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Current as of January 01, 2025 | Updated by Findlaw Staff
(a) Assessment.--The assessment implemented under this article shall be imposed as a fixed fee in accordance with subsection (b). The assessment shall be remitted electronically in periodic submissions as specified by the department not to exceed five times per year.
(b) Fixed fee.--Beginning July 1, 2016, and ending June 30, 2020, the managed care organization shall be assessed a fixed fee of $13.48 for each unduplicated member for each month the member is enrolled for any period of time with the managed care organization.
(c) Adjustments.--The secretary may make further adjustments to the fixed fee specified under subsection (b) for all or part of the fiscal year so long as the assessment does not exceed the maximum limit specified under subsection (d). Before adjusting the fixed fee, the secretary shall publish a notice in the Pennsylvania Bulletin that specifies the proposed adjusted fixed fee and identifies the estimated aggregate impact on managed care organizations. Interested parties shall have 30 days in which to submit comments to the secretary. Upon expiration of the 30-day comment period, the secretary, after consideration of the comments, shall publish a second notice in the Pennsylvania Bulletin announcing the adjusted fixed fee.
(d) Maximum amount.--In each year in which the assessment is implemented, the assessment shall not exceed the maximum aggregate amount that may be assessed under 42 CFR 433.68(f)(3)(i) (relating to permissible health care-related taxes) or any other maximum established under Federal law.
(e) Limited review.--
(1) Except as permitted under section 809-I, 1 the secretary's determination of the assessment amounts under subsections (b) and (c) shall not be subject to administrative or judicial review under 2 Pa.C.S. Chs. 5 Subch. A (relating to practice and procedure of Commonwealth agencies) and 7 Subch. A (relating to judicial review of Commonwealth agency action) or any other provision of law.
(2) Any assessments implemented under this article or forms or reports required to be completed by managed care organizations under this article shall not be subject to the act of July 31, 1968 (P.L. 769, No. 240), 2 referred to as the Commonwealth Documents Law, the act of October 15, 1980 (P.L. 950, No. 164), 3 known as the Commonwealth Attorneys Act, and the act of June 25, 1982 (P.L. 633, No. 181), 4 known as the Regulatory Review Act.
Cite this article: FindLaw.com - Pennsylvania Statutes Title 62 P.S. Poor Persons and Public Welfare § 803-I. Assessment amount - last updated January 01, 2025 | https://codes.findlaw.com/pa/title-62-ps-poor-persons-and-public-welfare/pa-st-sect-62-803-i/
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