Second Substitute S.B. 166

Senator Lyle W. Hillyard proposes the following substitute bill:

1 HOSPITAL ASSESSMENT AMENDMENTS
2 2013 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: Lyle W. Hillyard
5 House Sponsor: Brad R. Wilson
6
7 LONG TITLE
8 General Description:
9 This bill amends the Hospital Provider Assessment Act.
10 Highlighted Provisions:
11 This bill:
12 . defines terms;
13 . modifies the calculation of the annual assessment;
14 . modifies the manner in which a hospital's discharge data is derived;
15 . requires the Division of Health Care Financing of the Department of Health to
16 incorporate $154 million into the accountable care organization rate structure;
17 . grants rulemaking authority to the Department of Health over the penalties and
18 interest assessed under the Act;
19 . repeals the assessment on July 1, 2016; and
20 . makes technical changes.
21 Money Appropriated in this Bill:
22 This bill appropriates in fiscal year 2013:
23 . to Department of Health - Medicaid Mandatory Services:
24 . from Hospital Provider Assessment Special Revenue Fund, $6,300,600.
25 This bill appropriates in fiscal year 2014:

26 . to Department of Health - Medicaid Mandatory Services, as an ongoing
27 appropriation:
28 . from Hospital Provider Assessment Special Revenue Fund, $5,500,000.
29 Other Special Clauses:
30 If approved by two-thirds of all the members elected to each house, this bill takes effect
31 on April 1, 2013.
32 Utah Code Sections Affected:
33 AMENDS:
34 26-36a-103, as enacted by Laws of Utah 2010, Chapter 179
35 26-36a-202, as enacted by Laws of Utah 2010, Chapter 179
36 26-36a-203, as last amended by Laws of Utah 2012, Chapter 348
37 26-36a-204, as enacted by Laws of Utah 2010, Chapter 179
38 26-36a-205, as last amended by Laws of Utah 2012, Chapter 348
39 26-36a-206, as enacted by Laws of Utah 2010, Chapter 179
40 26-36a-207, as enacted by Laws of Utah 2010, Chapter 179
41 26-36a-208, as last amended by Laws of Utah 2011, Chapter 118
42 63I-1-226, as last amended by Laws of Utah 2012, Chapters 171 and 328
43 REPEALS:
44 26-36a-209, as last amended by Laws of Utah 2012, Chapter 348
45
46 Be it enacted by the Legislature of the state of Utah:
47 Section 1. Section 26-36a-103 is amended to read:
48 26-36a-103. Definitions.
49 As used in this chapter:
50 (1) "Assessment" means the Medicaid hospital provider assessment established by this
51 chapter.
52 (2) "Discharges" means the number of total hospital discharges reported on worksheet
53 S-3 Part I, column 15, lines 12, 14, and 14.01 of the 2552-96 Medicare Cost Report or on
54 Worksheet S-3 Part I, column 15, lines 14, 16, and 17 of the 2552-10 Medicare Cost Report for
55 the applicable assessment year.
56 (3) "Division" means the Division of Health Care Financing of the department.

57 (4) "Hospital":
58 (a) means a privately owned:
59 (i) general acute hospital operating in the state as defined in Section 26-21-2 ; and
60 (ii) specialty hospital operating in the state, which shall include a privately owned
61 hospital whose inpatient admissions are predominantly:
62 (A) rehabilitation;
63 (B) psychiatric;
64 (C) chemical dependency; or
65 (D) long-term acute care services; and
66 (b) does not include:
67 (i) a residential care or treatment facility as defined in Section 62A-2-101 ;
68 (ii) a hospital owned by the federal government, including the Veterans Administration
69 Hospital; or
70 [(iii) a Shriners hospital that does not charge for its services; or]
71 [(iv)] (iii) a hospital that is owned by the state government, a state agency, or a political
72 subdivision of the state, including:
73 (A) a state-owned teaching hospital; and
74 (B) the Utah State Hospital.
75 [(5) "Low volume select access hospital" means a hospital that furnished inpatient
76 hospital services during fiscal year 2008 to less than 300 Medicaid cases under the select
77 access program.]
78 [(6)] (5) "Medicare cost report" means CMS-2552-96 or CMS-2552-10, the cost report
79 for electronic filing of hospitals.
80 [(7) "Select access cases" means the number of hospital inpatient cases related to
81 individuals enrolled in the state's select access program for 2008.]
82 [(8)] (6) "State plan amendment" means a change or update to the state Medicaid plan.
83 [(9) "Upper payment limit" means the maximum ceiling imposed by federal regulation
84 on a hospital Medicaid reimbursement for inpatient services under 42 C.F.R. Sec. 447.272.]
85 [(10) "Upper payment limit gap":]
86 [(a) means the difference between:]
87 [(i) the inpatient hospital upper payment limit for hospitals; and]

