1     
MEDICAID EXPANSION PROGRAM REVISIONS

2     
2019 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Raymond P. Ward

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill amends provisions relating to Medicaid expansion.
10     Highlighted Provisions:
11          This bill:
12          ▸     removes the requirement that reimbursements for Medicaid providers increase
13     annually at a certain rate;
14          ▸     makes changes to the Inpatient Hospital Assessment and the Medicaid Expansion
15     Hospital Assessment;
16          ▸     permits funds from the Medicaid Expansion Fund to be used for the Medicaid
17     expansion to the full optional population under the Affordable Care Act;
18          ▸     amends provisions relating to the state sales tax; and
19          ▸     makes technical changes.
20     Money Appropriated in this Bill:
21          None
22     Other Special Clauses:
23          None
24     Utah Code Sections Affected:
25     AMENDS:
26          26-18-3.9, as enacted by Statewide Initiative -- Proposition 3, Nov. 6, 2018
27          26-36b-103, as last amended by Laws of Utah 2018, Chapters 285, 316, 384, and 468

28          26-36b-201, as last amended by Laws of Utah 2018, Chapters 384 and 468
29          26-36b-204, as last amended by Laws of Utah 2018, Chapters 384 and 468
30          26-36b-208, as last amended by Laws of Utah 2018, Chapters 384 and 468
31          26-36b-209, as last amended by Laws of Utah 2018, Chapters 384 and 468
32          26-36c-102, as enacted by Laws of Utah 2018, Chapter 468
33          26-36c-201, as enacted by Laws of Utah 2018, Chapter 468
34          26-36c-203, as enacted by Laws of Utah 2018, Chapter 468
35          26-36c-204, as enacted by Laws of Utah 2018, Chapter 468
36          26-36c-206, as enacted by Laws of Utah 2018, Chapter 468
37          26-36c-208, as enacted by Laws of Utah 2018, Chapter 468
38          26-36c-209, as enacted by Laws of Utah 2018, Chapter 468
39          59-12-103, as amended by Statewide Initiative -- Proposition 3, Nov. 6, 2018
40     

41     Be it enacted by the Legislature of the state of Utah:
42          Section 1. Section 26-18-3.9 is amended to read:
43          26-18-3.9. Protecting and expanding the Medicaid program and Utah Children's
44     Health Insurance Program.
45          (1) Findings and purpose.
46          (a) Findings. The People of the State of Utah find that:
47          (i) Adequate medical care is crucial to the health and welfare of the residents of Utah;
48          (ii) It is essential that all Utahns have access to medical care, including preventive care,
49     emergency services, and hospital care;
50          (iii) Utah's Medicaid program and CHIP provide care to Utahns who are unable to
51     afford private health insurance and are not eligible for other health insurance. Medicaid and
52     CHIP are vital parts of the Utah health care system and it is essential that they continue to
53     provide health care for the most vulnerable citizens of our state;
54          (iv) However, over 250,000 Utahns remain uninsured and do not have adequate access
55     to health care. Over 100,000 of the uninsured would be covered by Medicaid if the State of
56     Utah were to expand eligibility to all individuals who are in the federal optional Medicaid
57     expansion population, as defined as of January 1, 2017;
58          (v) When people don't have access to care they are far more likely to develop chronic

59     conditions, like diabetes or asthma, that often require expensive treatment for a patient's entire
60     life, resulting in unnecessary suffering and driving up the cost of healthcare;
61          (vi) When medical providers provide care for which patients are not insured, the cost
62     of that care is passed on to others, thus increasing the cost of medical care for all Utah
63     residents;
64          (vii) It is critical to the survival of the Medicaid program that it remain adequately
65     funded so that it can provide needed medical services to those who otherwise would not have
66     access to care, and can compensate the providers who serve participants. The compensation to
67     providers must be adequate to encourage providers to continue to treat patients on Medicaid;
68     and
69          (viii) From moral, health and fiscal perspectives, protecting and expanding the
70     Medicaid program in Utah is essential to maintaining the quality of life in our state.
71          (b) Purpose. The purpose of this measure is to preserve and strengthen medical care in
72     the State of Utah by the following:
73          (i) Protecting Medicaid and CHIP so that they can continue to provide medical care to
74     those who are currently eligible[,]; and
75          (ii) Expanding Medicaid eligibility to adults who are in the federal optional Medicaid
76     expansion population, as defined as of January 1, 2017.
77          (2) Eligibility. As set forth in Subsections (2)(a) through (2)(d), eligibility criteria for
78     the Medicaid program shall be maintained as they existed on January 1, 2017 and also
79     expanded to cover additional low-income individuals.
80          (a) The standards, methodologies, and procedures for determining eligibility for the
81     Medicaid program and CHIP shall be no more restrictive than the eligibility standards,
82     methodologies, and procedures, respectively, that were in effect on January 1, 2017.
83          (b) Notwithstanding Sections 26-18-18 and 63J-5-204, beginning April 1, 2019,
84     eligibility for the Medicaid program shall be expanded to include all persons in the optional
85     Medicaid expansion population under the Patient Protection and Affordable Care Act, Pub. L.
86     No. 111-148 and the Health Care Education Reconciliation Act of 2010, Pub. L. No. 111-152,
87     and related federal regulations and guidance, as those statutory and regulatory provisions and
88     guidance existed on January 1, 2017.
89          (c) There shall be no caps on enrollment beyond those in place as of January 1, 2017.

