Section 590-10-2 - AssessmentsA.Determination. Total annual assessments shall be based upon the total annual allocation authorized by the Maine State Legislature for the operational costs of the MHDO as indicated in the biennial budget. The amount to be assessed shall be reduced by the difference between the total annual authorized allocation for the next fiscal year and the beginning fund balance in the account established pursuant to Title 22 M.R.S.A. §8706, sub-§6 for the prior fiscal year. Any assessment reduction shall be applied proportionately to the categorical groups assessed and shall be based upon the maximum percentages of the total assessment as described in this section. Non-hospital health care facilities shall be assessed an aggregate amount that is 11.5% of the total annual authorized allocation and shall be individually assessed in the manner described in subsection B. Third-party administrators and carriers that provide only administrative services for a plan sponsor shall also be assessed an aggregate amount that is 11.5% of the total annual authorized allocation and shall be individually assessed in the manner described in subsection D. The remaining assessment balance shall be divided equally between hospitals and health insurance entities. The assessment share for hospitals and the assessment share for health insurance entities shall each not exceed 38.5% of the total annual authorized allocation. Individual hospitals and health insurance entities shall be assessed in the manner described in subsections C and E, respectively. Annual assessments shall be at least $100 for each individual entity required to pay an assessment under this Chapter.
B.Non-Hospital Health Care Facilities. The maximum assessment for each non-hospital health care facility by category is listed below. The specific dollar amount to be assessed for each non-hospital health care facility shall be established from the determination of the relative percentage reduction as described in subsection A. If an individual non-hospital health care facility is licensed or certified under multiple categories, only one assessment shall be imposed and it shall be the per facility assessment with the highest dollar amount. | Non-Hospital Health Care Facility Category Assessment | Maximum Per Facility |
| End-Stage Renal Disease | $2,500 |
| Federally Qualified Health Center | $150 |
| Freestanding Ambulatory Surgical Center | $2,500 |
| Independent Radiological Service Center | $2,500 |
| Home Health Agency | $150 |
| Mental Health Agency | $150 |
| Portable X-Ray Units | $150 |
| Rehabilitation Agencies | $150 |
| Retail Store Drug Outlets | $225 |
| Rural Health Clinic | $150 |
C.Hospitals. Hospitals shall be assessed by establishing the total net patient service revenue for each as a percentage of the total net patient service revenue for all. The individual total net patient service revenue numbers are to be established from the most recently completed fiscal year standardized accounting template for each hospital. The specific dollar amount to be assessed shall be determined by multiplying each percentage by the hospital assessment share as determined in subsection A.D.Third-Party Administrators and Carriers that Provide Administrative Services Only for a Plan Sponsor. Third-party administrators, carriers that provide administrative services only for a plan sponsor, and pharmacy benefits managers that process and pay claims shall be assessed by establishing the total dollar amount of health care claims processed or paid for each as a percentage of the total dollar amount of health care claims processed or paid for all. The total dollar amounts of health care claims processed or paid shall be derived from the most recent annual numbers for all covered individuals in the State compiled by the Maine Bureau of Insurance with direct verification from the third-party administrators and carriers that provide administrative services only for a plan sponsor and from the MHDO claims database. The specific dollar amount to be assessed shall be determined by multiplying each percentage by the third-party administrators, carriers that provide administrative services only for a plan sponsor, and pharmacy benefits managers that process and pay claims assessment share as determined in subsection A.E.Health Insurance Entities. Health insurance entities shall be assessed by establishing the total dollar amount of health care premiums written for each as a percentage of the total dollar amount of health care premiums written for all. The total dollar amounts of health care premiums written shall be derived from the most recent annual numbers compiled by the Maine Bureau of Insurance with direct verification from the health insurance entities. The specific dollar amount to be assessed shall be determined by multiplying each percentage by the health insurance entity assessment share as determined in subsection A.90-590 C.M.R. ch. 10, § 2