Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 514.00 - Rates For Family Stabilization Services › Section 514.02 - Definitions

Current through Register 1525, July 5, 2024
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 2019.
Assessment
. The total payment due by
				each hospital each month or quarter, as set forth in
				101 CMR
				514.00.
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 in 2019.
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 five
			 percent, any officer, and any director of any corporate licensee;
(2) any limited partner owning not less than
			 five percent 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 $880,000,000, 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.