The Commonwealth of Massachusetts Executive Office of Health and Human Services One Ashburton Place, Room 1109 Boston, MA 02108

CHARLES D. BAKER Tel: (617) 573-1600 Governor Fax: (627) 573-1891

www.mass.gov/eohhs KARYN E. POLITO Lieutenant Governor

MARYLOU SUDDERS Secretary

Administrative Bulletin 17-14 114.1 CMR 41.00: Rates of Payment for Services Provided to Industrial Accident Patients by Hospitals

Effective July 1, 2017

Publication of Payment on Account Factors (PAFs) for Hospital Services

The Executive Office of Health and Human Services (EOHHS), pursuant to 114.1 CMR 41.05(1) and (3) and in accordance with Section 123 of Chapter 224 of the Acts of 2012, is publishing the Payment on Account Factors (PAF) for acute and non-acute hospital services rendered to industrial accident patients. The PAF was computed using data from each hospital’s most recent complete fiscal year. 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. This payment calculation 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.

Provided below are the PAFs for acute and non-acute hospital services rendered on or after July 1, 2017.

Acute Hospitals PAF % Anna Jaques Hospital 54.74% 34.10% Baystate Franklin Medical Center 52.92% Baystate Mary Lane Hospital Corporation 50.92% Baystate Medical Center 57.41% Baystate Wing Hospital 44.29% 67.56% Beth Israel Deaconess Hospital - Milton 41.62% Beth Israel Deaconess Hospital - Needham 53.35% Beth Israel Deaconess Hospital - Plymouth 47.80% Beth Israel Deaconess Medical Center 58.02% 44.74%

Brigham and Women's Faulkner Hospital 43.97% Brigham and Women's Hospital 43.00% Cambridge Health Alliance 52.65% 70.12% Clinton Hospital - A member of the UMASS Memorial Health Center 29.29% Cooley Dickinson Hospital 57.73% Dana-Farber Cancer Institute 42.34% 47.46% Fairview Hospital 71.09% Falmouth Hospital 73.60% Hallmark Health 48.55% Harrington Memorial Hospital 44.13% HealthAlliance Hospital 37.44% Heywood Hospital 47.07% 45.10% Kindred Hospital Boston Median Kindred Hospital Boston North Shore Median Lahey Hospital and Medical Center 56.83% Lawrence General Hospital 43.94% 47.06% Marlborough Hospital - A member of the UMASS Memorial Health Center 29.77% Martha's Vineyard Hospital 54.50% Massachusetts Eye and Ear Infirmary 45.68% Massachusetts General Hospital 44.18% Mercy Medical Center 51.94% MetroWest Medical Center 46.75% Milford Regional Medical Center 50.75% Morton Hospital - A Steward Family Hospital Inc. 73.71% 60.67% Cottage Hospital 78.11% Nashoba Valley Medical Center - A Steward Family Hospital Inc. 41.14% New England Baptist Hospital 66.90% Newton-Wellesley Hospital 41.63% Noble Hospital 39.62% North Shore Medical Center 46.19% Northeast Hospital 54.80% 57.53% Signature Healthcare 44.39% 63.17% Southcoast Hospitals Group 50.50% Steward Inc. 75.01% Steward Good Samaritan Medical Center 66.86% Steward Holy Family Hospital Inc. 60.57% Steward Inc. 65.40% Steward Saint Anne's Hospital Inc. 53.89%

Steward St. Elizabeth's Medical Center 75.40% Sturdy Memorial Hospital 75.88% 49.41% UMass Memorial Medical Center 39.78% 59.18% Acute Hospital Median PAF for Out-of-State and New Hospitals 50.84%

Non-Acute Hospital PAF Braintree Rehabilitation Hospital 44.22% HealthSouth Fairlawn Rehabilitation Hospital 55.93% HealthSouth Rehabilitation Hospital of Western Massachusetts 52.97% Kindred Hospital Northeast - Stoughton 44.66% New England Rehabilitation Hospital 52.86% New England Sinai Hospital - A Steward Family Hospital Inc. 50.72% Spaulding Hospital - Cambridge 43.08% Spaulding Rehabilitation Hospital - Boston 40.98% Spaulding Rehabilitation Hospital - Cape Cod 56.89% Vibra Hospital of Western Massachusetts (formerly Kindred Park View) Median Whittier Rehabilitation Hospital - Bradford 39.52% Whittier Rehabilitation Hospital - Westborough 36.19% Non-Acute Hospital Median PAF for Out-of-State and New Hospitals 44.66%