General. The Center shall establish an assessment on
all Surcharge Payors.
Qualifying Surcharge Payor. A Surcharge Payor is
subject to assessment if the Surcharge Payor's Payments Subject to Assessment
were at least $1 million during the last 12-month period for which complete
data was received by the Center. A Surcharge Payor that administers health
payments for health care services on behalf of a client plan in exchange for an
administrative fee will be deemed to use the client plan's funds to pay for
health care services whether the Surcharge Payor pays providers with funds from
the client plan, with funds advanced by the Surcharge Payor subject to
reimbursement by the client plan, or with funds deposited with the Surcharge
Payor by the client plan.
Payments Subject to Assessment. Payments that are made
by Surcharge Payors to Hospitals and Ambulatory Surgical Centers pursuant to
M.G.L. c. 118E, § 68 are subject to assessment.
Calculation of the Surcharge
Payor Assessment Percentage. Using the best information available
as determined by the Center, the Center shall calculate each Qualifying
Surcharge Payor's assessment percentage by dividing an individual Surcharge
Payor's Payments Subject to Assessment during the last fiscal year for which
complete data was received by the Center by the total of all such payments by
all Qualifying Surcharge Payors.
. The assessment liability for each Qualifying Surcharge
Payor is the product of:
Payor Assessment Percentage as defined in 957 CMR 3.04
½ of Center Expenses.
(a) Each Qualifying
Surcharge Payor shall make a preliminary payment to the Center on October
1st of each year in an amount equal to ½ of
the Surcharge Payor's previous year's total assessment.
(b) Each Qualifying Surcharge Payor shall
pay, within 30 days' notice from the Center, the balance of its total
(c) The Center shall,
using the best information available as determined by the Center, adjust the
assessment to account for any variation in actual Center Expenses.
(d) All assessment payments must be payable
to the Commonwealth of Massachusetts in United States dollars and drawn on a
United States bank.