Code of Massachusetts Regulations
958 CMR - HEALTH POLICY COMMISSION
Title 958 CMR 2.00 - One-time Assessment On Certain Qualifying Hospitals And Qualifying Surcharge Payors
Section 2.02 - Definitions

Meaning of Terms: As used in 958 CMR 2.00, unless the context otherwise requires, terms have the following meanings. All defined terms in 958 CMR 2.00 are capitalized.

Acute Hospital. The teaching hospital of the University of Massachusetts Medical School and any hospital licensed under M.GL. c. 111, § 51 and which contains a majority of medical-surgical, pediatric, obstetric and maternity beds, as defined by the department of public health.

Acute Hospital System. A group of affiliated entities that includes one or more Acute Hospitals that are overseen by a common entity or parent corporation.

Commission. The Health Policy Commission established under M.G.L. c. 6D.

Commonwealth Care Program. An insurance program for low-income individuals administered by the Commonwealth Health Insurance Connector pursuant to M.G.L. c. 118H.

Executive Office. The Executive Office of Health and Human Services established under M.GL. c. 6A

Fiscal Year (FY). The time period of 12 months beginning on October 1s t of any calendar year and ending on September 30th of the following calendar year.

Health Care Services. Supplies, care and services of medical, behavioral health, substance use disorder, mental health, surgical, optometric, dental, podiatric, chiropractic, psychiatric, therapeutic, diagnostic, preventative, rehabilitative, supportive or geriatric nature including, but not limited to, inpatient and outpatient acute hospital care and services; services provided by a community health center home health and hospice care provider, or by a sanatorium, as included in the definition of "hospital" in Title XVIII of the federal Social Security Act, and treatment and care compatible with such services or by a health maintenance organization.

Hospital. A hospital licensed under M.G.L. c. 111, § 51, the teaching hospital of the University of Massachusetts Medical School and any psychiatric facility licensed under M.GL. c. 19, § 19.

Hospital Services. Services listed on an Acute Hospital's license by the Department of Public Health. This does not include services provided in transitional care units; services provided in skilled nursing facilities; and home health services, or separately licensed services, including residential treatment programs and ambulance services.

MassHealth. The medical assistance program administered by the Executive Office of Health and Human Services Office of Medicaid pursuant to M.G.L. c. 118E and in accordance with Titles XIX and XXI of the Federal Social Security Act, and a § 1115 Demonstration Waiver.

Qualifying Hospital. An Acute Hospital that, as of fiscal year 2010, meets one of the following criteria as determined by the Commission using the best data available:

(a) has more than $1,000,000,000 in total net assets and receives less than 50% revenues from public payers; or

(b) is a member of an Acute Hospital System that has more than $1,000,000,000 in total net assets and receives less than 50% revenues from public payers.

Qualifying Surcharge Payor. A Surcharge Payor which, as determined by the Commission using the best data available, made payments to the Health Safety Net during fiscal year 2012 for the purchase of at least $1,000,000 in Hospital Services.

Payment. A check, draft or other paper instrument, an electronic fund transfer, or any order, instruction, or authorization to a financial institution to debit one account and credit another.

Surcharge Payor. An individual or entity that pays for or arranges for the purchase of health care services provided by acute hospitals and ambulatory surgical center services provided by ambulatory surgical centers, including a managed care organization. The term "Surcharge Payor" shall not include Title XVIII and Title XIX programs and their beneficiaries or recipients, other governmental programs of public assistance and their beneficiaries or recipients and the workers' compensation program established under M.G.L. c. 152.