88 [(ii) Medicaid payments for inpatient hospital services not financed using hospital
89 assessments paid by all hospitals;]
90 [(b) shall be calculated separately for hospital inpatient services; and]
91 [(c) does not include Medicaid disproportionate share payments as part of the
92 calculation for the upper payment limit gap.]
93 (7) "Accountable care organization" means a managed care organization, as defined in
94 42 C.F.R. Sec. 438, that contracts with the department under the provisions of Section
95 26-18-405 .
96 Section 2. Section 26-36a-202 is amended to read:
97 26-36a-202. Assessment, collection, and payment of hospital provider assessment.
98 (1) A uniform, broad based, assessment is imposed on each hospital as defined in
99 Subsection 26-36a-103 (4)(a):
100 (a) in the amount designated in Section 26-36a-203 ; and
101 (b) in accordance with Section 26-36a-204 [, beginning when the division has obtained
102 approval from the Center for Medicare and Medicaid Services and provided notice of the
103 assessment to the hospital].
104 (2) (a) The assessment imposed by this chapter is due and payable on a quarterly basis
105 in accordance with Section 26-36a-204 .
106 (b) The collecting agent for this assessment is the department which is vested with the
107 administration and enforcement of this chapter, including the right to adopt administrative rules
108 in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, necessary to:
109 (i) implement and enforce the provisions of this act; and
110 (ii) audit records of a facility:
111 (A) that is subject to the assessment imposed by this chapter; and
112 (B) does not file a Medicare cost report.
113 (c) The department shall forward proceeds from the assessment imposed by this
114 chapter to the state treasurer for deposit in the restricted special revenue fund as specified in
115 Section 26-36a-207 .
116 (3) The department may, by rule, extend the time for paying the assessment.
117 Section 3. Section 26-36a-203 is amended to read:
118 26-36a-203. Calculation of assessment.

119 [(1) The division shall calculate the inpatient upper payment limit gap for hospitals for
120 each state fiscal year.]
121 [(2)] (1) (a) An annual assessment is payable on a quarterly basis for each hospital in
122 an amount calculated at a uniform assessment rate for each hospital discharge, in accordance
123 with this section.
124 (b) The uniform assessment rate shall be determined using the total number of hospital
125 discharges for assessed hospitals divided into the total non-federal portion [of the upper
126 payment limit gap] in an amount consistent with Section 26-36a-205 that is needed to support
127 capitated rates for accountable care organizations for purposes of hospital services provided to
128 Medicaid enrollees.
129 (c) Any quarterly changes to the uniform assessment rate shall be applied uniformly to
130 all assessed hospitals.
131 (d) [(i) Except as provided in Subsection (2)(d)(ii), the] The annual uniform
132 assessment rate may not generate more than [the non-federal share of the annual upper payment
133 limit gap for the fiscal year.]:
134 [(ii) For fiscal years 2011-12 and 2012-13 the department may generate an additional
135 amount from the assessment imposed under Subsection (2)(d)(i) in the amount of:]
136 [(A)] (i) $1,000,000 to offset Medicaid mandatory expenditures; and
137 [(B)] (ii) the non-federal share to seed amounts needed to support capitated rates for
138 accountable care organizations as provided for in Subsection (1)(b).
139 [(3) (a) For state fiscal years 2010 and 2011, discharges shall be determined using the
140 data from each hospital's Medicare Cost Report contained in the Centers for Medicare and
141 Medicaid Services' Healthcare Cost Report Information System file as of April 1, 2009, for
142 hospital fiscal years ending between October 1, 2007, and September 30, 2008.]
143 [(b) If a hospital's fiscal year Medicare Cost Report is not contained in the Centers for
144 Medicare and Medicaid Services' Healthcare Cost Report Information System file dated March
145 31, 2009:]
146 [(i) the hospital shall submit to the division a copy of the hospital's Medicare Cost
147 Report with a fiscal year end between October 1, 2007, and September 30, 2008; and]
148 [(ii) the division shall determine the hospital's discharges from the information
149 submitted under Subsection (3)(b)(i).]

