Connecticut 2022 Regular Session

Connecticut Senate Bill SB00441 Compare Versions

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Version 2 (New)

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7		-	General Assembly Substitute Bill No. 441
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	6	+	General Assembly Raised Bill No. 441
8	7		February Session, 2022
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	11	+	Referred to Committee on FINANCE, REVENUE AND
	12	+	BONDING
	13	+
	14	+
	15	+	Introduced by:
	16	+	(FIN)
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14	21		AN ACT CONCERNING A CREDIT FOR AMBULATORY SURGICAL
15	22		CENTERS.
16	23		Be it enacted by the Senate and House of Representatives in General
17	24		Assembly convened:
18	25
19	26		Section 1. Section 12-263aaa of the 2022 supplement to the general 1
20	27		statutes is repealed and the following is substituted in lieu thereof 2
21	28		(Effective July 1, 2023, and applicable to calendar quarters commencing on or 3
22	29		after July 1, 2023): 4
23	30		(a) As used in this section and sections 12-263bbb to 12-263fff, 5
24	31		inclusive, unless the context otherwise requires: 6
25	32		(1) "Ambulatory surgical center" means any distinct entity that (A) 7
26	33		operates exclusively for the purpose of providing surgical services to 8
27	34		patients not requiring hospitalization and in which the expected 9
28	35		duration of services would not exceed twenty-four hours following an 10
29	36		admission, (B) has an agreement with the Centers for Medicare and 11
30	37		Medicaid Services to participate in Medicare as an ambulatory surgical 12
31	38		center, and (C) meets the general and specific conditions for 13
32		-	participation in Medicare set forth in 42 CFR Part 416, Subparts B and 14
	39	+	participation in Medicare set forth in 42 CFR Part 416, Subparts B and 14 Raised Bill No. 441
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33	45		C, as amended from time to time; 15
34	46		(2) "Ambulatory surgical center services" means only those 16
35		-	procedures or services included in a facility fee payment to an 17 Substitute Bill No. 441
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	47	+	procedures or services included in a facility fee payment to an 17
42	48		ambulatory surgical center facility associated with each surgical 18
43	49		procedure and that are not reimbursable ancillary or professional 19
44	50		procedures or services. "Ambulatory surgical services" includes facility 20
45	51		services only and does not include surgical procedures, physicians' 21
46	52		services, anesthetists' services, radiology services, diagnostic services or 22
47	53		ambulance services, if such procedures or services would be reimbursed 23
48	54		as a separate line item from facility services under 42 CFR 416.164(a), as 24
49	55		amended from time to time; 25
50	56		(3) "Gross receipts" means the amount received, whether in cash or in 26
51	57		kind, from patients, third-party payers and others for taxable 27
52	58		ambulatory surgical center services provided by the ambulatory 28
53	59		surgical center in the state, including retroactive adjustments under 29
54	60		reimbursement agreements with third-party payers, without any 30
55	61		deduction for any expense of any kind; 31
56	62		(4) "Net revenue" means gross receipts less payer discounts, charity 32
57	63		care and bad debts, to the extent the ambulatory surgical center 33
58	64		previously paid tax under this section on the amount of such bad debts; 34
59	65		(5) "Payer discounts" means the difference between an ambulatory 35
60	66		surgical center's published charges and the payments received by the 36
61	67		ambulatory surgical center from one or more health care payers for a 37
62	68		rate or method of payment that is different than or discounted from such 38
63	69		published charges. "Payer discounts" does not include charity care or 39
64	70		bad debts; 40
65	71		(6) "Charity care" means free or discounted health care services 41
66	72		rendered by an ambulatory surgical center to an individual who cannot 42
67	73		afford to pay for such services, including, but not limited to, health care 43
68	74		services provided to an uninsured patient who is not expected to pay all 44
69	75		or part of an ambulatory surgical center's bill based on income 45
70		-	guidelines and other financial criteria set forth in the general statutes or 46
	76	+	guidelines and other financial criteria set forth in the general statutes or 46 Raised Bill No. 441
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	79	+
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71	82		in an ambulatory surgical center's charity care policies on file at the 47
72	83		office of such center. "Charity care" does not include bad debts or payer 48
73		-	discounts; 49 Substitute Bill No. 441
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	84	+	discounts; 49