90          (d) The eligibility criteria in Subsection (2)(b) shall be construed to include all
91     individuals eligible for the health coverage improvement program under Section 26-18-411.
92          (3) Care and Services. For each enrollment group or category in the Medicaid program
93     and CHIP, the categories of care or services and the types of benefits provided in each category
94     shall be no more restrictive than the categories of care or services and the types of benefits
95     provided on January 1, 2017. Such services and benefits shall be provided in sufficient
96     amount, duration, and scope to achieve their purposes.
97          (4) Out-of-Pocket Costs. Any premium, beneficiary enrollment fee, and cost sharing
98     requirement applicable to care and services described in this section, including but not limited
99     to co-pay, co-insurance, deductible, or out-of-pocket maximum, shall be no greater than those
100     in effect on January 1, 2017.
101          (5) Provider payments.
102          (a) Payments to providers under the Medicaid program and CHIP for covered care and
103     services shall be made at a rate not less than 100% of the payment rate that applied to such care
104     and services on January 1, 2017[, and shall increase annually at a rate not less than the region's
105     Consumer Price Index].
106          (b) Managed care.
107          (i) If the department contracts with an accountable care organization or other
108     organization to cover care and services under the Medicaid program or CHIP, a contract with
109     that organization shall provide that the organization shall make payments to providers for items
110     and services that are subject to the contract and that are furnished to individuals eligible for the
111     Medicaid program or CHIP at a rate not less than 100% of the payment rate that at least one
112     accountable care organization that contracted with the department paid for such care and
113     services on January 1, 2017 (regardless of the manner in which such payments are made,
114     including in the form of capitation or partial capitation)[, and that the minimum payment
115     required by this provision will increase annually at a rate not less than the region's Consumer
116     Price Index].
117          (ii) Payments by the department to accountable care organizations or such other
118     organizations shall be sufficient for the organizations to comply with the provider payment rate
119     requirements of this section.
120          (c) This [subsection] Subsection (5) shall not apply to physician reimbursement for

121     drugs or devices.
122          (6) Nothing in this section shall prevent the people acting through initiative, the
123     Legislature by statute, or the department by promulgating rules from:
124          (a) Expanding eligibility by adopting less restrictive eligibility standards,
125     methodologies, or procedures than those permitted by Subsection (2);
126          (b) Expanding covered care and services by adding to the list, amount, duration, or
127     scope of covered care and services required by Subsection (3);
128          (c) Reducing premiums, beneficiary enrollment fees, or cost sharing requirements
129     below the maximum levels permitted by Subsection (4); or
130          (d) Increasing provider payments above the minimum payments required by Subsection
131     (5).
132          (7) For purposes of this section:
133          (a) The "Medicaid program" means the Medicaid program defined by Section 26-18-2,
134     including any waivers.
135          (b) The "Utah Children's Health Insurance Program" or "CHIP" means the Utah
136     Children's Health Insurance Program created in Chapter 40, Utah Children's Health Insurance
137     Act.
138          (8) The department shall maximize federal financial participation in implementing this
139     section, including by seeking to obtain any necessary federal approvals or waivers.
140          (9) This section and Section 26-18-3.1(4) shall not apply to CHIP in any year for which
141     the State Children's Health Insurance Program, as described in Subchapter XXI, 42 U.S.C. Sec.
142     1397aa et seq., is not extended at the federal level.
143          (10) Notwithstanding Sections 17-43-201 and 17-43-301, a county does not have to
144     provide matching funds to the state for the cost of providing Medicaid services to newly
145     enrolled individuals who qualify for Medicaid coverage under Subsection (2)(b).
146          (11) Severability. If any provision of this section or its application to any person or
147     circumstance is held invalid, the remainder of this section shall be given effect without the
148     invalid provision or application, and to this end the provisions of this section are severable.
149          Section 2. Section 26-36b-103 is amended to read:
150          26-36b-103. Definitions.
151          As used in this chapter:

152          (1) "Assessment" means the inpatient hospital assessment established by this chapter.
153          (2) "CMS" means the Centers for Medicare and Medicaid Services within the United
154     States Department of Health and Human Services.
155          (3) "Discharges" means the number of total hospital discharges reported on:
156          (a) Worksheet S-3 Part I, column 15, lines 14, 16, and 17 of the 2552-10 Medicare cost
157     report for the applicable assessment year; or
158          (b) a similar report adopted by the department by administrative rule, if the report
159     under Subsection (3)(a) is no longer available.
160          (4) "Division" means the Division of Health Care Financing within the department.
161          (5) "Enhancement waiver program" means the program established by the Primary
162     Care Network enhancement waiver program described in Section 26-18-416.
163          (6) "Health coverage improvement program" means the health coverage improvement
164     program described in Section 26-18-411.
165          (7) "Hospital share" means the hospital share described in Section 26-36b-203.
166          (8) "Medicaid accountable care organization" means a managed care organization, as
167     defined in 42 C.F.R. Sec. 438, that contracts with the department under the provisions of
168     Section 26-18-405.
169          (9) "Medicaid expansion" means an expansion of the Medicaid program in accordance
170     with:
171          (a) Section 26-18-3.9; or
172          (b) the Medicaid waiver expansion.
173          [(9)] (10) "Medicaid waiver expansion" means a Medicaid expansion in accordance
174     with Section 26-18-415.
175          [(10)] (11) "Medicare cost report" means CMS-2552-10, the cost report for electronic
176     filing of hospitals.
177          [(11)] (12) (a) "Non-state government hospital" means a hospital owned by a non-state
178     government entity.
179          (b) "Non-state government hospital" does not include:
180          (i) the Utah State Hospital; or
181          (ii) a hospital owned by the federal government, including the Veterans Administration
182     Hospital.

