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SB890
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Oklahoma Senate Bill SB890

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Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB890 Compare Versions

Only one version of the bill is available at this time.

Version 1 (Old)

Version 2 (New)

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53	53		STATE OF OKLAHOMA
54	54
55	55		1st Session of the 58th Legislature (2021)
56	56
57	57		SENATE BILL 890 By: Jett
58	58
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63	63		AS INTRODUCED
64	64
65	65		An Act relating to the Supplemental Hospital Of fset
66	66		Payment Program; amending 63 O.S. 20 11, Section
67	67		3241.2, as last amended by Section 1, C hapter 56,
68	68		O.S.L. 2019 (63 O.S. Supp. 2020, Section 3241.2),
69	69		which relates to definitions; adding definitions;
70	70		making language gender neutral; amending 63 O.S.
71	71		2011, Section 3241.3, as last amended by Sect ion 2,
72	72		Chapter 56, O.S.L. 2019 (63 O.S. Supp. 2020, Section
73	73		3241.3), which relates to hospital assessment;
74	74		modifying certain exemptions; modifying assessment
75	75		methodology; fixing certain rates for specified
76	76		fiscal year; directing certain redetermination;
77	77		amending 63 O.S. 2011, Section 3241.4, as last
78	78		amended by Section 3, Chapter 345, O.S.L. 2016 (63
79	79		O.S. Supp. 2020, Section 3241.4), which relates to
80	80		Supplemental Hospital Offset Payment Program Fund;
81	81		modifying certain transfer authority; directing
82	82		certain notices to be sent; modifying allowable
83	83		expenses; providing an effective date; and declaring
84	84		an emergency.
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89	89		BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
90	90		SECTION 1. AMENDATORY 63 O.S. 2011, Section 3241.2, as
91	91		last amended by Section 1, Chapter 56, O.S.L. 2019 (63 O.S. Supp.
92	92		2020, Section 3241.2), is amended to read as follows:
93	93		Section 3241.2. As used in the Supplemental Hospital Offset
94	94		Payment Program Act:
95	95
96	96
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146	146		1. “Authority” means the Oklahoma Health Care Authority;
147	147		2. “Base year” means a hospital’s fiscal year as reported in
148	148		the Medicare Cost Report o r as determined by the Authority if the
149	149		hospital’s data is not included in the Medicare Cost Report. The
150	150		base year data will be use d in all assessment calculations;
151	151		3. “Net hospital patient revenue ” means the gross hospital
152	152		revenue as reported on Workshe et G-2 (Columns 1 and 2, Lines “Total
153	153		inpatient routine care services ”, “Ancillary services”, and
154	154		“Outpatient services”) of the Medicare Cost Report, multiplied by
155	155		the hospital’s ratio of total net to gross revenue, as r eported on
156	156		Worksheet G-3 (Column 1, Line “Net patient revenues”) and Worksheet
157	157		G-2 (Part I, Column 3, Line “Total patient revenues ”);
158	158		4. “Hospital” means an institution licensed by the State
159	159		Department of Health as a hospital pursuant to Section 1 -701 of this
160	160		title maintained primarily for the diagnosis, treatment, or care of
161	161		patients;
162	162		5. “Hospital Advisory Committee ” means the Committee
163	163		established for the purposes of advising the Oklahoma Health Care
164	164		Authority and recommending provisions within and appr oval of any
165	165		state plan amendment or waiver affecting hospital reimbursement made
166	166		necessary or advisable by the Supplemental Hospital Offset Payment
167	167		Program Act. In ord er to expedite the submission of the state plan
168	168		amendment required by Section 3241.6 of this title, the Committee
169	169		shall initially be appointed by the Executive Director of the
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221	221		Authority from recommendations submitted by a statewide association
222	222		representing rural and urban hospitals. The perm anent Committee
223	223		shall be appointed no later than th irty (30) days after November 1,
224	224		2011, and shall be composed of five (5) members to serve until
225	225		December 31, 2025, from lists of names submitted by a statewide
226	226		association representing rural and urban hosp itals, as follows:
227	227		a. one member, appointed by the Governor, who shall serve
228	228		as chairman chair, and
229	229		b. two members, appointed each by the Pre sident Pro
230	230		Tempore of the Oklahoma State Senate and the Speaker
231	231		of the Oklahoma House of Representatives.
232	232		Membership shall be extended until December 31, 2025, for th ose
233	233		members who are serving as of Dec ember 31, 2019;
234	234		6. “Medicaid” means the medical assi stance program established
235	235		in Title XIX of the federal Social Security Act and administered in
236	236		this state by the Ok lahoma Health Care Authority;
237	237		7. “Medicare Cost Report” means the Hospital Cost Report, Form
238	238		CMS-2552-96 or subsequent versions;
239	239		8. “Upper payment limit” means the maximum ceiling imposed by
240	240		42 C.F.R., Sections 447.272 and 447.321 on hospital Medicaid
241	241		reimbursement for inpatient and outpatient services, other than to
242	242		hospitals owned or oper ated by state government ; and
243	243		9. “Upper payment limit gap” means the difference between the
244	244		upper payment limit and Medicaid paymen ts not financed using
245	245
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296	296		hospital assessments made to all hospitals other than hospitals
297	297		owned or operated by state government.
