Acute Hospital Assessment

(1) General. The Commission shall establish a one-time surcharge assessment on all Qualifying Hospitals. The surcharge amount to be paid to the Commission by each Qualifying Hospital is the product of: (a) $60,000,000; and (b) the hospital surcharge percentage as defined in 958 CMR 2.03(2). (2) Calculation of the Hospital Surcharge Percentage. The Commission shall establish the hospital surcharge percentage, using the best data available as determined by the Commission, by dividing the operating surplus in fiscal year 2010 by the total operating surplus in fiscal year 2010 of all Qualifying Hospitals. (3) Payment Process. (a) Notification. The Commission shall notify all Qualifying Hospitals of its total surcharge amount by April 1, 2013. The notification shall be in writing and shall inform the hospital of its payment options as defined by 958 CMR 2.03(3)(b) and the option to apply for a waiver or mitigation pursuant to 958 CMR 2.03(4) and (5). (b) Payment Option. A Qualifying Hospital shall pay the full amount of the surcharge amount to the Commission in the following manner: 1. A single payment to be made no later than June 30, 2013; or 2. In four equal annual installments to be paid on or before June 30th of each year beginning on June 30, 2013. (c) All surcharge payments must be payable in United States dollars and drawn on a United States bank. The Commission will assess a $30 penalty on any Qualifying Hospital whose check is returned for insufficient funds. 2.03: continued (4) Hospital Waiver. A Qualifying Hospital may apply to the Commission for a waiver of its total surcharge amount. In order to be considered for such relief, the Qualifying Hospital must demonstrate to the satisfaction of the Commission that it, or the Acute Hospital System for which the Qualifying Hospital is a member, lacks access to the resources to pay the surcharge amount using the factors set for the in 958 CMR 2.03(4)(b). (a) Waiver Application. A Qualifying Hospital shall file its application for a waiver with the Commission within 21 calendar days of the date of the notice from the Commission pursuant to 958 CMR 2.03(3)(a). Applications received after 21 calendar days of the date of the notice from the Commission pursuant to 958 CMR 2.03(3)(a) shall not be accepted by the Commission. (b) Waiver Application Determination. The Commission shall take the following factors into account when determining whether to approve or disapprove a waiver application submitted by a Qualifying Hospital: 1. Cash and investments on hand; 2. Total cash and investments; 3. Total revenues; 4. Total reserves; 5. Total profits, margins or surplus; 6. Earnings before interest; 7. Depreciation and amortization; 8. Administrative expense ratio; and 9. The compensation of executive managers and board managers. (c) Supplemental Information. A Qualifying Hospital shall file or make available any information that the Commission deems reasonably necessary for evaluation of a waiver application. (5) Hospital Mitigation. (a) Qualifying Hospital may apply to the Commission for mitigation of up to 66% of its total surcharge amount. In order to be considered for such relief, the Qualifying Hospital must first demonstrate to the satisfaction of the Commission that it meets one of the following criteria: 1. Receives more than 25% of its reimbursements from Title XIX of the Social Security Act; 2. Is a member of an Acute Hospital System that receives more than 25% of its reimbursements from Title XIX of the Social Security Act; 3. Has less than $1,250,000,000 in net assets; or, 4. Is a member of an Acute Hospital System that has less than $1,250,000,000 in net assets. (b) Mitigation Application. A Qualifying Hospital shall file its application for partial mitigation with the Commission within 21 calendar days of the date of the notice from the Commission pursuant to 958 CMR 2.03(3)(a). Applications shall demonstrate that the Qualifying Hospital meets one or more of the mitigation criteria set forth in 958 CMR 2.03(5). Applications received after 21 calendar days of the date of the notice from the Commission pursuant to 958 CMR 2.03(3)(a) shall not be accepted by the Commission. (c) Mitigation Application Determination. The Commission shall make a determination on a mitigation application. (d) Supplemental Information. A Qualifying Hospital shall file or make available any information that the Commission deems reasonably necessary for evaluation of a mitigation application.