211 CMR 52.17 - Noncompliance with 211 CMR 52.00

Current through Register 1466, April 1, 2022

(1) Reporting. If the Commissioner issues a Finding of Neglect on the part of a Carrier, the Commissioner shall notify the Carrier in writing that the Carrier has failed to make and file the materials required by M.G.L. c. 176O or 211 CMR 52.00 in the form and within the time required. The notice shall identify all deficiencies and the manner in which the neglect must be remedied. Following the written notice, the Commissioner shall fine the Carrier $5000 for each Day during which the neglect continues.

Following notice and hearing, the Commissioner shall suspend the Carrier's authority to do new business until all required reports or materials are received in a form satisfactory to the Commissioner and the Commissioner has determined that the Finding of Neglect can be removed.

(2) Noncompliance with 211 CMR 52.00 .
(a) Investigation. The Bureau shall investigate all Complaints made against a Carrier or any entity with which it contracts for allegations of noncompliance with the Accreditation requirements established under 211 CMR 52.00.
(b) Notice. The Bureau shall notify a Carrier when, in the opinion of the Bureau, Complaints made against a Carrier or any entity with which it contracts indicate a pattern of noncompliance with a particular requirement. The notice shall detail the alleged noncompliance and establish a hearing date for the matter.
(c) Hearing Held Pursuant to 211 CMR 52.17(2)(b).
1. The hearing shall be held no later than 21 Days following the date of the notice specified in 211 CMR 52.17(2)(b).
2. The hearing shall be conducted pursuant to M.G.L. c. 30A.
3. The hearing shall provide the Carrier with an opportunity to respond to the alleged noncompliance.
(d) Penalties. Following the hearing specified in 211 CMR 52.17(2)(c), the Bureau may issue a finding against the Carrier, including but not limited to:
1. An order requesting a corrective action plan and timeframe to achieve compliance.
2. A reprimand or censure of the Carrier.
3. A penalty not to exceed $10,000 for each classification of violation.
4. The suspension or revocation of the Carrier's Accreditation.
(3) Action by a National Accreditation Organization. If a National Accreditation Organization takes any action to revoke the accreditation or otherwise limit or negatively affect the accreditation status of a Carrier, or any entity with which a Carrier contracts for services subject to M.G.L. c. 176O, the Carrier must notify the Bureau within two Days and shall specify the action taken and the reasons given by the National Accreditation Organization for such action.
(4) Revocation by a National Accreditation Organization. If the National Accreditation Organization revokes accreditation, the Bureau shall initiate proceedings pursuant to M.G.L. c. 30A to revoke or suspend the Carrier's Accreditation.
(5) Informal Resolutions. Nothing in 211 CMR 52.17 shall be construed to prohibit the Bureau and a Carrier from resolving compliance issues through informal means.

Notes

211 CMR 52.17
Amended by Mass Register Issue 1345, eff. 8/11/2017.

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