298	298		10. “Medicaid Expansion” may include enrollment of the newly
299	299		eligible Medicaid population, increases in enrollment from those
300	300		currently eligible but not enrolled and increased administrative
301	301		costs; and
302	302		11. “Newly eligible Medicaid population ” means those
303	303		individuals over age eighteen (18) and under age sixty -five (65)
304	304		whose income does not exceed one hundred thirty -three percent (133%)
305	305		of the Federal Poverty Level gui delines, as described by and using
306	306		the income methodology provided in 42 U.S.C. Sectio n 1396 et seq.,
307	307		whose coverage is eligible for enhanced federal financial
308	308		participation.
309	309		SECTION 2. AMENDATORY 63 O.S. 2011, Section 3241.3, as
310	310		last amended by Section 2, Chapter 56, O.S.L. 2019 (63 O.S. Supp.
311	311		2020, Section 3241.3), is amended to read as follows:
312	312		Section 3241.3. A. For the purpose of assuring access to
313	313		quality care for Oklahoma Medicaid co nsumers, the Oklahoma Health
314	314		Care Authority, after considering input and recommendations fr om the
315	315		Hospital Advisory Committe e, shall assess hospitals licensed in
316	316		Oklahoma, unless exempt under subsection B of this section, a
317	317		supplemental hospital offset pay ment program fee.
318	318		B. The following hosp itals shall be exempt from the
319	319		supplemental hospita l offset payment program fee:
320	320
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371	371		1. A hospital that is owned or operated by the state or a state
372	372		agency, the federal government , a federally recognized Indian tribe ,
373	373		or the Indian Health Service;
374	374		2. A hospital, located within the geographical boundaries of a
375	375		city with a population of less than fifty thousand (50,000),
376	376		according to the latest Fed eral Decennial Census, that provides more
377	377		than fifty percent (50%) of its inp atient days under a contract with
378	378		a state agency other than the Authority;
379	379		3. A hospital for, located within the geographical bo undaries
380	380		of a city with a population of less than fifty thousand (50,000),
381	381		according to the latest Fed eral Decennial Census, which the majority
382	382		of its inpatient days are for any one of the following services, as
383	383		determined by the Authority using the Inpatient Discharge Data File
384	384		published by the Oklahoma State Department of Health, or in the case
385	385		of a hospital, not included in the Inpatien t Discharge Data File,
386	386		using substantially equivalent data prov ided by the hospital:
387	387		a. treatment of a neurological injury,
388	388		b. treatment of cancer,
389	389		c. treatment of cardiovascular disease,
390	390		d. obstetrical or childbirth services,
391	391		e. surgical care, except that this exemption shall not
392	392		apply to any hospital located in a ci ty of less than
393	393		five hundred thousand (500,000) population an d for
394	394
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445	445		which the majority of inpatient days are for back,
446	446		neck, or spine surgery;
447	447		4. A hospital that is certified by the federal Cen ters for
448	448		Medicaid and Medicar e Services as a long-term acute care hospital or
449	449		as a children’s hospital; and
450	450		5. A hospital that is certified by the fede ral Centers for
451	451		Medicaid and Medicare Services as a critical access hospital.
452	452		C. The supplemental hospi tal offset payment program fe e shall
453	453		be an assessment imposed o n each hospital, except those exempted
454	454		under subsection B of this section, for each calen dar year in an
455	455		amount calculated as a percentage of each hospital ’s net patient
456	456		revenue.
457	457		1. The assessment rate shall be determined annually based upon
458	458		the percentage of net hospital patient revenue needed to generate an
459	459		amount up to the sum of:
460	460		a. the nonfederal portion of the upper payment limit gap,
461	461		plus
462	462		b. the annual fee to be paid to the Authority unde r
463	463		subparagraph c of paragraph 1 of subsection G of
464	464		Section 3241.4 of this title, plus
465	465		c. the amount to be transferred by the Authority to the
466	466		Medical Payments Cash Management Improvement Act
467	467		Programs Disbursing Fund under subsection C of Section
468	468		3241.4 of this title.
469	469
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520	520		2. The assessment rate until December 31, 2012, sh all be fixed
521	521		at two and one-half percent (2.5%).
522	522		a. At no time in subsequent years shall the annual
523	523		effective assessment rate exceed four percent (4%) .
524	524		b. For the state fiscal year ending June 30, 2022, for
525	525		those hospitals not exempted in subsection B of this
526	526		section, and located within the geographical
527	527		boundaries of a city with a population of fifty
528	528		thousand (50,000) or greater, according to the latest
529	529		Federal Decennial Census, the assessment rate shall be
530	530		fixed at four percent (4%).
