Initiation of a Cost and Market Impact Review; Notice

(1) If the Commission determines that the performance of a Provider Organization identified by the Center under M.G.L. c. 12C, § 18 has significantly impacted or is likely to significantly impact the state's ability to meet the health care cost growth benchmark established under M.G.L. c. 6D, § 9 or market functioning, the Commission may conduct a Cost and Market Impact Review of that Provider Organization when total health care expenditures exceed the health care cost growth benchmark established under M.G.L. c. 6D, § 9 in the calendar year for which the Provider Organization was identified by the Center. (2) To make the determination described in 958 CMR 10.16(1), the Commission may request additional information from the Provider Organization identified by the Center under M.G.L. c. 12C, § 18. Prior to any Board vote to determine whether to initiate a Cost and Market Impact Review pursuant to 958 CMR 10.16(1), the Commission shall provide written notice to the Provider Organization, an opportunity to review information used by the Commission relative to 958 CMR 10.16(1), and an opportunity to meet with the Executive Director. (3) The Commission shall determine whether to initiate a Cost and Market Impact Review by vote of the Board. (4) The Commission shall provide written notice to any Provider Organization for which it will conduct a Cost and Market Impact Review under 958 CMR 10.16(1).