Current through Supplement No. 394, October, 2024
1.
Insolvency deposit.
a. At the time of application, an
organization shall deposit one hundred thousand dollars in cash or securities,
or any combination thereof, into an account in a manner that is acceptable to
the department.
b. The deposit
must be restricted to use in the event of insolvency to help assure
continuation of services or pay costs associated with receivership or
liquidation.
c. At the time of the
provider-sponsored organization's application for a certification of authority,
and, thereafter, upon the department's request, a provider-sponsored
organization shall provide the department with proof of the insolvency deposit,
such proof to be in a form that the department considers appropriate.
2.
Uncovered
expenditures deposit.
a. If at any
time uncovered expenditures exceed ten percent of a provider-sponsored
organization's total health care expenditures, then the provider-sponsored
organization must place an uncovered expenditures deposit into an account with
any organization or trustee that is acceptable to the department.
b. The deposit must at all times have fair
market value of an amount that is one hundred twenty percent of the
provider-sponsored organization's outstanding liability for uncovered
expenditures for enrollees, including incurred, but not reported, claims.
c. The deposit must be calculated
as of the first day of each month required and maintained for the remainder of
each month required.
d. If a
provider-sponsored organization is not otherwise required to file a quarterly
report, it must file a report within forty-five days of the end of the calendar
quarter with information sufficient to demonstrate compliance with this
section.
e. The deposit required
under this section is restricted and in trust for the department's use to
protect the interests of the provider-sponsored organization's medicare
enrollees and to pay the costs associated with administering the insolvency. It
may be used only as provided under this section.
3.
Deposit as asset. A
provider-sponsored organization may use the deposits required under subsections
1 and 2 to satisfy the provider-sponsored organization's minimum net worth
amount required under section
45-06-13-04.
4.
Income. All income from the
deposits or trust accounts required under subsections 1 and 2 is considered
assets of the provider-sponsored organization. Upon the department's approval,
the income from the deposits may be withdrawn.
5.
Withdrawal. On prior written
approval from the department, a provider-sponsored organization that has made a
deposit under subsection 1 or 2may withdraw that deposit or any part thereof
if:
a. A substitute deposit of cash or
securities of equal amount and value is made;
b. The fair market value exceeds the amount
of the required deposit; or
c. The
required deposit under subsection 1 or 2 is reduced or eliminated.
General Authority: NDCC 26.1-01-07.6
Law Implemented: NDCC
26.1-01-07.6