531	531		c. For the state fiscal year ending Jun e 30, 2022, for
532	532		those hospitals not exempted in subsection B of this
533	533		section, and located within the geographical
534	534		boundaries of a city with a population of less than
535	535		fifty thousand (50,000), according to the latest
536	536		Federal Decennial Census, the assessment rate shall be
537	537		fixed at two and five-tenths percent (2.5%).
538	538		d. Funds shall be disbursed with priority given to the
539	539		supplemental payment as provided by subsection F of
540	540		Section 3241.4 of this title.
541	541		3. Net hospital patient revenue shall be determined using t he
542	542		data from each hospital ’s Medicare Cost Repo rt contained in the
543	543
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594	594		Centers for Medicare and Medicaid Services ’ Healthcare Cost Report
595	595		Information System file.
596	596		a. Through 2013, the base year for assessment shall be
597	597		the hospital’s fiscal year that ended in 2 009, as
598	598		contained in the Healthcare Cost Report Information
599	599		System file dated December 31, 2010.
600	600		b. For years after 2013, the base year for assessment
601	601		shall be determined by rul es established by the
602	602		Authority.
603	603		4. If a hospital’s applicable Medicare Cost R eport is not
604	604		contained in the Centers for Medic are and Medicaid Services’
605	605		Healthcare Cost Report Information System file, the hospital shall
606	606		submit a copy of the hospital’s applicable Medicare Cost Report to
607	607		the Authority in order to allow the Authority to determine the
608	608		hospital’s net hospital patient revenue for the base year.
609	609		5. If a hospital commenced operations after the due date for a
610	610		Medicare Cost Report, the hospital shal l submit its initial Medicar e
611	611		Cost Report to the Authority in order to allow th e Authority to
612	612		determine the hospital ’s net patient revenue for the base year.
613	613		6. Partial year reports may be prorated for an annual basis.
614	614		7. In the event that a hospital doe s not file a uniform cost
615	615		report under 42 U.S.C., Section 1396a(a)(40), the Aut hority shall
616	616		establish a uniform cost report fo r such facility subject to the
617	617
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668	668		Supplemental Hospital Offset Payment Program provided for in this
669	669		section.
670	670		8. The Authority shall review what hospitals are in cluded in
671	671		the Supplemental Hospital Offset Payment Program provided for in
672	672		this subsection and wha t hospitals are exempted from the
673	673		Supplemental Hospital Offset Payment Program pursuant to subsection
674	674		B of this section. Such rev iew shall occur at a fixed p eriod of
675	675		time. This review and decision shall occu r within twenty (20) days
676	676		of the time of federa l approval and annually thereafter in November
677	677		of each year.
678	678		9. The Authority shall review and determine the amount of the
679	679		annual assessment. Such review an d determination shall occur within
680	680		the twenty (20) days of federal approval and annually thereafte r in
681	681		November of each year. Within sixty (60) days of the effective date
682	682		of this act, the Authority shall redetermine the assessme nt amount
683	683		to include the nonfederal portion of Medicaid expansion for the
684	684		state fiscal year ending June 30, 202 2, only.
685	685		D. A hospital may not charge any patient for any portion of the
686	686		supplemental hospital offset payment program fee.
687	687		E. Closure, merger a nd new hospitals.
688	688		1. If a hospital ceases to operate as a hospital or for any
689	689		reason ceases to be subject t o the fee imposed under the
690	690		Supplemental Hospital Offset Payment Program Act, the assessm ent for
691	691		the year in which the cessation occurs shall be adj usted by
692	692
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698	698		5
699	699		6
700	700		7
701	701		8
702	702		9
703	703		10
704	704		11
705	705		12
706	706		13
707	707		14
708	708		15
709	709		16
710	710		17
711	711		18
712	712		19
713	713		20
714	714		21
715	715		22
716	716		23
717	717		24
718	718		1
719	719		2
720	720		3
721	721		4
722	722		5
723	723		6
724	724		7
725	725		8
726	726		9
727	727		10
728	728		11
729	729		12
730	730		13
731	731		14
732	732		15
733	733		16
734	734		17
735	735		18
736	736		19
737	737		20
738	738		21
739	739		22
740	740		23
741	741		24
742	742
743	743		multiplying the annual assessment by a fraction, the numerator of
744	744		which is the number of days in th e year during which the hospital is
745	745		subject to the assessment and the denominator of whic h is 365.
746	746		Immediately upon ceasing to operate as a hospita l, or otherwise
747	747		ceasing to be subject to the supplemental hospital offset paym ent
748	748		program fee, the hospital shall pay the assessment for the year as
749	749		so adjusted, to the extent not previously paid.
750	750		2. In the case of a hospital that did not operate as a hos pital
751	751		throughout the base y ear, its assessment and any potential receipt
752	752		of a hospital access payment will c ommence in accordance with rules
753	753		for implementation and enforcement promulgated by the Au thority,
754	754		after consideration of the input and recommendatio ns of the Hospital
755	755		Advisory Committee.