150 [(c) If a hospital started operations after the due date for a 2007 Medicare Cost Report:]
151 [(i) the hospital shall submit to the division a copy of the hospital's most recent
152 complete year Medicare Cost Report; and]
153 [(ii) the division shall determine the hospital's discharges from the information
154 submitted under Subsection (3)(c)(i).]
155 [(d) If a hospital is not certified by the Medicare program and is not required to file a
156 Medicare Cost Report:]
157 [(i) the hospital shall submit to the division its applicable fiscal year discharges with
158 supporting documentation;]
159 [(ii) the division shall determine the hospital's discharges from the information
160 submitted under Subsection (3)(d)(i); and]
161 [(iii) the failure to submit discharge information under Subsections (3)(d)(i) and (ii)
162 shall result in an audit of the hospital's records by the department and the imposition of a
163 penalty equal to 5% of the calculated assessment.]
164 [(4)] (2) (a) For each state fiscal year [2012 and 2013], discharges shall be determined
165 using the data from each hospital's Medicare Cost Report contained in the Centers for Medicare
166 and Medicaid Services' Healthcare Cost Report Information System file [as of]. The hospital's
167 discharge data will be derived as follows:
168 [(i) for state fiscal year 2012, September 30, 2010, for hospital fiscal years ending
169 between October 1, 2008, and September 30, 2009; and]
170 [(ii) for state fiscal year 2013, September 30, 2011, for hospital fiscal years ending
171 between October 1, 2009, and September 30, 2010.]
172 (i) for state fiscal year 2013, the hospital's cost report data for the hospital's fiscal year
173 ending between July 1, 2009, and June 30, 2010;
174 (ii) for state fiscal year 2014, the hospital's cost report data for the hospital's fiscal year
175 ending between July 1, 2010, and June 30, 2011;
176 (iii) for state fiscal year 2015, the hospital's cost report data for the hospital's fiscal year
177 ending between July 1, 2011, and June 30, 2012; and
178 (iv) for state fiscal year 2016, the hospital's cost report data for the hospital's fiscal year
179 ending between July 1, 2012, and June 30, 2013.
180 (b) If a hospital's fiscal year Medicare Cost Report is not contained in the Centers for

181 Medicare and Medicaid Services' Healthcare Cost Report Information System file:
182 (i) the hospital shall submit to the division a copy of the hospital's Medicare Cost
183 Report applicable to the assessment year; and
184 (ii) the division shall determine the hospital's discharges.
185 (c) If a hospital is not certified by the Medicare program and is not required to file a
186 Medicare Cost Report:
187 (i) the hospital shall submit to the division its applicable fiscal year discharges with
188 supporting documentation;
189 (ii) the division shall determine the hospital's discharges from the information
190 submitted under Subsection [(4)] (2)(c)(i); and
191 (iii) the failure to submit discharge information shall result in an audit of the hospital's
192 records and a penalty equal to 5% of the calculated assessment.
193 [(5)] (3) Except as provided in Subsection [(6)] (4), if a hospital is owned by an
194 organization that owns more than one hospital in the state:
195 (a) the assessment for each hospital shall be separately calculated by the department;
196 and
197 (b) each separate hospital shall pay the assessment imposed by this chapter.
198 [(6)] (4) Notwithstanding the requirement of Subsection [(5)] (3), if multiple hospitals
199 use the same Medicaid provider number:
200 (a) the department shall calculate the assessment in the aggregate for the hospitals
201 using the same Medicaid provider number; and
202 (b) the hospitals may pay the assessment in the aggregate.
203 [(7) (a) The assessment formula imposed by this section, and the inpatient access
204 payments under Section 26-36a-205 , shall be adjusted in accordance with Subsection (7)(b) if a
205 hospital, for any reason, does not meet the definition of a hospital subject to the assessment
206 under Section 26-36a-103 for the entire fiscal year.]
207 [(b) The department shall adjust the assessment payable to the department under this
208 chapter for a hospital that is not subject to the assessment for an entire fiscal year by
209 multiplying the annual assessment calculated under Subsection (3) or (4) by a fraction, the
210 numerator of which is the number of days during the year that the hospital operated, and the
211 denominator of which is 365.]

