Section 64 Managed Care Organization Services Assessment 7

Said section 64 of said chapter 118E, as so amended, is hereby further amended by striking out the definitions "Managed care organization" and "Payments subject to surcharge" and inserting in place thereof the following 6 definitions:-
"HSN MCO revenues amount", an amount equal to $160,000,000 plus 50 per cent 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 sections 65 to 69, inclusive.
"Immunization revenues amount", the estimated costs to purchase, store and distribute vaccines for routine childhood immunizations and to administer the Vaccine Purchase Trust Fund, established in section 24N of chapter 111, and the computerized immunization registry, established in section 24M of chapter 111, taking into consideration the limitations on expenditures described in subsection (b) of said section 24N of said chapter 111, as well as any anticipated surplus or deficit in said Vaccine Purchase Trust fund, but excluding any costs anticipated to be covered by federal contribution.
"MCO services subject to assessment", each individual member enrolled per month in an MCO for which a premium or membership payment is made by or on behalf of the member; provided however that MCO services subject to assessment shall not include (i) members enrolled per month in Medicare MCOs, (ii) members dually enrolled per month in both Medicaid and Medicare, (iii) members in a Medicaid MCO who are aged 65 or older, (iv) members enrolled per month in limited benefit plans (for example dental only or vision only member months), whose services are paid for as part of a subcontract under another MCO, or (v) services which are preempted from taxation by section 8909(f) of title 5 of the United States Code.
"Managed care organization" or "MCO", any of the following entities, as further defined by the secretary via regulation promulgated by the secretary: (A) an entity that is accredited under chapter 176O and that is (1) licensed or otherwise authorized to transact accident or health insurance under chapter 175, (2) a nonprofit hospital service corporation organized under chapter 176A, (3) a nonprofit medical service corporation organized under chapter 176B, (4) a health maintenance organization organized under chapter 176G, or (5) an organization entering into a preferred provider arrangement under chapter 176I; (B) a Medicaid managed care organization; (C) a health care organization, as such term is defined under section 2 of chapter 32A; (D) a self-insured group for which a carrier provides administrative services under section 21 of chapter 176O; and (E) a health insurance plan that contracts with the commonwealth health insurance connector authority.
"MCO reinvestment revenues amount", a fixed amount equal to $246,000,000.
''Medicaid managed care organization'' or "Medicaid MCO", a managed care organization, as defined in 42 CFR 438.2, that contracts with MassHealth pursuant to an approved state plan or federal waiver.

This section, along with other related sections, creates a unified assessment mechanism for all managed care organization assessments.