756	756		F. 1. In the event that federal finan cial participation
757	757		pursuant to Title XIX of the Social Security Act is not available to
758	758		the Oklahoma Medicaid program f or purposes of matching expenditures
759	759		from the Supplemental Hospital Offset Payment Pro gram Fund at the
760	760		approved federal medical assistanc e percentage for the applicabl e
761	761		year, the supplemental hospital offset payment program fee shall be
762	762		null and void as of the date of the nonavailability of such federal
763	763		funding through and during any period of nonavailability.
764	764		2. In the event of an invalid ation of the Supplemental Hosp ital
765	765		Offset Payment Program Act by any court of last resort, the
766	766
767	767
768	768		Req. No. 1637 Page 11 1
769	769		2
770	770		3
771	771		4
772	772		5
773	773		6
774	774		7
775	775		8
776	776		9
777	777		10
778	778		11
779	779		12
780	780		13
781	781		14
782	782		15
783	783		16
784	784		17
785	785		18
786	786		19
787	787		20
788	788		21
789	789		22
790	790		23
791	791		24
792	792		1
793	793		2
794	794		3
795	795		4
796	796		5
797	797		6
798	798		7
799	799		8
800	800		9
801	801		10
802	802		11
803	803		12
804	804		13
805	805		14
806	806		15
807	807		16
808	808		17
809	809		18
810	810		19
811	811		20
812	812		21
813	813		22
814	814		23
815	815		24
816	816
817	817		supplemental hospital of fset payment program fee shall be null and
818	818		void as of the effective date of that inval idation.
819	819		3. In the event that the supplemental hos pital offset payment
820	820		program fee is determined to be null and void for any of the reasons
821	821		enumerated in this subsection , any supplemental hospital offset
822	822		payment program fee asse ssed and collected for any period after such
823	823		invalidation shall be returned in full within twenty (20) days by
824	824		the Authority to the hospital from which it was collected.
825	825		G. The Authority, after co nsidering the input and
826	826		recommendations of the Hospital Adv isory Committee, shall prom ulgate
827	827		rules for the implementation and enforcement of the supplemental
828	828		hospital offset payment program fee. Unless otherwise provided, the
829	829		rules adopted under this subs ection shall not grant any exceptions
830	830		to or exemptions from the hospital assessment im posed under this
831	831		section.
832	832		H. The Authority shall p rovide for administrative pena lties in
833	833		the event a hospital fails to:
834	834		1. Submit the supplemental hospital offset payme nt program fee;
835	835		2. Submit the fee in a timely manner;
836	836		3. Submit reports as required by this section; or
837	837		4. Submit reports timely.
838	838		I. The supplemental hospital offs et payment program fee shall
839	839		terminate effective December 31, 2025.
840	840
841	841
842	842		Req. No. 1637 Page 12 1
843	843		2
844	844		3
845	845		4
846	846		5
847	847		6
848	848		7
849	849		8
850	850		9
851	851		10
852	852		11
853	853		12
854	854		13
855	855		14
856	856		15
857	857		16
858	858		17
859	859		18
860	860		19
861	861		20
862	862		21
863	863		22
864	864		23
865	865		24
866	866		1
867	867		2
868	868		3
869	869		4
870	870		5
871	871		6
872	872		7
873	873		8
874	874		9
875	875		10
876	876		11
877	877		12
878	878		13
879	879		14
880	880		15
881	881		16
882	882		17
883	883		18
884	884		19
885	885		20
886	886		21
887	887		22
888	888		23
889	889		24
890	890
891	891		J. The Authority sha ll have the power to promulgate emergency
892	892		rules to enact the provisions of this act the Supplemental Hospital
893	893		Offset Payment Program Act .
894	894		SECTION 3. AMENDATORY 63 O.S. 2011, Section 3241.4, as
895	895		last amended by Section 3, Chapter 345, O.S.L. 2016 (63 O.S. Supp.
896	896		2020, Section 3241.4), is amended to read as follows:
897	897		Section 3241.4. A. There is hereby created in the S tate
898	898		Treasury a revolving fund to be designated the “Supplemental
899	899		Hospital Offset Payment Program Fund ”.
900	900		B. The fund shall be a continuing fund, not subje ct to fiscal
901	901		year limitations, be interest bearing and consisting of:
902	902		1. All monies received by the Oklahoma Health Care Authority
903	903		from hospitals pursu ant to the Supplemental Hospital Offset Payment
904	904		Program Act and otherwise specified or authorized by law ;
905	905		2. Any interest or pena lties levied and collect ed in
906	906		conjunction with the administration of this s ection; and
907	907		3. All interest attributable to invest ment of money in the
908	908		fund.
