New York State Health Care Reform Act (HCRA)

February 14, 1997

Re: 1997 Public Goods Pool Reporting Forms

Dear Administrator/Comptroller:

Enclosed please find reporting forms and instructions for designated providers to use when calculating and remitting payments to the 1997 Public Goods Pools. The reporting forms are required to be filed monthly even if there is no activity to report.

ALL PAYMENT CHECKS SHOULD BE MADE PAYABLE TO THE "1997 PUBLIC GOODS POOL" AND MAILED WITH THE APPLICABLE REPORTING FORMS VIA:

Regular Mail:

Mr. Jerome Alaimo, Pool Administrator
Office of Pool Administration
Excellus BlueCross BlueShield,
Central New York Region
P.O. Box 4757
Syracuse, New York 13221-4757

-OR-

Express or Overnight Mail:

Mr. Jerome Alaimo, Pool Administrator
Office of Pool Administration
Excellus BlueCross BlueShield,
Central New York Region
344 South Warren Street
Syracuse, New York 13202-2008

A schedule of report and payment due dates for the months of January through December 1997 is provided on the first page of the instructions. Note also that the first report, covering the month of January, 1997, must be submitted (postmarked) by March 3, 1997.

Failure to comply with the reporting provisions provided in Sections 2807-j and 2807-s of the Public Health Law may result in the recoupment of the facility´s estimated monthly assessment liability, along with interest and/or penalty, from various third party payments pursuant to Section 2807-j(6) of the Public Health Law.

Should you have any questions concerning the foregoing or the enclosed forms, please contact Mr. Richard Pellegrini, Director of the Bureau of Financial Management and Information Support at (518) 473-4653.

Sincerely,

Mark H. Van Guysling
Assistant Director
Division of Health Care Financing

Enclosures