212 [(c) A hospital described in Subsection (7)(a):]
213 [(i) that is ceasing to operate in the state, shall pay any assessment owed to the
214 department immediately upon ceasing to operate in the state; and]
215 [(ii) shall receive Medicaid inpatient hospital access payments under Section
216 26-36a-205 for the state fiscal year, adjusted using the same formula described in Subsection
217 (7)(b).]
218 [(8) A hospital that is subject to payment of the assessment at the beginning of a state
219 fiscal year, but during the state fiscal year experiences a change in status so that it no longer
220 falls under the definition of a hospital subject to the assessment in Section 26-36a-204 , shall:]
221 [(a) not be required to pay the hospital assessment beginning on the date established by
222 the department by administrative rule; and]
223 [(b) not be entitled to Medicaid inpatient hospital access payments under Section
224 26-36a-205 on the date established by the department by administrative rule.]
225 Section 4. Section 26-36a-204 is amended to read:
226 26-36a-204. Quarterly notice -- Collection.
227 [(1) (a) The division shall submit to the Center for Medicare and Medicaid Services:]
228 [(i) the payment methodology for the assessment imposed by this chapter; and]
229 [(ii) if necessary, a waiver under 42 C.F.R. Sec. 433.68.]
230 [(b) When the division receives notice of approval of the assessment and access
231 payments under this chapter from the Center for Medicare and Medicaid Services, the division
232 shall, within 45 days of the notice from the Center for Medicare and Medicaid Services,
233 provide a hospital that is subject to the assessment notice of:]
234 [(i) the approval of the assessment methodology from the Center for Medicare and
235 Medicaid Services;]
236 [(ii) the assessment rate;]
237 [(iii) the hospital's discharges subject to the assessment; and]
238 [(iv) the assessment amount owed by the hospital for the applicable fiscal year.]
239 [(2) The initial quarterly installments of the assessment imposed by this chapter are due
240 and payable if:]
241 [(a) the division has provided notice of the annual assessment under Subsection (1);
242 and]

243 [(b) the division has made all the quarterly installments of the Medicaid inpatient
244 hospital access payments that were otherwise due under Section 26-36a-205 , consistent with
245 the effective date of the approved state plan amendment.]
246 [(3) After the initial quarterly installments of the Medicaid inpatient hospital access
247 payments are made by the division, a hospital shall pay to the division the initial quarterly
248 assessments imposed by this chapter within 10 business days. Subsequent quarterly]
249 Quarterly assessments imposed by this chapter shall be paid to the division within [10]
250 15 business days after the [hospital receives its Medicaid inpatient hospital access payment due
251 for the applicable quarter under Section 26-36a-205 ] original invoice date that appears on the
252 invoice issued by the division.
253 Section 5. Section 26-36a-205 is amended to read:
254 26-36a-205. Medicaid hospital adjustment under accountable care organization
255 rates.
256 [(1)] To preserve and improve access to [hospitals] hospital services, the division shall
257 [make Medicaid inpatient hospital access payments to hospitals in accordance with this section,
258 Section 26-36a-204 , and Subsection 26-36a-203 (7)], for accountable care organization rates
259 effective on or after April 1, 2013, incorporate an annualized amount equal to $154 million into
260 the accountable care organization rate structure calculation consistent with the certified
261 actuarial rate range.
262 [(2) (a) The Medicaid inpatient hospital access payment amount to a particular hospital
263 shall be established by the division.]
264 [(b) The aggregate of all hospital's Medicaid inpatient hospital access payments shall
265 be:]
266 [(i) equal to the upper payment limit gap for inpatient services for all hospitals; and]
267 [(ii) designated as the Medicaid inpatient hospital access payment pool.]
268 [(3) In addition to any other funds paid to hospitals during fiscal years 2010 and 2011
269 for inpatient hospital services to Medicaid patients, a Medicaid hospital inpatient access
270 payment shall be made:]
271 [(a) for state fiscal years 2010 and 2011:]
272 [(i) the amount of $825 per Medicaid fee for service day, to a hospital that:]
273 [(A) was not a specialty hospital; and]