909	909		C. 1. Notwithstanding any other provisions of law, each fiscal
910	910		quarter the Oklahoma Health Care Aut hority is authorized to
911	911		transfer:
912	912		a. Seven Million Five Hundred Thousand Doll ars
913	913		($7,500,000.00) each fiscal quarter to fund the
914	914
915	915
916	916		Req. No. 1637 Page 13 1
917	917		2
918	918		3
919	919		4
920	920		5
921	921		6
922	922		7
923	923		8
924	924		9
925	925		10
926	926		11
927	927		12
928	928		13
929	929		14
930	930		15
931	931		16
932	932		17
933	933		18
934	934		19
935	935		20
936	936		21
937	937		22
938	938		23
939	939		24
940	940		1
941	941		2
942	942		3
943	943		4
944	944		5
945	945		6
946	946		7
947	947		8
948	948		9
949	949		10
950	950		11
951	951		12
952	952		13
953	953		14
954	954		15
955	955		16
956	956		17
957	957		18
958	958		19
959	959		20
960	960		21
961	961		22
962	962		23
963	963		24
964	964
965	965		nonfederal portion of the existing Medicaid
966	966		population, and
967	967		b. Thirty-three Million Dollars ($33,000,000.00) to fund
968	968		the nonfederal portion of the Medicaid expansion for
969	969		enrollees receiving services on or after July 1, 2021,
970	970		from the Supplemental Hospita l Offset Payment Program
971	971		Fund to the Authority ’s Medical Payments Cash
972	972		Management Improvement Act Programs Disburs ing Fund.
973	973		D. Notice of Assessment.
974	974		1. The Authority shall send a notice of assessment to e ach
975	975		hospital informing the hospital of the assessm ent rate, the
976	976		hospital’s net patient revenue calculation , and the assessment
977	977		amount owed by the hospital for the a pplicable year.
978	978		2. Annual notices of ass essment shall be sent at least thirty
979	979		(30) days before the due date for the first quarterly assessmen t
980	980		payment of each year. Within sixty (60) days of the effective date
981	981		of this act, the Authority shall send notices of the redetermined
982	982		assessment amount including the nonfederal portion of Medicaid
983	983		expansion for the state fiscal year ending June 30, 2022, only.
984	984		3. The first notice of assessment shall be sent within forty -
985	985		five (45) days after receipt by the Authority of notification f rom
986	986		the Centers for Medicare and Medicaid Services that the assessments
987	987		and payments required under the Supplemental Hospital Offset Payment
988	988
989	989
990	990		Req. No. 1637 Page 14 1
991	991		2
992	992		3
993	993		4
994	994		5
995	995		6
996	996		7
997	997		8
998	998		9
999	999		10
1000	1000		11
1001	1001		12
1002	1002		13
1003	1003		14
1004	1004		15
1005	1005		16
1006	1006		17
1007	1007		18
1008	1008		19
1009	1009		20
1010	1010		21
1011	1011		22
1012	1012		23
1013	1013		24
1014	1014		1
1015	1015		2
1016	1016		3
1017	1017		4
1018	1018		5
1019	1019		6
1020	1020		7
1021	1021		8
1022	1022		9
1023	1023		10
1024	1024		11
1025	1025		12
1026	1026		13
1027	1027		14
1028	1028		15
1029	1029		16
1030	1030		17
1031	1031		18
1032	1032		19
1033	1033		20
1034	1034		21
1035	1035		22
1036	1036		23
1037	1037		24
1038	1038
1039	1039		Program Act and, if necessary, the waiver granted under 42 C.F.R.,
1040	1040		Section 433.68 have been approved.
1041	1041		4. The hospital shall have thirty ( 30) days from the date of
1042	1042		its receipt of a notice o f assessment to review and verify the
1043	1043		assessment rate, the hospital’s net patient revenue calculation , and
1044	1044		the assessment amount.
1045	1045		5. A hospital subject to an assessment under the Su pplemental
1046	1046		Hospital Offset Payment Program Act that has not been previousl y
1047	1047		licensed as a hospital in Oklahoma and that commen ces hospital
1048	1048		operations during a year shall pay the required assessment computed
1049	1049		under subsection E of Section 3241.3 of this titl e and shall be
1050	1050		eligible for hospital access payments under subsection E of this
1051	1051		section on the date specified in rules promulg ated by the Authority
1052	1052		after consideration of input and recommendations of the Hospital
1053	1053		Advisory Committee.
1054	1054		E. Quarterly Notice an d Collection.
1055	1055		1. The annual assessment imposed under subsection A of Sect ion
1056	1056		3241.3 of this title shall be due and payable on a quarterly basis.