183          [(12)] (13) (a) "Private hospital" means:
184          (i) a general acute hospital, as defined in Section 26-21-2, that is privately owned and
185     operating in the state; and
186          (ii) a privately owned specialty hospital operating in the state, including a privately
187     owned hospital whose inpatient admissions are predominantly for:
188          (A) rehabilitation;
189          (B) psychiatric care;
190          (C) chemical dependency services; or
191          (D) long-term acute care services.
192          (b) "Private hospital" does not include a facility for residential treatment as defined in
193     Section 62A-2-101.
194          [(13)] (14) "State teaching hospital" means a state owned teaching hospital that is part
195     of an institution of higher education.
196          [(14)] (15) "Upper payment limit gap" means the difference between the private
197     hospital outpatient upper payment limit and the private hospital Medicaid outpatient payments,
198     as determined in accordance with 42 C.F.R. Sec. 447.321.
199          Section 3. Section 26-36b-201 is amended to read:
200          26-36b-201. Assessment.
201          (1) An assessment is imposed on each private hospital:
202          (a) beginning upon the later of CMS approval of:
203          (i) the health coverage improvement program waiver under Section 26-18-411; and
204          (ii) the assessment under this chapter;
205          (b) in the amount designated in Sections 26-36b-204 and 26-36b-205; and
206          (c) in accordance with Section 26-36b-202.
207          (2) Subject to Section 26-36b-203, the assessment imposed by this chapter is due and
208     payable on a quarterly basis, after payment of the outpatient upper payment limit supplemental
209     payments under Section 26-36b-210 have been paid.
210          (3) The first quarterly payment is not due until at least three months after the earlier of
211     the effective dates of the coverage provided through:
212          (a) the health coverage improvement program;
213          (b) the enhancement waiver program; or

214          (c) [the] Medicaid [waiver] expansion.
215          Section 4. Section 26-36b-204 is amended to read:
216          26-36b-204. Hospital financing of health coverage improvement program
217     Medicaid waiver expansion -- Hospital share.
218          (1) The hospital share is:
219          (a) 45% of the state's net cost of the health coverage improvement program, including
220     Medicaid coverage for individuals with dependent children up to the federal poverty level
221     designated under Section 26-18-411;
222          (b) 45% of the state's net cost of the enhancement waiver program;
223          (c) if [the waiver for the] Medicaid [waiver] expansion is [approved] implemented,
224     $11,900,000; and
225          (d) 45% of the state's net cost of the upper payment limit gap.
226          (2) (a) The hospital share is capped at no more than $13,600,000 annually, consisting
227     of:
228          (i) an $11,900,000 cap for the programs specified in Subsections (1)(a) through (c);
229     and
230          (ii) a $1,700,000 cap for the program specified in Subsection (1)(d).
231          (b) The department shall prorate the cap described in Subsection (2)(a) in any year in
232     which the programs specified in Subsections (1)(a) and (d) are not in effect for the full fiscal
233     year.
234          (3) Private hospitals shall be assessed under this chapter for:
235          (a) 69% of the portion of the hospital share for the programs specified in Subsections
236     (1)(a) through (c); and
237          (b) 100% of the portion of the hospital share specified in Subsection (1)(d).
238          (4) (a) The department shall, on or before October 15, 2017, and on or before October
239     15 of each subsequent year, produce a report that calculates the state's net cost of each of the
240     programs described in Subsections (1)(a) through (c) that are in effect for that year.
241          (b) If the assessment collected in the previous fiscal year is above or below the hospital
242     share for private hospitals for the previous fiscal year, the underpayment or overpayment of the
243     assessment by the private hospitals shall be applied to the fiscal year in which the report is
244     issued.

