101 CMR, § 515.05 - Payment of Managed Care Organization Services Assessment
(1)
Managed Care Organization
Services Monthly Assessment Payment. Beginning January 1, 2025,
each managed care organization must pay a monthly assessment to EOHHS in a form
and manner specified by EOHHS.
(2)
Due Date.
(a) Managed
care organization services assessment payments are due the first business day
after the month following the month assessed. For example, the January 1, 2025,
monthly assessment is due on March 3, 2025.
(c) If a managed care organization ceases to
exist or ceases to render assessed services, it must pay any outstanding
managed care organization services assessment obligations within 30 days of the
date of such cessation. If a managed care organization is acquired by or merges
with another managed care organization, any outstanding managed care
organization services assessments owed by the managed care organization being
acquired or merging must be paid within 30 days of the date of the acquisition
or merger.
(3)
Administration. EOHHS may provide updates and further
details for implementation of the managed care organization services
assessment, by administrative bulletin or other written issuance. Such written
issuances may provide additional requirements for matters including, but not
limited to, procedures for the payment and collection of the managed care
organization services assessment, reporting requirements, annual assessment
rate setting, mid-assessment year rate adjustments, enforcement processes and
procedures, etc.
(4)
Interest and Late
Fees.
(a) EOHHS may assess
interest and late fees on unpaid liabilities. If a managed care organization
fails to remit an assessment by the due date, EOHHS may assess interest at up
to 3% per month on the outstanding balance and calculate the interest from the
due date. EOHHS will calculate the interest on the outstanding balance as of
the due date.
(b) EOHHS may assess
up to an additional 3% penalty against the outstanding balance and prior
penalties for each month that a managed care organization remains delinquent.
EOHHS will credit partial payments from delinquent managed care organizations
to the current outstanding liability. If any amount remains from the partial
payment, EOHHS will then credit such amount to the penalty amount.
(c) In determining the penalty amount, EOHHS
may consider factors including, but not limited to, the managed care
organization's payment history, financial situation, and relative share of the
payments.
(5)
Assessment Revenue. An amount equal to the total
amount of assessments collected, plus any penalties and interest, will be
credited to the Health Safety Net Trust Fund.
Notes
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(1) Managed Care Organization Services Monthly Assessment Payment. Beginning January 1, 2025, each managed care organization must pay a monthly assessment to EOHHS in a form and manner specified by EOHHS.
(2) Due Date.
(a) Managed care organization services assessment payments are due the first business day after the month following the month assessed. For example, the January 1, 2025, monthly assessment is due on March 3, 2025.
(c) If a managed care organization ceases to exist or ceases to render assessed services , it must pay any outstanding managed care organization services assessment obligations within 30 days of the date of such cessation. If a managed care organization is acquired by or merges with another managed care organization , any outstanding managed care organization services assessments owed by the managed care organization being acquired or merging must be paid within 30 days of the date of the acquisition or merger.
(3) Administration. EOHHS may provide updates and further details for implementation of the managed care organization services assessment , by administrative bulletin or other written issuance. Such written issuances may provide additional requirements for matters including, but not limited to, procedures for the payment and collection of the managed care organization services assessment , reporting requirements, annual assessment rate setting, mid-assessment year rate adjustments, enforcement processes and procedures, etc.
(4) Interest and Late Fees.
(a) EOHHS may assess interest and late fees on unpaid liabilities. If a managed care organization fails to remit an assessment by the due date, EOHHS may assess interest at up to 3% per month on the outstanding balance and calculate the interest from the due date. EOHHS will calculate the interest on the outstanding balance as of the due date.
(b) EOHHS may assess up to an additional 3% penalty against the outstanding balance and prior penalties for each month that a managed care organization remains delinquent. EOHHS will credit partial payments from delinquent managed care organizations to the current outstanding liability. If any amount remains from the partial payment, EOHHS will then credit such amount to the penalty amount.
(c) In determining the penalty amount, EOHHS may consider factors including, but not limited to, the managed care organization 's payment history, financial situation, and relative share of the payments.
(5) Assessment Revenue. An amount equal to the total amount of assessments collected, plus any penalties and interest, will be credited to the Health Safety Net Trust Fund .