Section 118E:67 - [Effective Until 10/1/2027] Acute hospital's liability to fund(a) Subject to all required federal approvals, including any required waivers under 42 CFR 433.68, a hospital's annual liability to the fund shall be calculated in accordance with this section. The annual aggregate liability of all hospitals to the fund shall equal the total hospital assessment amount.(c) The office shall promulgate regulations establishing an appropriate mechanism for enforcing each hospital's liability to the fund if a hospital does not make a scheduled payment to the fund.(d) For the purposes of the assessment in this section, all hospitals in the commonwealth shall be divided into the following groups, as determined by the secretary: (i) large group 1 safety net hospitals which, for the purposes of this section, shall mean, any group 1 safety net hospital that had not less than 355 staffed beds in fiscal year 2022, as reported by the center for health information and analysis; (ii) small group 1 safety net hospitals which, for the purposes of this section, shall mean any group 1 safety net hospital that had less than 355 staffed beds in fiscal year 2022 as reported by the center for health information and analysis; (iii) large group 2 safety net hospitals which, for the purposes of this section, shall mean any group 2 safety net hospital that had not less than 355 staffed beds in fiscal year 2022 as reported by the center for health information and analysis; (iv) small group 2 safety net hospitals which, for the purposes of this section, shall mean any group 2 safety net hospital that had less than 355 staffed beds in fiscal year 2022 as reported by the center for health information and analysis; (v) freestanding pediatric acute hospitals; (vi) academic, teaching and specialty hospitals which, for the purposes of this section, shall mean an academic medical center, teaching hospital or specialty hospital as determined by the center for health information and analysis as of September 30, 2019, but excluding any high public payer hospital; (vii) private acute hospitals which, for the purposes of this section, shall mean a private hospital licensed under section 51 of chapter 111 that contains a majority of medical-surgical, pediatric, obstetric and maternity beds as defined by the department of public health and operating as of September 30, 2019, but excluding any safety net hospital or academic, teaching and specialty hospital; (viii) non-state public hospitals which, for the purposes of this section, shall mean any non-state-owned public hospital in the commonwealth as determined by the secretary; and (ix) non-acute hospitals which, for the purposes of this section shall mean any nonpublic hospital licensed by the department of public health under said section 51 of said chapter 111; provided, however, that non-acute hospital shall not include an acute care hospital under section 25B of said chapter 111 or a nonpublic hospital licensed as an inpatient facility by the department of mental health under section 19 of chapter 19 and regulations promulgated thereunder but not categorized as a class VII licensee under the regulations.(e) Each of the groups described in subsection (d) shall be subject to the following assessment rates: (i) large group 1 safety net hospitals shall be subject to a rate of 24.000 per cent for inpatient services and 5.950 per cent for outpatient services; (ii) small group 1 safety net hospitals shall be subject to a rate of 14.500 per cent for inpatient services and 5.500 per cent for outpatient services; (iii) large group 2 safety net hospitals shall be subject to a rate of 18.000 per cent for inpatient services and 18.200 per cent for outpatient services; (iv) small group 2 safety net hospitals shall be subject to a rate of 18.000 per cent for inpatient services and 10.200 per cent for outpatient services; (v) freestanding pediatric acute hospitals shall be subject to a rate of 4.800 per cent for inpatient services and 4.250 per cent for outpatient services; (vi) academic, teaching and specialty hospitals shall be subject to a rate of 4.701 per cent for inpatient services and 1.065 per cent for outpatient services; (vii) private acute hospitals shall be subject to a rate of 8.500 per cent for inpatient services and 1.045 per cent for outpatient services; (viii) non-state public hospitals shall be subject to a rate of 1.615 per cent for inpatient services and 1.500 per cent for outpatient services; and (ix) non-acute hospitals shall be subject to a rate of 3.300 per cent for inpatient services and 3.300 per cent for outpatient services; provided, however, that the office shall increase each such rate by the amount necessary to generate 50 per cent of the estimated cost as determined by the secretary of administration and finance, of administering the health safety net and related assessments in accordance with sections 65 to 69, inclusive. If hospital closures or hospital changes in status to a different type of provider would result in a reduction of total hospital assessment amount, the secretary may, by regulation, adjust the assessment rates to ensure the total hospital assessment amount is not reduced by more than $10,000,000 on an annual basis; provided, however, that any such adjustments to the rates shall ensure the rates remain in the same proportion to each other as established herein.(f) The assessment rates described in subsection (e) shall be applied to each hospital's fiscal year 2019 assessed charges for inpatient and outpatient services as determined by the secretary of health and human services; provided, however, that the term "assessed charges" shall have the meaning ascribed to it in section 64. The total of the resulting products shall equal a hospital's annual assessment liability.(g) Subject to receipt of all required federal approvals, the executive office shall implement the assessment structure described in this section and shall promulgate regulations, in consultation with the Massachusetts Health and Hospital Association, Inc., necessary to support implementation of said assessment structure. In promulgating such regulations, and in consultation with the Massachusetts Health and Hospital Association, Inc., the executive office shall, at a minimum: (i) specify an appropriate mechanism for determination and payment of an acute hospital's liability to the fund; (ii) identify the hospitals that belong to each group identified in subsection (d); (iii) specify an appropriate mechanism for the determination of a hospital's liability in cases of merger or transfer of ownership; and (iv) specify an appropriate mechanism by which any amounts paid by a hospital in excess of a hospital's total annual assessment liability may be refunded or otherwise credited to the hospital. (h) The secretary of health and human services may enforce the payment of required assessments under this section: (i) for hospitals licensed by the department of health, by notifying the department of the unpaid assessments and such information shall be considered by the department in determining suitability in accordance with section 51 of chapter 111 for the hospital or its affiliate provider entities; (ii) by offsetting payments from the office of Medicaid against the claims for payment by the delinquent hospital, against other hospitals or MassHealth-contracted entities under common ownership as the delinquent hospital or against any successor in interest to the hospital or such provider entities under common ownership, in the amount of the delinquent fees owed, including any interest, penalties and reasonable attorneys' fees, and by transferring such funds into the fund; or (iii) creating, after demand for payment, a lien in favor of the commonwealth in an amount not to exceed the delinquent fees owed, including any interest, penalties and reasonable attorneys' fees, encumbering the building in which the delinquent hospital is located, encumbering the real property upon which the delinquent hospital is located, including fixtures, equipment or goods used in the operation of the delinquent hospital, or encumbering any real property in which the delinquent hospital holds an interest.Mass. Gen. Laws ch. 118E, § 118E:67
Amended by Acts 2024, c. 140,§ 129, eff. the later of (i) one full calendar month following the calendar month in which the secretary receives all federal approvals deemed necessary to implement said sections; or (ii) October 1, 2024.Amended by Acts 2022 , c. 126, § 62, eff. 10/1/2022.Amended by Acts 2017 , c. 47, § 55, eff. 10/1/2017.Added by Acts 2012 , c. 224, § 131, eff. 11/4/2012.This section is set out more than once due to postponed, multiple, or conflicting amendments.