1057	1057		However, the first installment payment of an assessment imposed by
1058	1058		the Supplemental Hospital Offset Payment P rogram Act shall not be
1059	1059		due and payable until:
1060	1060		a. the Authority issues wri tten notice stating that the
1061	1061		assessment and payment methodologies required under
1062	1062		the Supplemental Hospital Offset Payment Program Act
1063	1063
1064	1064
1065	1065		Req. No. 1637 Page 15 1
1066	1066		2
1067	1067		3
1068	1068		4
1069	1069		5
1070	1070		6
1071	1071		7
1072	1072		8
1073	1073		9
1074	1074		10
1075	1075		11
1076	1076		12
1077	1077		13
1078	1078		14
1079	1079		15
1080	1080		16
1081	1081		17
1082	1082		18
1083	1083		19
1084	1084		20
1085	1085		21
1086	1086		22
1087	1087		23
1088	1088		24
1089	1089		1
1090	1090		2
1091	1091		3
1092	1092		4
1093	1093		5
1094	1094		6
1095	1095		7
1096	1096		8
1097	1097		9
1098	1098		10
1099	1099		11
1100	1100		12
1101	1101		13
1102	1102		14
1103	1103		15
1104	1104		16
1105	1105		17
1106	1106		18
1107	1107		19
1108	1108		20
1109	1109		21
1110	1110		22
1111	1111		23
1112	1112		24
1113	1113
1114	1114		have been approved by the Centers for Medicare a nd
1115	1115		Medicaid Services an d the waiver under 42 C.F.R.,
1116	1116		Section 433.68, if ne cessary, has been granted by the
1117	1117		Centers for Medicare and Medicaid Services,
1118	1118		b. the thirty-day verification period required by
1119	1119		paragraph 4 of subse ction D of this section has
1120	1120		expired, and
1121	1121		c. the Authority issues a notice giving a due date for
1122	1122		the first payment.
1123	1123		2. After the initial installment of an annual assessment has
1124	1124		been paid under this section, each subsequent quarterly installment
1125	1125		payment shall be due and payable by the fiftee nth day of the first
1126	1126		month of the applicable quarter.
1127	1127		3. If a hospital fa ils to timely pay the full amount of a
1128	1128		quarterly assessment, the Authority shall add to the assessment:
1129	1129		a. a penalty assessment equal to five perce nt (5%) of the
1130	1130		quarterly amount not paid on or before the due date,
1131	1131		and
1132	1132		b. on the last day of each quarter af ter the due date
1133	1133		until the assessed amount and the p enalty imposed
1134	1134		under subparagraph a of this paragraph are paid in
1135	1135		full, an additional five -percent penalty assessment on
1136	1136		any unpaid quarterly and unpaid penalty assessment
1137	1137		amounts.
1138	1138
1139	1139
1140	1140		Req. No. 1637 Page 16 1
1141	1141		2
1142	1142		3
1143	1143		4
1144	1144		5
1145	1145		6
1146	1146		7
1147	1147		8
1148	1148		9
1149	1149		10
1150	1150		11
1151	1151		12
1152	1152		13
1153	1153		14
1154	1154		15
1155	1155		16
1156	1156		17
1157	1157		18
1158	1158		19
1159	1159		20
1160	1160		21
1161	1161		22
1162	1162		23
1163	1163		24
1164	1164		1
1165	1165		2
1166	1166		3
1167	1167		4
1168	1168		5
1169	1169		6
1170	1170		7
1171	1171		8
1172	1172		9
1173	1173		10
1174	1174		11
1175	1175		12
1176	1176		13
1177	1177		14
1178	1178		15
1179	1179		16
1180	1180		17
1181	1181		18
1182	1182		19
1183	1183		20
1184	1184		21
1185	1185		22
1186	1186		23
1187	1187		24
1188	1188
1189	1189		4. The quarterly asses sment including applicable penalties and
1190	1190		interest must be paid regardless of any appeals action requested by
1191	1191		the facility. If a provider fails to pay the Authority the
1192	1192		assessment within the time frames no ted on the invoice to the
1193	1193		provider, the assessment, applicable penalty, and interest will be
1194	1194		deducted from the facility’s payment. Any change in payment amount
1195	1195		resulting from an appeals decision wi ll be adjusted in future
1196	1196		payments.
1197	1197		F. Medicaid Hospital Access Payments.
1198	1198		1. To preserve the quality and imp rove access to hospital
1199	1199		services for hospital inpati ent and outpatient services rendered on
1200	1200		or after the effective date of this act August 26, 2011, the
1201	1201		Authority shall make hospital access payments as set forth in this
1202	1202		section.
1203	1203		2. The Authority shall pay all quarterly hospital a ccess
1204	1204		payments within ten (10) calendar day s of the due date for quarterly
1205	1205		assessment payments established in subsection E of this section .
1206	1206		3. The Authority shall calculate the hospital access payment
1207	1207		amount up to but not to excee d the upper payment limit gap for
1208	1208		inpatient and outpatient services.
1209	1209		4. All hospitals shall be eligible for inpatient and outpatient
1210	1210		hospital access payments each year as set forth in this subsecti on
1211	1211		except hospitals described in paragraph 1, 2, 3 or 4 of subsection B
1212	1212		of Section 3241.3 of this title.
