New York State Health Care Reform Act (HCRA)

March 20, 1997

Dear Payor:

Enclosed are revised monthly reporting forms and instructions for electing payors to use in calculating and remitting payments to the 1997 Public Goods Pools. The forms and instructions have been revised based on comments we received from payors. The changes to the instructions have been highlighted to assist you in identifying those that may affect your monthly reporting submittal. The major changes include the following:

  • In order to ease the reporting burden on third-party administrators (TPAs), a new Attachment 2 has been added for the use of those third-party administrators representing self-insured funds that have no Public Goods Pool liability for a reporting month or that are submitting the reporting forms separately on their own behalf. In these instances only, TPAs may complete Attachment 2 rather than submit separate reports for such funds.
  • You may now wire transfer your monthly Public Goods Pool payment to the Department´s Pool Administrator. We have enclosed a Wire Transfer Instructions Form DOH-4075, Part D for your use when processing Federal or Automated Clearing House (ACH) wire transfers. (Please see the last page of this transmittal and follow closely the instructions listed at the bottom of such form).

If you are a self-insured fund represented by a TPA, be advised that we are forwarding all revised reporting forms and instructions, and all other correspondence relating to your Public Goods Pools payment and reporting obligations, to you as well as your TPA. The primary responsibility of insuring that the monthly reporting forms are timely filed by any electing self-insured fund rests with the self-insured fund. If reports are not filed, or timely filed, any penalties and interest would be imposed on the fund.

If you have an agreement with a TPA whereby the TPA is preparing and/or submitting reporting forms on your behalf, it is your responsibility to insure that your TPA files all appropriate monthly report forms in compliance with the instructions in this transmittal.

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