80	85		(7) "Received" means received or accrued, construed according to the 50
81	86		method of accounting customarily employed by the amb ulatory 51
82	87		surgical center; 52
83	88		(8) "Medicaid" means the program operated by the Department of 53
84	89		Social Services pursuant to section 17b-260 and authorized by Title XIX 54
85	90		of the Social Security Act, as amended from time to time; 55
86	91		(9) "Medicare" means the programs operated by the Centers for 56
87	92		Medicare and Medicaid Services in accordance with Title XVIII of the 57
88	93		Social Security Act, as amended from time to time, including, but not 58
89	94		limited to, those programs established pursuant to Parts A, B and C of 59
90	95		Title XVIII of said act, as amended from time to time; 60
91	96		(10) "Medicaid investment" means an amount, as selected by each 61
92	97		ambulatory surgical center, equal to (A) fifty per cent of the aggregate 62
93	98		Medicaid payments received by the ambulatory surgical center during 63
94	99		the applicable reporting period for the provision of ambulatory surgical 64
95	100		center services, or (B) fifty per cent of the difference between the 65
96	101		aggregate amount of Medicaid payments received by the ambulatory 66
97	102		surgical center during the applicable reporting period for the provision 67
98	103		of ambulatory surgical center services and the aggregate amount of 68
99	104		Medicaid payments that would have been received by a hospital during 69
100	105		the applicable reporting period if substantially similar services had been 70
101	106		performed at a hospital; 71
102	107		(11) "State health plan investment" means an amount equal to twenty-72
103	108		five per cent of the aggregate payments received, from or on behalf of 73
104	109		each individual who is covered under a health plan pursuant to section 74
105	110		5-259, by an ambulatory surgical center during the applicable reporting 75
106	111		period for the provision of ambulatory surgical center services; 76
107		-	[(10)] (12) "Commissioner" means the Commissioner of Revenue 77
108		-	Services; and 78
109		-	[(11)] (13) "Department" means the Department of Revenue Services. 79 Substitute Bill No. 441
	112	+	[(10)] (12) "Commissioner" means the Commissioner of Revenue 77 Raised Bill No. 441
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	118	+	Services; and 78
	119	+	[(11)] (13) "Department" means the Department of Revenue Services. 79
116	120		(b) For each calendar quarter commencing on or after July 1, 2023, 80
117	121		there is hereby imposed a tax on each ambulatory surgical center in this 81
118	122		state to be paid each calendar quarter. 82
119	123		(1) The tax imposed by this section for each calendar quarter shall be 83
120	124		at the rate of three per cent of each ambulatory surgical center's net 84
121	125		revenue received during the calendar quarter, except that such tax shall 85
122	126		not be imposed on any amount of such net revenue that constitutes any 86
123	127		of the following: (A) Net revenue of a hospital that is subject to the tax 87
124	128		imposed under section 12-263q; (B) Medicaid payments received by the 88
125	129		ambulatory surgical center for the provision of ambulatory surgical 89
126	130		center services; and (C) Medicare payments received by the ambulatory 90
127	131		surgical center for the provision of ambulatory surgical center services. 91
128	132		(2) Each ambulatory surgical center doing business in the state shall, 92
129	133		on or before the last day of January, April, July and October of each year, 93
130	134		render to the commissioner a return, on forms prescribed or furnished 94
131	135		by the commissioner, reporting the name and location of such 95
132	136		ambulatory surgical center, the entire amount of net revenue received 96
133	137		by such ambulatory surgical center during the calendar quarter ending 97
134	138		on the last day of the preceding month and such other information as 98
135	139		the commissioner deems necessary for the proper administration of this 99
136	140		section. Except as provided in subdivision (3) of this subsection, the tax 100
137	141		imposed under this section shall be due and payable on the due date of 101
138	142		such return. Each ambulatory surgical center shall be required to file 102
139	143		such return electronically with the department and to make payment of 103
140	144		such tax by electronic funds transfer in the manner provided by chapter 104
141	145		228g, regardless of whether such ambulatory surgical center would 105
142	146		have otherwise been required to file such return electronically or to 106
143	147		make such tax payment by electronic funds transfer under the 107
144	148		provisions of chapter 228g. 108
145		-	(3) (A) Any ambulatory surgical center may file, on or before the due 109
	149	+	(3) (A) Any ambulatory surgical center may file, on or before the due 109 Raised Bill No. 441
