Health Safety Net (HSN)

Health Safety Net

Health Safety Net (HSN) pays acute care hospitals and community health centers for certain essential health care services provided to qualified uninsured and underinsured Massachusetts residents. 

Who we serve

The Health Safety Net pays for certain medically necessary services provided to qualified low-income patients at Massachusetts community health centers (CHCs) and acute care hospitals. The HSN also pays CHCs and acute care hosptials for medical hardship expenses (when qualifying medical expenses exceed a specified percentage of a family's income), and for some types of bad debt. 

Health Safety Net information by group

For patients

This section includes information for patients about qualifying for the HSN, HSN copayments and deductibles, HSN providers, and other important information.

For providers

This section includes information for acute care hospitals and community health centers about HSN claims, billing and payments, serious reportable events guidelines, the special circumstances application, and other important information.

For surcharge payers

This section contains information about which entities and individuals are subject to the surcharge, surcharge registration, and other important information.

Effective on October 1, 2016, the Health Safety Net surcharge percentage is 1.76%. This applies to payments made to hospitals and ambulatory surgical centers for the period from October 1, 2016, through September 30, 2017.

Health Safety Net additional information

Health Safety Net regulations

HSN regulations govern:

  • The types of services that can be paid by the HSN, the criteria used to determine low income patient status, and the rules for medical hardship and bad debt.
  • Payments to acute hospitals and community health centers and payments from acute hospitals and surcharge payers.

Health Safety Net annual reports

This section contains the HSN current and historic annual reports. The Health Safety Net Trust Fund typically issues an annual report that includes the following information:

  • The number of persons whose medical expenses were billed to the Health Safety Net Trust Fund,
  • The total dollar amount billed to the Health Safety Net Trust Fund,
  • The age, income level, and insurance status of recipients using the Health Safety Net Trust Fund,
  • The types of services paid for out of the Health Safety Net Trust Fund, and
  • The amount disbursed from the Health Safety Net Trust Fund to each acute hospital and Community Health Center.

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