Performance Improvement Plan Approval

(1) The Commission shall approve a proposed Performance Improvement Plan by vote of the Board if it determines that the proposed Performance Improvement Plan meets the criteria described in 958 CMR 10.09(2), is reasonably likely to successfully address the underlying cause(s) of the PIP Entity's cost growth, and has a reasonable expectation that the PIP Entity will be capable of successfully implementing the proposed Performance Improvement Plan. (2) Examples of factors the Commission may consider in determining whether to approve a Performance Improvement Plan include: (a) Whether the proposed Performance Improvement Plan proposes a strategy or activity that has a reasonable economic, business, or medical rationale with a sufficient evidence base; (b) The scope and likelihood of potential savings and the potential impact on the Commonwealth's ability to meet the health care cost growth benchmark established under M.G.L. c. 6D, § 9; (c) Whether savings and efficiencies associated with the proposed Performance Improvement Plan are likely to continue after the implementation of the Performance Improvement Plan; (d) The extent to which a proposed Performance Improvement Plan carries a risk of negative consequences that would be inconsistent with other policy goals of the Commonwealth (e.g., negative impacts on the quality of care or access to needed services); and (e) Any other factors the Commission determines to be in the public interest. (3) The Commission shall consult with other state agencies in the event that a regulatory review by or filing with another state agency would be necessary to implement components of the proposed Performance Improvement Plan. If the proposed Performance Improvement Plan is determined to be acceptable and complete, the Commission shall notify the PIP Entity of such determination and may specify reporting requirements and any assistance to be provided by the Commission. If the proposed Performance Improvement Plan is determined to be unacceptable or incomplete, the Commission shall notify the PIP Entity of such determination and shall provide additional time, up to 30 days, for resubmission. The Commission shall encourage the PIP Entity to consult with the Commission on criteria that have not been met.