Section 155.06 - Actuarial CertificationsA Risk-bearing Provider Organization shall provide the following Actuarial Certification in a form acceptable to the Commissioner:
(a) For a Provider Organization that is seeking to enter into an arrangement to manage the treatment of a group of patients and bears Downside Risk according to the terms of an Alternative Payment Contract, certification by an actuary that the prospective terms within the contract or in anticipation of the contract are such that the contract is not expected to threaten the financial solvency of the Provider Organization or any entity with which it has a Contracting Affiliation that involves Downside Risk or any entity with which it has a Contracting Affiliation that involves Downside Risk; or(b) For a Risk-bearing Provider Organization that already has entered into an arrangement to manage the treatment of a group of patients and bears Downside Risk according to the terms of an Alternative Payment Contract, certification by an actuary that the terms of the contract are not expected to threaten the financial solvency of the Risk-bearing Provider Organization during the period that the Risk Certificate is in effect.Adopted by Mass Register Issue 1268, eff. 8/29/2014.Amended by Mass Register Issue 1323, eff. 10/7/2016.