Notice of Identification by the Center for Health Information and Analysis

(1) The Commission shall provide written notice to each CHIA-identified Entity. Such notice shall state, at a minimum: (a) That the Commission has received notice from CHIA identifying the Health Care Entity under M.G.L. c. 12C, § 18 as an entity whose increase in health status adjusted total medical expense is considered excessive and who threatens the ability of the state to meet the health care cost growth benchmark established under M.G.L. c. 6D, § 9; (b) The data relied upon by CHIA to identify the Health Care Entity under M.G.L. c. 12C, § 18; (c) hat the Commission may require a Performance Improvement Plan if, after a review of the factors described in 958 CMR 10.04(2), the Commission identifies significant concerns about the CHIA-identified Entity's costs and determines that a Performance Improvement Plan could result in meaningful, cost-saving reforms; and (d) If the CHIA-identified Entity is a Provider Organization, that when total health care expenditures exceed the health care cost growth benchmark established under M.G.L. c. 6D, § 9 in the previous calendar year, the Commission may conduct a Cost and Market Impact Review of the CHIA-identified Entity if the Commission determines that its performance has significantly impacted or is likely to significantly impact market functioning or the state's ability to meet the benchmark established under M.G.L. c. 6D, § 9. (2) Such notice may also include requests for additional information from the CHIA-identified Entity or may state that the Commission may request additional information from the CHIA-identified Entity as part of its reviews under 958 CMR 10.04 or 10.16.