1213	1213
1214	1214
1215	1215		Req. No. 1637 Page 17 1
1216	1216		2
1217	1217		3
1218	1218		4
1219	1219		5
1220	1220		6
1221	1221		7
1222	1222		8
1223	1223		9
1224	1224		10
1225	1225		11
1226	1226		12
1227	1227		13
1228	1228		14
1229	1229		15
1230	1230		16
1231	1231		17
1232	1232		18
1233	1233		19
1234	1234		20
1235	1235		21
1236	1236		22
1237	1237		23
1238	1238		24
1239	1239		1
1240	1240		2
1241	1241		3
1242	1242		4
1243	1243		5
1244	1244		6
1245	1245		7
1246	1246		8
1247	1247		9
1248	1248		10
1249	1249		11
1250	1250		12
1251	1251		13
1252	1252		14
1253	1253		15
1254	1254		16
1255	1255		17
1256	1256		18
1257	1257		19
1258	1258		20
1259	1259		21
1260	1260		22
1261	1261		23
1262	1262		24
1263	1263
1264	1264		5. A portion of the hospital access payment amount, not to
1265	1265		exceed the upper payment limit gap for inpatient service s, shall be
1266	1266		designated as the inpat ient hospital access payment pool.
1267	1267		a. In addition to any o ther funds paid to hospit als for
1268	1268		inpatient hospital services to Medi caid patients, each
1269	1269		eligible hospital shall receive inpatient hospital
1270	1270		access payments each yea r equal to the hospital ’s pro
1271	1271		rata share of the inpatient hospital access payment
1272	1272		pool based upon the hospital’s Medicaid payments for
1273	1273		inpatient services divided by the total Medicaid
1274	1274		payments for inpatient services of all eligible.
1275	1275		b. Inpatient hospital a ccess payments shall be made on a
1276	1276		quarterly basis.
1277	1277		6. A portion of the hospital access payme nt amount, not to
1278	1278		exceed the upper payment limit gap for outpatient services, shall be
1279	1279		designated as the outpatient hospital access payment pool.
1280	1280		a. In addition to any other funds paid to hospitals for
1281	1281		outpatient hospital services to Medicaid patients,
1282	1282		each eligible hospital shall receive outpatient
1283	1283		hospital access payment s each year equal to the
1284	1284		hospital’s pro rata share of the outpatient hospital
1285	1285		access payment pool based upon the hospital ’s Medicaid
1286	1286		payments for outpatient services divided by the total
1287	1287
1288	1288
1289	1289		Req. No. 1637 Page 18 1
1290	1290		2
1291	1291		3
1292	1292		4
1293	1293		5
1294	1294		6
1295	1295		7
1296	1296		8
1297	1297		9
1298	1298		10
1299	1299		11
1300	1300		12
1301	1301		13
1302	1302		14
1303	1303		15
1304	1304		16
1305	1305		17
1306	1306		18
1307	1307		19
1308	1308		20
1309	1309		21
1310	1310		22
1311	1311		23
1312	1312		24
1313	1313		1
1314	1314		2
1315	1315		3
1316	1316		4
1317	1317		5
1318	1318		6
1319	1319		7
1320	1320		8
1321	1321		9
1322	1322		10
1323	1323		11
1324	1324		12
1325	1325		13
1326	1326		14
1327	1327		15
1328	1328		16
1329	1329		17
1330	1330		18
1331	1331		19
1332	1332		20
1333	1333		21
1334	1334		22
1335	1335		23
1336	1336		24
1337	1337
1338	1338		Medicaid payments for outp atient services of all
1339	1339		eligible.
1340	1340		b. Outpatient hospital access payments shall be made on a
1341	1341		quarterly basis.
1342	1342		7. A portion of the inpatient hospital access payment pool and
1343	1343		of the outpatient hospital access payment pool shall be des ignated
1344	1344		as the critical access hospital payment pool.
1345	1345		a. In addition to any other funds paid to critical access
1346	1346		hospitals for inpatient and outpatient hospital
1347	1347		services to Medicaid patients, each cr itical access
1348	1348		hospital shall receive hospital access payme nts equal
1349	1349		to the amount by which the payment for these services
1350	1350		was less than one hundred one percent (101%) of the
1351	1351		hospital’s cost of providing these services, as
1352	1352		determined using the Medicare Cost Report.
1353	1353		b. The Authority shall calculate hospital access payments
1354	1354		for critical access hospitals and deduct these
1355	1355		payments from the inpatient hospital access payment
1356	1356		pool and the outpatient hospital access payment pool
1357	1357		before allocating the remaining balan ce in each pool
1358	1358		as provided in subparagraph a of paragraph 5 and
1359	1359		subparagraph a of paragraph 6 of this subsection.
1360	1360		c. Critical access hospital payments shall be made on a
1361	1361		quarterly basis.
1362	1362
1363	1363
1364	1364		Req. No. 1637 Page 19 1
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1412	1412
1413	1413		8. A hospital access payment sha ll not be used to offset any
1414	1414		other payment by Medicaid for hospital inpatient or outpatient
1415	1415		services to Medicaid benef iciaries, including without limitation any
1416	1416		fee-for-service, per diem, private hospital inpatient adjustment , or
1417	1417		cost-settlement payment.
1418	1418		9. If the Centers for Medicare and Medicaid Services finds that
1419	1419		the Authority has made paymen ts to hospitals that exce ed the upper
1420	1420		payment limits determined in a ccordance with 42 C.F.R. 447.272 and
1421	1421		42 C.F.R. 447.321, hospitals shall refund to the Authority a share
1422	1422		of the recouped federal fu nds that is proportionate to the
1423	1423		hospitals’ positive contribution to the upper paym ent limit.
