care market reform invoice (H 5159) would give state well being regulators and Legal professional Basic Andrea Campbell extra regulatory oversight and enforcement authority over transactions involving non-public fairness buyers, well being care actual property funding trusts and administration companies organizations.
Home and Senate negotiators introduced their settlement Friday night, alongside a prescription drug reform bundle that the Legislature additionally despatched to Healey on Monday. After negotiations collapsed on the finish of formal lawmaking in July, the breakthroughs emerged simply earlier than the two-year time period should finish on Tuesday.
The late-session breakthrough leaves little time for any backwards and forwards with Healey on potential adjustments to the invoice and basically provides the governor a take-it-or-leave-it dynamic the place she will signal the invoice into legislation or let it die by pocket veto because the Legislature that drafted the sweeping invoice is about to dissolve.
The invoice will increase penalties for hospitals that fail to adjust to information reporting necessities, mandates that lessors notify the state 60 days earlier than repossessing medical gear, overhauls how regulators handle care prices and assess sources, and blocks the Division of Public Well being from issuing a license to ascertain or preserve acute care hospitals whose fundamental campuses are leased from an actual property funding belief.
The compromise doesn’t outright ban actual property sale-leaseback agreements, although it might require a proper materials change discover with state well being regulators. The Senate took that strategy in its oversight invoice, whereas the Home invoice had prohibited such leases that partially led to Steward’s chapter.
Sen. Cindy Friedman, the Senate’s lead negotiator on each well being care packages, made no express point out of Steward as she defined the compromises. However the Arlington Democrat decried the function of personal fairness in well being care, a perspective that Senate Minority Chief Bruce Tarr refuted.
“There is no such thing as a room for personal fairness within the supply of well being care. These two issues are fully at odds with one another — not a judgment, it’s a reality,” Friedman asserted on the Senate ground. “Non-public fairness’s job is to generate income within the brief time period for buyers. Well being care is round delivering care and taking good care of the wants of people that want our assist as a result of they’re sick. These two issues don’t jive.”
Tarr, who additionally didn’t instantly identify Steward, mentioned he “usually” agreed that Massachusetts has seen the “devastating penalties” of personal fairness in well being care.
“I’m not ready to agree with a blanket exclusion, to the extent that for a lot of suppliers, non-public fairness, and significantly smaller apply teams, is the means by which they purchase the instruments that they should ship well being care,” the Gloucester Republican mentioned. “And so whereas I believe these issues have to be correctly overseen and controlled, I can not agree with the proposition that there isn’t a function for personal fairness within the supply of well being care.”
The compromise broadens the oversight capability of the Well being Coverage Fee, which in current months helped vet the gross sales of the some Steward hospitals to new house owners.
At its annual value hearings, the HPC underneath the invoice would be capable of scrutinize pharmaceutical manufacturing corporations, pharmacy profit managers, non-public fairness buyers, well being care actual property funding trusts, and administration companies organizations.
Non-public fairness transactions can be topic to the HPC’s materials change discover course of, and regulators may require info like audited monetary statements. After transactions are authorized, the HPC may require that entities submit further info over the subsequent 5 years, a software the company lacked in dealing with the sale of Steward’s doctor community to a non-public fairness agency.
The settlement additionally requires non-public fairness buyers, well being care actual property funding trusts and administration companies organizations to adjust to monetary reporting necessities to the Heart for Well being Data and Evaluation. Fines for entities that fail to submit requested information on time would skyrocket from $1,000 to $25,000 per week — with out a cap.
The lawyer normal’s workplace would acquire instruments to carry non-public fairness companies accountable underneath the compromise, together with extra investigative authority over well being care transactions.
The Home had handed its hospital oversight invoice on a 152-1 vote in Could, with the Senate voting 38-2 to go its model in July. Home Speaker Ron Mariano pulled the payments from convention committee negotiations in the course of the early morning hours of Aug. 1, and by Oct. 22, he instructed reporters the “trades” weren’t lining up.
Tarr, a conferee on each the hospital oversight and prescription drug reform payments, aired his frustration Monday over how the Legislature was dealing with the agreements.
“These are issues which might be extraordinarily important, they’re extraordinarily complicated, and they’re extraordinarily impactful,” Tarr mentioned on the Senate ground. “And it’s unlucky that we’re contemplating them in an off-the-cuff session, Mr. President, and that we weren’t capable of think about these within the formal session in order that they might have the controversy and the recorded votes that they deserve.”
Leaders in each branches have suggested legislators of “potential” periods on Tuesday.
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