957 CMR 3.04 - Surcharge Payor Assessment

Current through Register 1466, April 1, 2022

(1) General. The Center shall establish an assessment on all Surcharge Payors.
(2) 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.
(3) 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.
(4) 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.
(5) Surcharge Payor Liability. The assessment liability for each Qualifying Surcharge Payor is the product of:
(a) the Surcharge Payor Assessment Percentage as defined in 957 CMR 3.04(4); and
(b) ½ of Center Expenses.
(6) Payment Process.
(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 assessment.
(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.

Notes

957 CMR 3.04
Amended by Mass Register Issue 1368, eff. 6/29/2018.

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