1424	1424		G. All monies accruing to the c redit of the Supplemental
1425	1425		Hospital Offset Payment Program Fund are hereby appropriated and
1426	1426		shall be budgeted and expended by the A uthority after consideration
1427	1427		of the input and recommendati on of the Hospital Adviso ry Committee.
1428	1428		1. Monies in the Supplementa l Hospital Offset Payment Program
1429	1429		Fund shall be used only for:
1430	1430		a. transfers to the Medical Paym ents Cash Management
1431	1431		Improvement Act Programs Disbursing Fund (Fund 340)
1432	1432		for the state share of supplemental payments for
1433	1433		Medicaid and SCHIP inpatient and outpat ient services
1434	1434		to hospitals that participate in the assessment,
1435	1435		b. transfers to the Medical Paym ents Cash Management
1436	1436		Improvement Act Programs Disbursing Fund (Fund 340)
1437	1437
1438	1438
1439	1439		Req. No. 1637 Page 20 1
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1487	1487
1488	1488		for the state share of supplemental payments for
1489	1489		Critical Access Hospitals,
1490	1490		c. transfers to the Administrative Revolving Fund (Fund
1491	1491		200) for the state share of payment of administrati ve
1492	1492		expenses incurred by the Authori ty or its agents and
1493	1493		employees in performing the activitie s authorized by
1494	1494		the Supplemental Hospital Offset Payment Program Act
1495	1495		but not more than Two Hundred Thousand Dollars
1496	1496		($200,000.00) each year,
1497	1497		d. transfers to the Medical Payments Cash Management
1498	1498		Improvement Act Programs Disbursing Fund (Fund 340) in
1499	1499		an amount not to exceed Seven Mi llion Five Hundred
1500	1500		Thousand Dollars ($7,500 ,000.00) each fiscal quarter ,
1501	1501		and to fund the nonfederal portion of the existing
1502	1502		Medicaid population,
1503	1503		e. transfers to the Medical Payments Cash Management
1504	1504		Improvement Act Programs Disbursi ng Fund (Fund 340) in
1505	1505		an amount not to exceed Thirty -three Million Dollars
1506	1506		($33,000,000.00) each fiscal quarter to fund the
1507	1507		nonfederal portion of Medicaid expansion for enrollees
1508	1508		receiving services on or after July 1, 2021, and
1509	1509		f. the reimbursement of moni es collected by the Autho rity
1510	1510		from hospitals through error or mistak e in performing
1511	1511
1512	1512
1513	1513		Req. No. 1637 Page 21 1
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1560	1560		24
1561	1561
1562	1562		the activities authorized under the Supplemental
1563	1563		Hospital Offset Payment Program Act.
1564	1564		2. The Authority shall pay from the Supplemental Hospital
1565	1565		Offset Payment Program Fund quarterly installment pa yments to
1566	1566		hospitals of amounts available fo r supplemental inpatient and
1567	1567		outpatient payments, and supplemental payments for Critical Access
1568	1568		Hospitals.
1569	1569		3. Except for the tran sfers described in subsection C of this
1570	1570		section, monies in the Supplemental Hospita l Offset Payment Program
1571	1571		Fund shall not be used to replace other general revenues
1572	1572		appropriated and funded by the Legislature or other revenues used to
1573	1573		support Medicaid.
1574	1574		4. The Supplemental Hospital Offset Payment Program Fund and
1575	1575		the program specified in the Supplemental Hospital Offset Payment
1576	1576		Program Act are exempt from budgetary reductions or eliminations
1577	1577		caused by the lack of general revenue funds or other funds
1578	1578		designated for or appropriated to the Authority.
1579	1579		5. No hospital shall be guaranteed, expre ssly or otherwise,
1580	1580		that any additional cost s reimbursed to the facility will equal or
1581	1581		exceed the amount of the supplemental hospital offset payment
1582	1582		program fee paid by the h ospital.
1583	1583		H. After considering input and recommendations f rom the
1584	1584		Hospital Advisory Committee, the Authority shall promulgate
1585	1585		regulations that:
1586	1586
1587	1587
1588	1588		Req. No. 1637 Page 22 1
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1636	1636
1637	1637		1. Allow for an appeal of the annual assessment of the
1638	1638		Supplemental Hospital Offset Payment Program payable und er this act
1639	1639		the Supplemental Hospital Offset Payment Progr am Act; and
1640	1640		2. Allow for an appeal of an assessment of any fees or
1641	1641		penalties determined.
1642	1642		SECTION 4. This act shall become effective July 1, 2021.
1643	1643		SECTION 5. It being immediately necessary for the preservation
1644	1644		of the public peace, health or safety, an emergency is hereby
1645	1645		declared to exist, by reason whereof this act shall take effect and
1646	1646		be in full force from and after its passage and approval.
1647	1647
1648	1648		58-1-1637 WR 1/21/2021 4:18:25 PM