801 Mass. Reg. 56.14

Current through Register 1524, June 21, 2024
Section 56.14 - Actions to Ensure Repayment of Funds to the Commonwealth
(1) When a borrower fails to reimburse the Commonwealth for any transfers made by the Commonwealth to the Agency to replenish the Community Hospital and Community Health Center Capital Reserve Fund under 801 CMR 56.12 within six months after any such transfer and as otherwise provided under the terms of the approval under 801 CMR 56.11 pursuant to the intercept agreement, the A&F Secretary may, in the A&F Secretary's sole discretion, direct the Comptroller to withhold any funds in the Comptroller's custody that are due or payable to the borrower to cover all or a portion of the amount the borrower has failed to pay to the Commonwealth to reimburse the Commonwealth for any such transfers.
(2) To the extent permitted by federal law, in contracts between the Group Insurance Commission and a third party for the purposes of providing health care insurance or health care services paid for by the Commonwealth, the Group Insurance Commission shall make a good faith effort to secure an obligation on the part of the third party to provide that, at the direction of the A&F Secretary, the third party shall withhold payments to a borrower that fails to reimburse the Commonwealth under the terms of the approval granted under 801 CMR 56.11 and shall transfer the withheld amount to the Commonwealth pursuant to the intercept agreement. Any such withheld and transferred amounts shall be considered to have been paid to the borrower for all other purposes of law, and the borrower shall be considered to have reimbursed the Commonwealth in an amount equal to such withheld and transferred funds for purposes of the approval granted under 801 CMR 56.11.
(3) To the extent permitted by federal law, MassHealth and the Commonwealth Health Insurance Connector Authority shall make a good faith effort to secure an obligation on the part of its contracted managed care entities to provide that, at the direction of the A&F Secretary, they will withhold payments to a contracted provider who is also a borrower that fails to reimburse the Commonwealth under the terms of the approval granted under 801 CMR 56.11 and shall transfer the withheld amount to the Commonwealth pursuant to the intercept agreement. Any such withheld and transferred amounts shall be considered to have been paid to the borrower for all other purposes of law, and the borrower shall be considered to have reimbursed the Commonwealth in an amount equal to such withheld and transferred funds for purposes of the approval granted under 801 CMR 56.11.
(4) In addition, to the extent permitted by federal law, at the direction of the A&F Secretary, MassHealth shall withhold payments to a MassHealth contracted provider who is also a borrower that fails to reimburse the Commonwealth under the terms of the approval granted under 801 CMR 56.11 and shall transfer the withheld amount to the Commonwealth pursuant to the intercept agreement. Any such withheld and transferred amounts shall be considered to have been paid to the borrower for all other purposes of law, and the borrower shall be considered to have reimbursed the Commonwealth in an amount equal to such withheld and transferred funds for purposes of the approval granted under 801 CMR 56.11.
(5) In the event that funds are withheld from a borrower pursuant to 801 CMR 56.14(5) and the intercept agreement, the borrower shall deem the withheld amounts to have been paid in full, and shall not seek to recover withheld funds from insured individuals, health plans, MassHealth, the Commonwealth or any other entity insured through the Group Insurance Commission or the Commonwealth Health Insurance Connector Authority.

801 CMR 56.14

Adopted by Mass Register Issue 1263, eff. 6/20/2014.