245          (5) A Medicaid accountable care organization shall, on or before October 15 of each
246     year, report to the department the following data from the prior state fiscal year for each private
247     hospital, state teaching hospital, and non-state government hospital provider that the Medicaid
248     accountable care organization contracts with:
249          (a) for the traditional Medicaid population:
250          (i) hospital inpatient payments;
251          (ii) hospital inpatient discharges;
252          (iii) hospital inpatient days; and
253          (iv) hospital outpatient payments; and
254          (b) if the Medicaid accountable care organization enrolls any individuals in the health
255     coverage improvement program, the enhancement waiver program, or [the] Medicaid [waiver]
256     expansion, for the population newly eligible for any of those programs:
257          (i) hospital inpatient payments;
258          (ii) hospital inpatient discharges;
259          (iii) hospital inpatient days; and
260          (iv) hospital outpatient payments.
261          (6) The department shall, by rule made in accordance with Title 63G, Chapter 3, Utah
262     Administrative Rulemaking Act, provide details surrounding specific content and format for
263     the reporting by the Medicaid accountable care organization.
264          Section 5. Section 26-36b-208 is amended to read:
265          26-36b-208. Medicaid Expansion Fund.
266          (1) There is created an expendable special revenue fund known as the Medicaid
267     Expansion Fund.
268          (2) The fund consists of:
269          (a) assessments collected under this chapter;
270          (b) intergovernmental transfers under Section 26-36b-206;
271          (c) savings attributable to the health coverage improvement program as determined by
272     the department;
273          (d) savings attributable to the enhancement waiver program as determined by the
274     department;
275          (e) savings attributable to [the] Medicaid [waiver] expansion as determined by the

276     department;
277          (f) savings attributable to the inclusion of psychotropic drugs on the preferred drug list
278     under Subsection 26-18-2.4(3) as determined by the department;
279          (g) savings attributable to the services provided by the Public Employees' Health Plan
280     under Subsection 49-20-401(1)(u);
281          (h) gifts, grants, donations, or any other conveyance of money that may be made to the
282     fund from private sources;
283          (i) interest earned on money in the fund; and
284          (j) additional amounts as appropriated by the Legislature.
285          (3) (a) The fund shall earn interest.
286          (b) All interest earned on fund money shall be deposited into the fund.
287          (4) (a) A state agency administering the provisions of this chapter may use money from
288     the fund to pay the costs, not otherwise paid for with federal funds or other revenue sources, of:
289          (i) the health coverage improvement program;
290          (ii) the enhancement waiver program;
291          (iii) [the] Medicaid [waiver] expansion; and
292          (iv) the outpatient upper payment limit supplemental payments under Section
293     26-36b-210.
294          (b) A state agency administering the provisions of this chapter may not use:
295          (i) funds described in Subsection (2)(b) to pay the cost of private outpatient upper
296     payment limit supplemental payments; or
297          (ii) money in the fund for any purpose not described in Subsection (4)(a).
298          Section 6. Section 26-36b-209 is amended to read:
299          26-36b-209. Hospital reimbursement.
300          (1) If the health coverage improvement program, the enhancement waiver program, or
301     [the] Medicaid [waiver] expansion is implemented by contracting with a Medicaid accountable
302     care organization, the department shall, to the extent allowed by law, include, in a contract to
303     provide benefits under the health coverage improvement program, the enhancement waiver
304     program, or [the] Medicaid [waiver] expansion, a requirement that the Medicaid accountable
305     care organization reimburse hospitals in the accountable care organization's provider network
306     at no less than the Medicaid fee-for-service rate.

307          (2) If the health coverage improvement program, the enhancement waiver program, or
308     [the] Medicaid [waiver] expansion is implemented by the department as a fee-for-service
309     program, the department shall reimburse hospitals at no less than the Medicaid fee-for-service
310     rate.
311          (3) Nothing in this section prohibits a Medicaid accountable care organization from
312     paying a rate that exceeds the Medicaid fee-for-service rate.
313          Section 7. Section 26-36c-102 is amended to read:
314          26-36c-102. Definitions.
315          As used in this chapter:
316          (1) "Assessment" means the Medicaid expansion hospital assessment established by
317     this chapter.
318          (2) "CMS" means the Centers for Medicare and Medicaid Services within the United
319     States Department of Health and Human Services.
320          (3) "Discharges" means the number of total hospital discharges reported on:
321          (a) Worksheet S-3 Part I, column 15, lines 14, 16, and 17 of the 2552-10 Medicare cost
322     report for the applicable assessment year; or
323          (b) a similar report adopted by the department by administrative rule, if the report
324     under Subsection (3)(a) is no longer available.
325          (4) "Division" means the Division of Health Care Financing within the department.
326          (5) "Hospital share" means the hospital share described in Section 26-36c-203.
327          (6) "Medicaid accountable care organization" means a managed care organization, as
328     defined in 42 C.F.R. Sec. 438, that contracts with the department under the provisions of
329     Section 26-18-405.
330          (7) "Medicaid Expansion Fund" means the Medicaid Expansion Fund created in
331     Section 26-36b-208.
332          (8) "Medicaid expansion" means an expansion of the Medicaid program in accordance
333     with:
334          (a) Section 26-18-3.9; or
335          (b) the Medicaid waiver expansion.
336          [(8)] (9) "Medicaid waiver expansion" means the same as that term is defined in
337     Section 26-18-415.