274 [(B) had less than 300 select access inpatient cases during state fiscal year 2008; and]
275 [(ii) inpatient hospital access payments as determined by dividing the remaining
276 spending room available in the current year UPL, after offsetting the payments authorized
277 under Subsection (3)(a)(i) by the total 2008 Medicaid inpatient hospital payments, multiplied
278 by the hospital's Medicaid inpatient payments for state fiscal year 2008, exclusive of medical
279 education and Medicaid disproportionate share payments;]
280 [(b) for state fiscal year 2012:]
281 [(i) the amount of $825 per Medicaid fee for service day, to a hospital that:]
282 [(A) is not a specialty hospital; and]
283 [(B) has less than 300 select access inpatient cases during the state fiscal year 2008;
284 and]
285 [(ii) inpatient hospital access payments as determined by dividing the remaining
286 spending room available in the current year upper payment limit, after offsetting the payments
287 authorized under Subsection (3)(a)(i), by the total 2009 Medicaid inpatient hospital payments,
288 multiplied by the hospital's Medicaid inpatient payments for state fiscal year 2009; and]
289 [(c) for state fiscal year 2013:]
290 [(i) the amount of $825 per Medicaid fee for service day, to a hospital that:]
291 [(A) is not a specialty hospital; and]
292 [(B) has less than 300 select access inpatient cases during the state fiscal year 2008;
293 and]
294 [(ii) inpatient hospital access payments as determined by dividing the remaining
295 spending room available in the current year upper payment limit, after offsetting the payments
296 authorized under Subsection (3)(a)(i), by the total 2010 Medicaid inpatient hospital payments,
297 multiplied by the hospital's Medicaid inpatient payments for state fiscal year 2010.]
298 [(4) Medicaid inpatient hospital access payments shall be made:]
299 [(a) on a quarterly basis for inpatient hospital services furnished to Medicaid
300 individuals during each quarter; and]
301 [(b) within 15 days after the end of each quarter.]
302 [(5) A hospital's Medicaid inpatient access payment shall not be used to offset any
303 other payment by Medicaid for hospital inpatient or outpatient services to Medicaid
304 beneficiaries, including a:]

305 [(a) fee-for-service payment;]
306 [(b) per diem payment;]
307 [(c) hospital inpatient adjustment; or]
308 [(d) cost settlement payment.]
309 [(6) When the division obtains approval from the Centers for Medicare and Medicaid
310 Services for the Medicaid Waiver - Accountable Care Organizations, and has determined the
311 capitated rate for the accountable care organizations, the department shall consult with the Utah
312 Hospitals Association to develop an alternative supplemental payment methodology that can be
313 approved by the Centers for Medicare and Medicaid Services.]
314 [(7) A hospital shall not be guaranteed that the hospital's Medicaid inpatient hospital
315 access payments will equal or exceed the amount of the hospital's assessment.]
316 Section 6. Section 26-36a-206 is amended to read:
317 26-36a-206. Penalties and interest.
318 (1) A facility that fails to pay any assessment or file a return as required under this
319 chapter, within the time required by this chapter, shall pay, in addition to the assessment,
320 penalties and interest established by the department.
321 (2) (a) Consistent with Subsection (2)(b), the department shall adopt rules in
322 accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, which establish
323 reasonable penalties and interest for the violations described in Subsection (1).
324 (b) If a hospital fails to timely pay the full amount of a quarterly assessment, the
325 department shall add to the assessment:
326 (i) a penalty equal to 5% of the quarterly amount not paid on or before the due date;
327 and
328 (ii) on the last day of each quarter after the due date until the assessed amount and the
329 penalty imposed under Subsection (2)(b)(i) are paid in full, an additional 5% penalty on:
330 (A) any unpaid quarterly assessment; and
331 (B) any unpaid penalty assessment.
332 [(c) The division may waive, reduce, or compromise the penalties and interest provided
333 for in this section in the same manner as provided in Subsection 59-1-401 (8).]
334 (c) Upon making a record of its actions, and upon reasonable cause shown, the division
335 may waive, reduce, or compromise any of the penalties imposed under this part.