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146	155		date of a payment of tax imposed under this section, a request for a 110
147	156		reasonable extension of time for such payment for reasons of undue 111
148		-	hardship. Undue hardship shall be demonstrated by a showing that the 112 Substitute Bill No. 441
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	157	+	hardship. Undue hardship shall be demonstrated by a showing that the 112
155	158		ambulatory surgical center is at substantial risk of defaulting on a bond 113
156	159		or loan covenant or similar obligation if such ambulatory surgical center 114
157	160		were to make payment on the due date of the amount for which the 115
158	161		extension is requested. Such request shall be filed on forms prescribed 116
159	162		by the commissioner and shall include complete information of such 117
160	163		ambulatory surgical center's inability, due to undue hardship, to make 118
161	164		payment of the tax on or before the due date of such payment. The 119
162	165		commissioner shall not grant any extension for a general statement of 120
163	166		hardship by an ambulatory surgical center or for the convenience of an 121
164	167		ambulatory surgical center. 122
165	168		(B) The commissioner may grant an extension if the commissioner 123
166	169		determines an undue hardship exists. Such extension shall not exceed 124
167	170		three months from the original due date of the payment, except that the 125
168	171		commissioner may grant an additional extension not exceeding three 126
169	172		months from the initial extended due date of the payment (i) upon the 127
170	173		filing of a subsequent request by the ambulatory surgical center on or 128
171	174		before the extended due date of the payment, on forms prescribed by 129
172	175		the commissioner, and (ii) upon a showing of extraordinary 130
173	176		circumstances, as determined by the commissioner. 131
174	177		(4) If the commissioner grants an extension pursuant to subdivision 132
175	178		(3) of this subsection, no penalty shall be imposed and no interest shall 133
176	179		accrue during the period of time for which an extension is granted if the 134
177	180		ambulatory surgical center pays the tax due on or before the extended 135
178	181		due date of the payment. If the ambulatory surgical center does not pay 136
179	182		such tax by the extended due date, a penalty shall be imposed in 137
180	183		accordance with subsection [(c)] (d) of this section and interest shall 138
181	184		begin to accrue at a rate of one per cent per month for each month or 139
182	185		fraction thereof from the extended due date of such tax until the date of 140
183	186		payment. 141
184		-	(5) Nothing in this section shall prohibit an ambulatory surgical 142
185		-	center from seeking remuneration for the tax imposed by this section. 143
186		-	(c) Each ambulatory surgical center shall be allowed, for each 144 Substitute Bill No. 441
	187	+	(5) Nothing in this section shall prohibit an ambulatory surgical 142 Raised Bill No. 441
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	193	+	center from seeking remuneration for the tax imposed by this section. 143
	194	+	(c) Each ambulatory surgical center shall be allowed, for each 144
193	195		reporting period, a credit against the tax imposed under subsection (b) 145
194	196		of this section in an amount equal to the sum of the Medicaid investment 146
195	197		and the state health plan investment. If the amount of the credit allowed 147
196	198		pursuant to this subsection exceeds the ambulatory surgical center's tax 148
197	199		liability for the tax imposed under subsection (b) of this section, the 149
198	200		ambulatory surgical center shall file a claim for refund in accordance 150
199	201		with the provisions of section 12-263ccc. Upon verification of the claim, 151
200	202		the commissioner shall treat such excess as an overpayment and shall 152
201	203		refund such excess, without interest, to the ambulatory surgical center. 153
202	204		[(c)] (d) (1) Except as provided in subdivision (3) of subsection (b) of 154
203	205		this section, if any ambulatory surgical center fails to pay the amount of 155
204	206		tax reported to be due on such ambulatory surgical center's return 156
205	207		within the time specified under the provisions of this section, there shall 157
206	208		be imposed a penalty equal to ten per cent of such amount due and 158
207	209		unpaid or fifty dollars, whichever is greater. The tax shall bear interest 159
208	210		at the rate of one per cent per month or fraction thereof from the due 160
209	211		date of such tax until the date of payment. 161
210	212		(2) If any ambulatory surgical center has not filed its return within 162
211	213		one month of the due date of such return, the commissioner may file 163