338          [(9)] (10) "Medicare cost report" means CMS-2552-10, the cost report for electronic
339     filing of hospitals.
340          [(10)] (11) (a) "Non-state government hospital" means a hospital owned by a non-state
341     government entity.
342          (b) "Non-state government hospital" does not include:
343          (i) the Utah State Hospital; or
344          (ii) a hospital owned by the federal government, including the Veterans Administration
345     Hospital.
346          [(11)] (12) (a) "Private hospital" means:
347          (i) a privately owned general acute hospital operating in the state as defined in Section
348     26-21-2; or
349          (ii) a privately owned specialty hospital operating in the state, including a privately
350     owned hospital for which inpatient admissions are predominantly:
351          (A) rehabilitation;
352          (B) psychiatric;
353          (C) chemical dependency; or
354          (D) long-term acute care services.
355          (b) "Private hospital" does not include a facility for residential treatment as defined in
356     Section 62A-2-101.
357          [(12)] (13) "State teaching hospital" means a state owned teaching hospital that is part
358     of an institution of higher education.
359          Section 8. Section 26-36c-201 is amended to read:
360          26-36c-201. Assessment.
361          (1) An assessment is imposed on each private hospital:
362          (a) beginning upon the later of CMS approval of:
363          (i) Medicaid expansion;
364          [(i)] (ii) the waiver for the Medicaid waiver expansion; and
365          [(ii)] (iii) the assessment under this chapter;
366          (b) in the amount designated in Sections 26-36c-204 and 26-36c-205; and
367          (c) in accordance with Section 26-36c-202.
368          (2) Subject to Subsection 26-36c-202(4), the assessment imposed by this chapter is due

369     and payable on the last day of each quarter.
370          (3) The first quarterly payment is not due until at least three months after the effective
371     date of the coverage provided through [the] Medicaid [waiver] expansion.
372          Section 9. Section 26-36c-203 is amended to read:
373          26-36c-203. Hospital share.
374          (1) The hospital share is 100% of the state's net cost of [the] Medicaid [waiver]
375     expansion, after deducting:
376          (a) appropriate offsets and savings expected as a result of implementing [the] Medicaid
377     [waiver] expansion, including savings from:
378          [(a)] (i) the Primary Care Network program;
379          [(b)] (ii) the health coverage improvement program, as defined in Section 26-18-411;
380          [(c)] (iii) the state portion of inpatient prison medical coverage;
381          [(d)] (iv) behavioral health coverage; and
382          [(e)] (v) county contributions to the non-federal share of Medicaid expenditures[.]; and
383          (b) any amount remaining in the Medicaid Expansion Fund.
384          (2) (a) The hospital share is capped at no more than $25,000,000 annually.
385          (b) The division shall prorate the cap specified in Subsection (2)(a) in any year in
386     which the Medicaid [waiver] expansion is not in effect for the full fiscal year.
387          Section 10. Section 26-36c-204 is amended to read:
388          26-36c-204. Hospital financing of Medicaid expansion.
389          (1) Private hospitals shall be assessed under this chapter for the portion of the hospital
390     share described in Section 26-36c-209.
391          (2) The department shall, on or before October 15, 2019, and on or before October 15
392     of each subsequent year, produce a report that calculates the state's net cost of [the] Medicaid
393     [waiver] expansion.
394          (3) If the assessment collected in the previous fiscal year is above or below the hospital
395     share for private hospitals for the previous fiscal year, the division shall apply the
396     underpayment or overpayment of the assessment by the private hospitals to the fiscal year in
397     which the report is issued.
398          Section 11. Section 26-36c-206 is amended to read:
399          26-36c-206. State teaching hospital and non-state government hospital

400     mandatory intergovernmental transfer.
401          (1) A state teaching hospital and a non-state government hospital shall make an
402     intergovernmental transfer to the Medicaid Expansion Fund, in accordance with this section.
403          (2) The hospitals described in Subsection (1) shall pay the intergovernmental transfer
404     beginning on the later of CMS approval of:
405          (a) Medicaid expansion;
406          [(a)] (b) the waiver for the Medicaid waiver expansion; or
407          [(b)] (c) the assessment for private hospitals in this chapter.
408          (3) The intergovernmental transfer is apportioned between the non-state government
409     hospitals as follows:
410          (a) the state teaching hospital shall pay for the portion of the hospital share described in
411     Section 26-36c-209; and
412          (b) non-state government hospitals shall pay for the portion of the hospital share
413     described in Section 26-36c-209.
414          (4) The department shall, by rule made in accordance with Title 63G, Chapter 3, Utah
415     Administrative Rulemaking Act, designate:
416          (a) the method of calculating the amounts designated in Subsection (3); and
417          (b) the schedule for the intergovernmental transfers.
418          Section 12. Section 26-36c-208 is amended to read:
419          26-36c-208. Hospital reimbursement.
420          (1) If [the] Medicaid [waiver] expansion is implemented by contracting with a
421     Medicaid accountable care organization, the department shall, to the extent allowed by law,
422     include in a contract to provide benefits under [the] Medicaid [waiver] expansion a
423     requirement that the accountable care organization reimburse hospitals in the accountable care
424     organization's provider network at no less than the Medicaid fee-for-service rate.
425          (2) If [the] Medicaid [waiver] expansion is implemented by the department as a
426     fee-for-service program, the department shall reimburse hospitals at no less than the Medicaid
427     fee-for-service rate.
428          (3) Nothing in this section prohibits the department or a Medicaid accountable care
429     organization from paying a rate that exceeds the Medicaid fee-for-service rate.
430          Section 13. Section 26-36c-209 is amended to read:

