Hospital Groups

(1) Hospital Assessment Liability. Hospital assessment liability will vary by hospital group and by inpatient versus outpatient revenues. The nine groups of hospitals for purposes of 101 CMR 514.00 are defined as follows. (a) Group I: Any acute hospital that had not less than 355 staffed beds in fiscal year 2022 as reported by CHIA and that is identified as a group 1 safety net hospital in the MassHealth demonstration waiver approved under subsection (a) of section 1115 of Title XI of the federal Social Security Act and in effect as of October 1, 2022. (b) Group II: Any acute hospital that that had less than 355 staffed beds in fiscal year 2022 as reported by CHIA and that is identified as a group 1 safety net hospital in the MassHealth demonstration waiver approved under subsection (a) of section 1115 of Title XI of the federal Social Security Act and in effect as of October 1, 2022. (c) Group III: Any acute hospital that had not less than 355 staffed beds in fiscal year 2022 as reported by CHIA and that is identified as a group 2 safety net hospital in the MassHealth demonstration waiver approved under subsection (a) of section 1115 of Title XI of the federal Social Security Act and in effect as of October 1, 2022. (d) Group IV: Any acute hospital that had less than 355 staffed beds in fiscal year 2022 as reported by CHIA and that is identified as a group 2 safety net hospital in the MassHealth demonstration waiver approved under subsection (a) of section 1115 of Title XI of the federal Social Security Act and in effect as of October 1, 2022. (e) Group V: Any acute hospital that is a freestanding pediatric hospital. (f) Group VI: Any acute hospital that is an academic medical center, teaching hospital, or specialty hospital, as determined by CHIA as of September 30, 2019, but excluding any high public payer hospital as defined by CHIA or any hospital included in Group V. (g) Group VII: Any private acute hospital operating as of September 30, 2019, but excluding any hospital included in Groups I through VI. (h) Group VIII: The Commonwealth’s only non-state-owned public hospital, operating as of September 30, 2019. (i) Group IX: Any nonpublic non-acute hospital operating as of September 30, 2019. (2) Consistent Application of Assessment. Hospitals will remain in the group they are in as of October 1, 2024, and will be subject to the same assessment rate established for their group, except as follows. (a) New Acute Hospitals. New acute hospitals that come into operation subsequent to October 1, 2022, or for whom there is no FY 2019 hospital-specific gross patient service revenue data (as reported by CHIA based on the annual collection of cost report data), or acute hospitals otherwise not included in the approved waiver application, will be considered Group VI hospitals, under 101 CMR 514.03(1), until EOHHS determines the hospital’s group eligibility. (b) New Non-acute Hospitals. New non-acute hospitals that come into operation subsequent to October 1, 2022, or for whom there is no FY 2019 hospital-specific gross patient service revenue data (as reported by CHIA based on the annual collection of cost report data), or non- acute hospitals otherwise not included in the approved waiver application, will be considered Group IX hospitals, under 101 CMR 514.03(1), until EOHHS determines the hospital’s group eligibility. (c) Hospital Closures. If a hospital subject to the assessment closes, with no successor in interest or assignee as determined by EOHHS consistent with the criteria described in 101 CMR 514.03(2)(d), the former hospital will no longer be subject to the assessment, provided that the hospital is subject to the assessment up to and included its date of closure. No changes will be made to the assessment rates for remaining assessed hospitals as a result of a hospital’s closure when there is no successor in interest or assignee. (d) Mergers and Acquisitions. The original assessment obligation of any hospital is applied to and becomes an obligation of any successor in interest or assignee of such hospital, as determined by EOHHS. A successor in interest may include, but is not limited to, any purchaser of the assets or stock, any new licensee of an existing acute or non-acute hospital, any surviving entity resulting from merger or liquidation, or any receiver or any trustee of the original hospital. The assessment obligation of the successor in interest or assignee with respect to the acquired or merged hospital(s) will be equal to the assessment obligation of the affected hospitals prior to the merger or acquisition. The assessment will be applied to hospitals that merge, or hospitals that acquire another or are acquired, as if no such merger or acquisition occurred. (e) Multi-factorial Changes. The assessment obligation will follow the rules established in 101 CMR 514.03(2)(a) through (d), provided that: 1. In the event an existing hospital has merged with or acquired only a portion of another existing hospital and the two hospitals both continue to exist as hospitals after the merger or acquisition, the original assessment obligations of the two hospitals will be applied proportionally to each hospital based on the gross patient service revenue attributable to each portion of each hospital after the merger or acquisition. 2. In the event that a new hospital opens and also acquires a portion or all of an existing hospital, and the portion of the hospital that is new accounts for greater than 50% of the gross patient service revenue of the total hospital entity, the hospital’s assessment obligation will be determined in accordance with 101 CMR 514.03(2)(a) or (b), as applicable depending on the hospital’s status as an acute or non-acute hospital. 3. In the event that a new hospital opens and also acquires a portion or all of an existing hospital, and the portion of the hospital that is new accounts for 50% or less of the gross patient service revenue of the total hospital entity, the hospital’s assessment obligation will be equal to the portion of the assessment attributable to the acquired portion of the hospital.