336 Section 7. Section 26-36a-207 is amended to read:
337 26-36a-207. Restricted Special Revenue Fund -- Creation -- Deposits.
338 (1) There is created a restricted special revenue fund known as the "Hospital Provider
339 Assessment Special Revenue Fund."
340 (2) The fund shall consist of:
341 (a) the assessments collected by the department under this chapter;
342 (b) any interest and penalties levied with the administration of this chapter; and
343 (c) any other funds received as donations for the restricted fund and appropriations
344 from other sources.
345 (3) Money in the fund shall be used:
346 [(a) to make inpatient hospital access payments under Section 26-36a-205 ; and]
347 (a) to support capitated rates consistent with Subsection 26-36a-203 (1)(d) for
348 accountable care organizations; and
349 (b) to reimburse money collected by the division from a hospital through a mistake
350 made under this chapter.
351 Section 8. Section 26-36a-208 is amended to read:
352 26-36a-208. Repeal of assessment.
353 (1) The repeal of the assessment imposed by this chapter shall occur upon the
354 certification by the executive director of the department that the sooner of the following has
355 occurred:
356 (a) the effective date of any action by Congress that would disqualify the assessment
357 imposed by this chapter from counting towards state Medicaid funds available to be used to
358 determine the federal financial participation;
359 (b) the effective date of any decision, enactment, or other determination by the
360 Legislature or by any court, officer, department, or agency of the state, or of the federal
361 government that has the effect of:
362 (i) disqualifying the assessment from counting towards state Medicaid funds available
363 to be used to determine federal financial participation for Medicaid matching funds; or
364 (ii) creating for any reason a failure of the state to use the assessments for the Medicaid
365 program as described in this chapter; [and]
366 (c) the effective date of:

367 (i) an appropriation for any state fiscal year from the General Fund for hospital
368 payments under the state Medicaid program that is less than the amount appropriated for state
369 fiscal year 2012;
370 (ii) the annual revenues of the state General Fund budget return to the level that was
371 appropriated for fiscal year 2008;
372 (iii) approval of any change in the state Medicaid plan that requires a greater
373 percentage of Medicaid patients to enroll in Medicaid managed care plans than what is
374 required:
375 (A) to implement accountable care organizations in the state plan; and
376 (B) by other managed care enrollment requirements in effect on or before January 1,
377 2012;
378 (iv) a division change in rules that reduces any of the following below July 1, 2011
379 payments:
380 (A) aggregate hospital inpatient payments;
381 (B) adjustment payment rates; or
382 (C) any cost settlement protocol; or
383 (v) a division change in rules that reduces the aggregate outpatient payments below
384 July 1, 2011 payments[.]; and
385 (d) the sunset of this chapter in accordance with Section 63I-1-226 .
386 (2) If the assessment is repealed under Subsection (1), money in the fund that was
387 derived from assessments imposed by this chapter, before the determination made under
388 Subsection (1), shall be disbursed under Section 26-36a-205 to the extent federal matching is
389 not reduced due to the impermissibility of the assessments. Any funds remaining in the special
390 revenue fund shall be refunded to the hospitals in proportion to the amount paid by each
391 hospital.
392 Section 9. Section 63I-1-226 is amended to read:
393 63I-1-226. Repeal dates, Title 26.
394 (1) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
395 1, 2015.
396 (2) Section 26-18-12 , Expansion of 340B drug pricing programs, is repealed July 1,
397 2013.

398 (3) Section 26-21-23 , Licensing of non-Medicaid nursing care facility beds, is repealed
399 July 1, 2016.
400 (4) Section 26-21-211 is repealed July 1, 2013.
401 (5) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1, 2014.
402 (6) Title 26, Chapter 36a, Hospital Provider Assessment Act, is repealed July 1, [2013]
403 2016.
404 (7) Section 26-38-2.5 is repealed July 1, 2017.
405 (8) Section 26-38-2.6 is repealed July 1, 2017.
406 Section 10. Repealer.
407 This bill repeals:
408 Section 26-36a-209, State plan amendment.
409 Section 11. Appropriation.
410 Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures Act, for
411 the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following sums of money
412 are appropriated from resources not otherwise appropriated, or reduced from amounts
413 previously appropriated, out of the funds or accounts indicated. These sums of money are in
414 addition to any amounts previously appropriated for fiscal year 2013.
415 To Department of Health - Medicaid Mandatory Services
416 From Hospital Provider Assessment Special Revenue Fund

$6,300,600

417 Schedule of Programs:
418 Department of Health - Medicaid Mandatory Services $6,300,600
419 Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures Act, for
420 the fiscal year beginning July 1, 2013, and ending June 30, 2014, the following sums of money
421 are appropriated from resources not otherwise appropriated, or reduced from amounts
422 previously appropriated, out of the funds or accounts indicated. These sums of money are in
423 addition to any amounts previously appropriated for fiscal year 2014.
424 To Department of Health - Medicaid Mandatory Services
425 From Hospital Provider Assessment Special Revenue Fund

$5,500,000

426 Schedule of Programs:
427 Department of Health - Medicaid Mandatory Services $5,500,000
428 Section 12. Effective date.

429 If approved by two-thirds of all the members elected to each house, this bill takes effect
430 on April 1, 2013.

[Bill Documents]