431          26-36c-209. Hospital financing of the hospital share.
432          (1) For the first two full fiscal years that the assessment is in effect, the department
433     shall:
434          (a) assess private hospitals under this chapter for 69% of the hospital share for [the]
435     Medicaid [waiver] expansion;
436          (b) require the state teaching hospital to make an intergovernmental transfer under this
437     chapter for 30% of the hospital share for [the] Medicaid [waiver] expansion; and
438          (c) require non-state government hospitals to make an intergovernmental transfer under
439     this chapter for 1% of the hospital share for [the] Medicaid [waiver] expansion.
440          (2) (a) At the beginning of the third full fiscal year that the assessment is in effect, and
441     at the beginning of each subsequent fiscal year, the department may set a different percentage
442     share for private hospitals, the state teaching hospital, and non-state government hospitals by
443     rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, with
444     input from private hospitals and private teaching hospitals.
445          (b) If the department does not set a different percentage share under Subsection (2)(a),
446     the percentage shares in Subsection (1) shall apply.
447          Section 14. Section 59-12-103 is amended to read:
448          59-12-103. Sales and use tax base -- Rates -- Effective dates -- Use of sales and use
449     tax revenues.
450          (1) A tax is imposed on the purchaser as provided in this part on the purchase price or
451     sales price for amounts paid or charged for the following transactions:
452          (a) retail sales of tangible personal property made within the state;
453          (b) amounts paid for:
454          (i) telecommunications service, other than mobile telecommunications service, that
455     originates and terminates within the boundaries of this state;
456          (ii) mobile telecommunications service that originates and terminates within the
457     boundaries of one state only to the extent permitted by the Mobile Telecommunications
458     Sourcing Act, 4 U.S.C. Sec. 116 et seq.; or
459          (iii) an ancillary service associated with a:
460          (A) telecommunications service described in Subsection (1)(b)(i); or
461          (B) mobile telecommunications service described in Subsection (1)(b)(ii);

462          (c) sales of the following for commercial use:
463          (i) gas;
464          (ii) electricity;
465          (iii) heat;
466          (iv) coal;
467          (v) fuel oil; or
468          (vi) other fuels;
469          (d) sales of the following for residential use:
470          (i) gas;
471          (ii) electricity;
472          (iii) heat;
473          (iv) coal;
474          (v) fuel oil; or
475          (vi) other fuels;
476          (e) sales of prepared food;
477          (f) except as provided in Section 59-12-104, amounts paid or charged as admission or
478     user fees for theaters, movies, operas, museums, planetariums, shows of any type or nature,
479     exhibitions, concerts, carnivals, amusement parks, amusement rides, circuses, menageries,
480     fairs, races, contests, sporting events, dances, boxing matches, wrestling matches, closed circuit
481     television broadcasts, billiard parlors, pool parlors, bowling lanes, golf, miniature golf, golf
482     driving ranges, batting cages, skating rinks, ski lifts, ski runs, ski trails, snowmobile trails,
483     tennis courts, swimming pools, water slides, river runs, jeep tours, boat tours, scenic cruises,
484     horseback rides, sports activities, or any other amusement, entertainment, recreation,
485     exhibition, cultural, or athletic activity;
486          (g) amounts paid or charged for services for repairs or renovations of tangible personal
487     property, unless Section 59-12-104 provides for an exemption from sales and use tax for:
488          (i) the tangible personal property; and
489          (ii) parts used in the repairs or renovations of the tangible personal property described
490     in Subsection (1)(g)(i), regardless of whether:
491          (A) any parts are actually used in the repairs or renovations of that tangible personal
492     property; or

493          (B) the particular parts used in the repairs or renovations of that tangible personal
494     property are exempt from a tax under this chapter;
495          (h) except as provided in Subsection 59-12-104(7), amounts paid or charged for
496     assisted cleaning or washing of tangible personal property;
497          (i) amounts paid or charged for tourist home, hotel, motel, or trailer court
498     accommodations and services that are regularly rented for less than 30 consecutive days;
499          (j) amounts paid or charged for laundry or dry cleaning services;
500          (k) amounts paid or charged for leases or rentals of tangible personal property if within
501     this state the tangible personal property is:
502          (i) stored;
503          (ii) used; or
504          (iii) otherwise consumed;
505          (l) amounts paid or charged for tangible personal property if within this state the
506     tangible personal property is:
507          (i) stored;
508          (ii) used; or
509          (iii) consumed; and
510          (m) amounts paid or charged for a sale:
511          (i) (A) of a product transferred electronically; or
512          (B) of a repair or renovation of a product transferred electronically; and
513          (ii) regardless of whether the sale provides:
514          (A) a right of permanent use of the product; or
515          (B) a right to use the product that is less than a permanent use, including a right:
516          (I) for a definite or specified length of time; and
517          (II) that terminates upon the occurrence of a condition.
518          (2) (a) Except as provided in Subsections (2)(b) through (e), a state tax and a local tax
519     is imposed on a transaction described in Subsection (1) equal to the sum of:
520          (i) a state tax imposed on the transaction at a tax rate equal to the sum of:
521          (A) (I) through March 31, 2019, 4.70%; and
522          (II) beginning on April 1, 2019, 4.70% plus the rate specified in Subsection (14)(a); and
523          (B) (I) the tax rate the state imposes in accordance with Part 18, Additional State Sales

