Purpose and Scope

The purpose of 956 CMR 13.00 is to implement a Risk Adjustment Program as described in 42 U.S.C. § 18063, pursuant to M.G.L. c. 176Q, § 3(v). Risk Adjustment is a permanent risk mitigation provision under the federal Patient Protection and Affordable Care Act. 956 CMR 13.00 applies to all Carriers that offer at least one Risk Adjustment Covered Plan in the Commonwealth.