Reporting Requirements

(1) General. Each provider must file with or make available to the Health Safety Net office or to an entity designated by the Health Safety Net office to collect data, as applicable, information that is required or that the Health Safety Net office deems reasonably necessary for implementation of 101 CMR 614.00. (a) The Health Safety Net office may revise the data specifications, the data collection scheduled, or other administrative requirements by administrative bulletin. (b) The Health Safety Net office or its designee may audit data submitted under 101 CMR 614.00 to ensure accuracy. The Health Safety Net office may adjust payments to reflect audit findings. Providers must maintain records sufficient to document compliance with all documentation requirements of 101 CMR 613.00: Health Safety Net Eligible Services and 101 CMR 614.08. (2) Acute Hospitals. (a) The Health Safety Net office may require acute hospitals to submit interim data on revenues and costs to the Health Safety Net or to an entity designated by the Health Safety Net office to collect data to monitor compliance with federal upper limit, cost limit, and disproportionate share payment limits. Such data may include, but not be limited to, gross and net patient service revenue for Medicaid non- managed care, Medicaid managed care, the Premium Assistance Payment Program operated by the Health Connector, and all payers combined; and total patient service expenses for all payers combined. (101 CMR 614.08(2)(b) Reserved) (c) Penalties. The Health Safety Net office may deny payment for eligible services to any acute hospital that fails to comply with the reporting requirements of 101 CMR 613.00: Health Safety Net Eligible Services or 101 CMR 614.08 until such acute hospital complies with the requirements. The Health Safety Net office will notify such acute hospital in advance of its intention to withhold payment. (3) Community Health Centers. The Health Safety Net office may deny payment for eligible services to any community health center that fails to comply with the reporting requirements of 101 CMR 613.00: Health Safety Net Eligible Services or 101 CMR 614.08 until such community health center complies with the requirements. The Health Safety Net office will notify such community health center in advance of its intention to withhold payment. (101 CMR 614.08(4) and (5) Reserved)