524     and Use Tax Act, if the location of the transaction as determined under Sections 59-12-211
525     through 59-12-215 is in a county in which the state imposes the tax under Part 18, Additional
526     State Sales and Use Tax Act; and
527          (II) the tax rate the state imposes in accordance with Part 20, Supplemental State Sales
528     and Use Tax Act, if the location of the transaction as determined under Sections 59-12-211
529     through 59-12-215 is in a city, town, or the unincorporated area of a county in which the state
530     imposes the tax under Part 20, Supplemental State Sales and Use Tax Act; and
531          (ii) a local tax equal to the sum of the tax rates a county, city, or town imposes on the
532     transaction under this chapter other than this part.
533          (b) Except as provided in Subsection (2)(d) or (e), a state tax and a local tax is imposed
534     on a transaction described in Subsection (1)(d) equal to the sum of:
535          (i) a state tax imposed on the transaction at a tax rate of 2%; and
536          (ii) a local tax equal to the sum of the tax rates a county, city, or town imposes on the
537     transaction under this chapter other than this part.
538          (c) Except as provided in Subsection (2)(d) or (e), a state tax and a local tax is imposed
539     on amounts paid or charged for food and food ingredients equal to the sum of:
540          (i) a state tax imposed on the amounts paid or charged for food and food ingredients at
541     a tax rate of 1.75%; and
542          (ii) a local tax equal to the sum of the tax rates a county, city, or town imposes on the
543     amounts paid or charged for food and food ingredients under this chapter other than this part.
544          (d) (i) For a bundled transaction that is attributable to food and food ingredients and
545     tangible personal property other than food and food ingredients, a state tax and a local tax is
546     imposed on the entire bundled transaction equal to the sum of:
547          (A) a state tax imposed on the entire bundled transaction equal to the sum of:
548          (I) the tax rate described in Subsection (2)(a)(i)(A); and
549          (II) (Aa) the tax rate the state imposes in accordance with Part 18, Additional State
550     Sales and Use Tax Act, if the location of the transaction as determined under Sections
551     59-12-211 through 59-12-215 is in a county in which the state imposes the tax under Part 18,
552     Additional State Sales and Use Tax Act; and
553          (Bb) the tax rate the state imposes in accordance with Part 20, Supplemental State
554     Sales and Use Tax Act, if the location of the transaction as determined under Sections

555     59-12-211 through 59-12-215 is in a city, town, or the unincorporated area of a county in which
556     the state imposes the tax under Part 20, Supplemental State Sales and Use Tax Act; and
557          (B) a local tax imposed on the entire bundled transaction at the sum of the tax rates
558     described in Subsection (2)(a)(ii).
559          (ii) If an optional computer software maintenance contract is a bundled transaction that
560     consists of taxable and nontaxable products that are not separately itemized on an invoice or
561     similar billing document, the purchase of the optional computer software maintenance contract
562     is 40% taxable under this chapter and 60% nontaxable under this chapter.
563          (iii) Subject to Subsection (2)(d)(iv), for a bundled transaction other than a bundled
564     transaction described in Subsection (2)(d)(i) or (ii):
565          (A) if the sales price of the bundled transaction is attributable to tangible personal
566     property, a product, or a service that is subject to taxation under this chapter and tangible
567     personal property, a product, or service that is not subject to taxation under this chapter, the
568     entire bundled transaction is subject to taxation under this chapter unless:
569          (I) the seller is able to identify by reasonable and verifiable standards the tangible
570     personal property, product, or service that is not subject to taxation under this chapter from the
571     books and records the seller keeps in the seller's regular course of business; or
572          (II) state or federal law provides otherwise; or
573          (B) if the sales price of a bundled transaction is attributable to two or more items of
574     tangible personal property, products, or services that are subject to taxation under this chapter
575     at different rates, the entire bundled transaction is subject to taxation under this chapter at the
576     higher tax rate unless:
577          (I) the seller is able to identify by reasonable and verifiable standards the tangible
578     personal property, product, or service that is subject to taxation under this chapter at the lower
579     tax rate from the books and records the seller keeps in the seller's regular course of business; or
580          (II) state or federal law provides otherwise.
581          (iv) For purposes of Subsection (2)(d)(iii), books and records that a seller keeps in the
582     seller's regular course of business includes books and records the seller keeps in the regular
583     course of business for nontax purposes.
584          (e) (i) Except as otherwise provided in this chapter and subject to Subsections (2)(e)(ii)
585     and (iii), if a transaction consists of the sale, lease, or rental of tangible personal property, a

