Definitions

As used in 101 CMR 514.00, unless the context requires otherwise, terms have the following meanings. Acute Hospital. A hospital licensed under M.G.L. c. 111, § 51 that contains a majority of medical-surgical, pediatric, obstetric, and maternity beds, as defined by the Department of Public Health. Assessed Charges. Gross patient service revenue attributable to all patients less gross patient service revenue attributable to programs administered pursuant to Titles XVIII, XIX, and XXI of the Social Security Act in each hospital’s fiscal year 2023. Assessment. The total payment due by each hospital each month or quarter, as set forth in 101 CMR 514.00. Center for Health Information and Analysis (CHIA). The Center for Health Information and Analysis established under M.G.L. c. 12C. Centers for Medicare & Medicaid Services (CMS). The federal agency under the U.S. Department of Health and Human Services that is responsible for administering the Medicare and Medicaid programs. Department of Public Health (DPH). An agency of the Commonwealth of Massachusetts, established under M.G.L. c. 17, § 1. Executive Office of Health and Human Services (EOHHS). The executive department of the Commonwealth of Massachusetts established under M.G.L. c. 6A, § 2 that, through the Department of Elder Affairs and other agencies within EOHHS, as appropriate, operates and administers the programs of medical assistance and medical benefits under M.G.L. c. 118E and that serves as the single state agency under section 1902(a)(5) of the Social Security Act. Fiscal Year (FY). The 12-month period that hospitals use for financial reporting and budgeting. Gross Patient Service Revenue. The total dollar amount of a hospital's charges for services rendered in a hospital’s fiscal year, as reported to the Center for Health Information and Analysis (CHIA) through Hospital Cost Reports for 2023. Health Safety Net. The payment program established and administered in accordance with M.G.L. c. 118E, § 8A, and §§ 64 through 69 and regulations promulgated thereunder, and other applicable legislation. Health Safety Net Office. The office within the Office of Medicaid established under M.G.L. c. 118E, § 65. Health Safety Net Trust Fund. The fund established under M.G.L. c. 118E, § 66. Hospital Cost Report. The Massachusetts Hospital Statement of Costs, Revenues, and Statistics required to be reported to CHIA pursuant to 957 CMR 9.00: Hospital Financial Data Reporting Requirements. Licensee. Any natural person, corporation, partnership, trust, estate, or other legal entity holding a license to operate a nonpublic acute or non-acute hospital in Massachusetts; and, in the case of a licensee that is not a natural person, includes (1) any shareholder owning not less than 5%, any officer, and any director of any corporate licensee; (2) any limited partner owning not less than 5% and any general partner of a partnership licensee; (3) any trustee of any trust licensee; (4) any sole proprietor of any licensee that is a sole proprietorship; or (5) any mortgagee in possession and any executor or administrator of any licensee that is an estate. MassHealth Program (MassHealth). The medical assistance benefits plans operated and administered by EOHHS pursuant to M.G.L. c. 118E, § 1 et seq. and 42 U.S.C. § 1396 et seq., Title XXI of the Social Security Act (42 U.S.C. 1397), and other applicable laws and waivers to provide and pay for medical services to eligible members (Medicaid). Medicare. The federal health insurance program for people who are 65 years of age or older, certain younger people with disabilities, and people with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD) established by Title XVIII of the Social Security Act. Non-public Gross Patient Service Revenue. Total gross patient service revenues (as defined in Gross Patient Service Revenue) minus gross patient service revenues attributable to Medicare, Medicaid, and Out-of-state Medicaid, as determined by EOHHS. Non-acute Hospital. A nonpublic hospital that is (1) licensed by the Department of Public Health under M.G.L. c. 111, § 51 but not defined as an acute-care hospital under M.G.L. c. 111, § 25B; or (2) licensed as an inpatient facility by the Department of Mental Health (DMH) under M.G.L. c. 19, § 19 and regulations promulgated thereunder, but not categorized as Class VII licensees under the regulations. Rate Year (RY). The 12 months from October 1st through September 30th. Total Assessment Amount. A fixed amount equal to $1,534,050,000, plus 50% of the estimated cost, as determined by the Secretary of Administration and Finance, of administering the Health Safety Net and related assessments in accordance with M.G.L. c. 118E, §§ 65 to 69.