ADMINISTRATIVE BULLETIN 11-12
114.1 CMR 41.00: Rates of Payment for Services Provided to Industrial Accident Patients by Hospitals
May 27, 2011
Publication of Payment on Account Factors (PAFs) for Hospital Services
The Division of Health Care Finance and Policy, pursuant to 114.1 CMR 41.05(3), is issuing this bulletin to publish the Payment on Account Factors (PAFs) for acute and non-acute hospital services rendered to industrial accident patients effective July 1, 2011. The application of the PAF to all billed charges payable pursuant to 114.1 CMR 41.00 results in the payment of the average percentage of charges paid by the private sector to each hospital for its services and shall be deemed to meet the test of reasonable cost of medical services prescribed by M.G.L. c. 152, The Workers’ Compensation Act. No lesser amount shall be paid unless agreed to by the provider, insurer and employer. The PAFs for acute and non-acute hospitals for services rendered on or after July 1, 2011 are as follows:
July 1, 2011 Acute Hospitals PAF Anna Jaques Hospital 54.55% Athol Memorial Hospital 32.83% Baystate Franklin Medical Center 50.45% Baystate Mary Lane Hospital 52.43% Baystate Medical Center 57.91% Berkshire Medical Center 70.62% Beth Israel Deaconess Hospital - Needham 45.77% Beth Israel Deaconess Medical Center 49.53% Boston Medical Center 43.47% Brigham and Women's 44.21% Cambridge Health Alliance 56.89% Cape Cod Hospital 67.37% Clinton Hospital 27.06% Cooley Dickinson Hospital 64.89% July 1, 2011 Acute Hospitals PAF Dana Farber Cancer Center 41.81% Emerson Hospital 38.12% Fairview Hospital 75.37% Falmouth Hospital 68.60% Faulkner Hospital 39.83% Hallmark Health Systems 43.81% Harrington Memorial Hospital 57.94% HealthAlliance Hospitals, Inc. 37.44% Heywood Hospital 42.15% Holyoke Hospital 50.04% Jordan Hospital 46.97% Lahey Clinic Hospital 59.72% Lawrence General Hospital 42.64% Lowell General Hospital 50.23% Marlborough Hospital 31.54% Martha's Vineyard Hospital 51.70% Mass Eye & Ear Infirmary 39.74% Mass General Hospital 48.25% Mercy Hospital 37.86% Merrimack Valley Hospital 49.02% MetroWest Medical Center 42.62% Milford-Whittinsville Regional Hospital 46.07% Milton Hospital 41.66% Morton Hospital 53.45% Mount Auburn Hospital 54.36% Nantucket Cottage Hospital 54.57% Nashoba Valley Medical Center 23.23% New England Baptist Hospital 61.76% Newton-Wellesley Hospital 38.35% Noble Hospital 37.64% North Adams Regional Hospital 48.74% North Shore Medical Center 43.24% Northeast 53.99% Quincy Hospital 49.23% Saint Vincent Hospital 50.68% Saints Medical Center 44.94% Signature Healthcare Brockton Hospital 42.02% South Shore Hospital 63.64% Southcoast Health Systems 56.50% July 1, 2011 Acute Hospitals PAF Steward Carney Hospital, Inc. 66.15% Steward Good Samaritan Medical Center 58.63% Steward Holy Family Hospital 48.27% Steward Norwood Hospital 54.59% Steward Saint Anne's Hospital 53.01% Steward St. Elizabeth's Medical Center 51.59% Sturdy Memorial Hospital 79.40% Tufts Medical Center 43.28% UMMC 42.57% Winchester Hospital & Family Medical Center 59.05% Wing Memorial Hospital 43.68% Median PAF 49.13%
Non-Acute Hospitals Fairlawn 54.9% HealthSouth Braintree Rehab Hospital 47.6% HealthSouth New England Rehab Hospital 52.1% Kindred Braintree Hospital 35.7% Kindred Park View Hospital 35.4% N.E. Sinai 50.6% Rehab Hospital of the Cape and Islands 64.9% Shaughnessy-Kaplan 57.2% Spaulding Rehab 49.2% Median PAF 50.6%