212	214		such return at any time thereafter, according to the best information 164
213	215		obtainable and according to the forms prescribed. There shall be added 165
214	216		to the tax imposed upon the basis of such return an amount equal to ten 166
215	217		per cent of such tax or fifty dollars, whichever is greater. The tax shall 167
216	218		bear interest at the rate of one per cent per month or fraction thereof 168
217	219		from the due date of such tax until the date of payment. 169
218	220		(3) Subject to the provisions of section 12-3a, the commissioner may 170
219	221		waive all or part of the penalties provided under this subsection when 171
220	222		it is proven to the commissioner's satisfaction that the failure to pay any 172
221	223		tax on time was due to reasonable cause and was not intentional or due 173
222		-	to neglect. 174
223		-	(4) The commissioner shall notify the Commissioner of Social 175
224		-	Services of any amount delinquent under this section and, upon receipt 176 Substitute Bill No. 441
	224	+	to neglect. 174 Raised Bill No. 441
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	230	+	(4) The commissioner shall notify the Commissioner of Social 175
	231	+	Services of any amount delinquent under this section and, upon receipt 176
231	232		of such notice, the Commissioner of Social Services shall deduct and 177
232	233		withhold such amount from amounts otherw ise payable by the 178
233	234		Department of Social Services to the delinquent ambulatory surgical 179
234	235		center. 180
235	236		[(d)] (e) (1) Any person required under this section to pay any tax, file 181
236	237		a return, keep any records or supply any information and who wilfully 182
237	238		fails, at the time required by law, to pay such tax, file such return, keep 183
238	239		such records or supply such information shall, in addition to any other 184
239	240		penalty provided by law, be fined not more than one thousand dollars 185
240	241		or imprisoned not more than one year, or both. As used in this 186
241	242		subsection, "person" includes any officer or employee of an ambulatory 187
242	243		surgical center under a duty to pay such tax, file such return, keep such 188
243	244		records or supply such information. Notwithstanding the provisions of 189
244	245		section 54-193, no person shall be prosecuted for a violation of the 190
245	246		provisions of this subsection committed on or after July 1, 1997, except 191
246	247		within three years after such violation has been committed. 192
247	248		(2) Any person who wilfully delivers or discloses to the commissioner 193
248	249		or the commissioner's authorized agent any list, return, account, 194
249	250		statement or other document, known by such person to be fraudulent 195
250	251		or false in any material matter, shall, in addition to any other penalty 196
251	252		provided by law, be guilty of a class D felony. No person shall be 197
252	253		charged with an offense under both this subdivision and subdivision (1) 198
253	254		of this subsection in relation to the same tax period but such person may 199
254	255		be charged and prosecuted for both such offenses upon the same 200
255	256		information. 201
256	257		[(e)] (f) For the fiscal year ending June 30, 2024, and each fiscal year 202
257	258		thereafter, the Comptroller is authorized to record as revenue for each 203
258	259		fiscal year the amount of tax imposed under the provisions of this 204
259	260		section prior to the end of each fiscal year and which tax is received by 205
260	261		the Commissioner of Revenue Services not later than five business days 206
261		-	after the last day of July immediately following the end of each fiscal 207
262		-	year. 208 Substitute Bill No. 441
	262	+	after the last day of July immediately following the end of each fiscal 207 Raised Bill No. 441
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269		-	Sec. 2. (Effective from passage) Section 465 of public act 21-2 of the June 209
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	267	+
	268	+	year. 208
	269	+	Sec. 2. (Effective from passage) Section 465 of public act 12-2 of the June 209
270	270		special session shall take effect July 1, 2023, and shall be applicable to 210
271	271		calendar quarters commencing on or after July 1, 2023. 211
272	272		This act shall take effect as follows and shall amend the following
273	273		sections:
274	274
275	275		Section 1 July 1, 2023, and
276	276		applicable to calendar
277	277		quarters commencing on or
278	278		after July 1, 2023
279	279		12-263aaa
280	280		Sec. 2 from passage New section
281	281
282		-	FIN Joint Favorable Subst.
	282	+	Statement of Purpose:
	283	+	To establish a credit for ambulatory surgical centers against the
	284	+	ambulatory surgical centers net revenue tax.
	285	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	286	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	287	+	underlined.]
283	288