586     product, or a service that is subject to taxation under this chapter, and the sale, lease, or rental
587     of tangible personal property, other property, a product, or a service that is not subject to
588     taxation under this chapter, the entire transaction is subject to taxation under this chapter unless
589     the seller, at the time of the transaction:
590          (A) separately states the portion of the transaction that is not subject to taxation under
591     this chapter on an invoice, bill of sale, or similar document provided to the purchaser; or
592          (B) is able to identify by reasonable and verifiable standards, from the books and
593     records the seller keeps in the seller's regular course of business, the portion of the transaction
594     that is not subject to taxation under this chapter.
595          (ii) A purchaser and a seller may correct the taxability of a transaction if:
596          (A) after the transaction occurs, the purchaser and the seller discover that the portion of
597     the transaction that is not subject to taxation under this chapter was not separately stated on an
598     invoice, bill of sale, or similar document provided to the purchaser because of an error or
599     ignorance of the law; and
600          (B) the seller is able to identify by reasonable and verifiable standards, from the books
601     and records the seller keeps in the seller's regular course of business, the portion of the
602     transaction that is not subject to taxation under this chapter.
603          (iii) For purposes of Subsections (2)(e)(i) and (ii), books and records that a seller keeps
604     in the seller's regular course of business includes books and records the seller keeps in the
605     regular course of business for nontax purposes.
606          (f) (i) If the sales price of a transaction is attributable to two or more items of tangible
607     personal property, products, or services that are subject to taxation under this chapter at
608     different rates, the entire purchase is subject to taxation under this chapter at the higher tax rate
609     unless the seller, at the time of the transaction:
610          (A) separately states the items subject to taxation under this chapter at each of the
611     different rates on an invoice, bill of sale, or similar document provided to the purchaser; or
612          (B) is able to identify by reasonable and verifiable standards the tangible personal
613     property, product, or service that is subject to taxation under this chapter at the lower tax rate
614     from the books and records the seller keeps in the seller's regular course of business.
615          (ii) For purposes of Subsection (2)(f)(i), books and records that a seller keeps in the
616     seller's regular course of business includes books and records the seller keeps in the regular

617     course of business for nontax purposes.
618          (g) Subject to Subsections (2)(h) and (i), a tax rate repeal or tax rate change for a tax
619     rate imposed under the following shall take effect on the first day of a calendar quarter:
620          (i) Subsection (2)(a)(i)(A);
621          (ii) Subsection (2)(b)(i);
622          (iii) Subsection (2)(c)(i); or
623          (iv) Subsection (2)(d)(i)(A)(I).
624          (h) (i) A tax rate increase takes effect on the first day of the first billing period that
625     begins on or after the effective date of the tax rate increase if the billing period for the
626     transaction begins before the effective date of a tax rate increase imposed under:
627          (A) Subsection (2)(a)(i)(A);
628          (B) Subsection (2)(b)(i);
629          (C) Subsection (2)(c)(i); or
630          (D) Subsection (2)(d)(i)(A)(I).
631          (ii) The repeal of a tax or a tax rate decrease applies to a billing period if the billing
632     statement for the billing period is rendered on or after the effective date of the repeal of the tax
633     or the tax rate decrease imposed under:
634          (A) Subsection (2)(a)(i)(A);
635          (B) Subsection (2)(b)(i);
636          (C) Subsection (2)(c)(i); or
637          (D) Subsection (2)(d)(i)(A)(I).
638          (i) (i) For a tax rate described in Subsection (2)(i)(ii), if a tax due on a catalogue sale is
639     computed on the basis of sales and use tax rates published in the catalogue, a tax rate repeal or
640     change in a tax rate takes effect:
641          (A) on the first day of a calendar quarter; and
642          (B) beginning 60 days after the effective date of the tax rate repeal or tax rate change.
643          (ii) Subsection (2)(i)(i) applies to the tax rates described in the following:
644          (A) Subsection (2)(a)(i)(A);
645          (B) Subsection (2)(b)(i);
646          (C) Subsection (2)(c)(i); or
647          (D) Subsection (2)(d)(i)(A)(I).

648          (iii) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
649     the commission may by rule define the term "catalogue sale."
650          (3) (a) The following state taxes shall be deposited into the General Fund:
651          (i) the tax imposed by Subsection (2)(a)(i)(A);
652          (ii) the tax imposed by Subsection (2)(b)(i);
653          (iii) the tax imposed by Subsection (2)(c)(i); or
654          (iv) the tax imposed by Subsection (2)(d)(i)(A)(I).
655          (b) The following local taxes shall be distributed to a county, city, or town as provided
656     in this chapter:
657          (i) the tax imposed by Subsection (2)(a)(ii);
658          (ii) the tax imposed by Subsection (2)(b)(ii);
659          (iii) the tax imposed by Subsection (2)(c)(ii); and
660          (iv) the tax imposed by Subsection (2)(d)(i)(B).
661          (4) (a) Notwithstanding Subsection (3)(a), for a fiscal year beginning on or after July 1,
662     2003, the lesser of the following amounts shall be expended as provided in Subsections (4)(b)
663     through (g):
664          (i) for taxes listed under Subsection (3)(a), the amount of tax revenue generated:
665          (A) by a 1/16% tax rate on the transactions described in Subsection (1); and
666          (B) for the fiscal year; or
667          (ii) $17,500,000.
668          (b) (i) For a fiscal year beginning on or after July 1, 2003, 14% of the amount
669     described in Subsection (4)(a) shall be transferred each year as dedicated credits to the
670     Department of Natural Resources to:
671          (A) implement the measures described in Subsections 79-2-303(3)(a) through (d) to
672     protect sensitive plant and animal species; or
673          (B) award grants, up to the amount authorized by the Legislature in an appropriations
674     act, to political subdivisions of the state to implement the measures described in Subsections
675     79-2-303(3)(a) through (d) to protect sensitive plant and animal species.
676          (ii) Money transferred to the Department of Natural Resources under Subsection
677     (4)(b)(i) may not be used to assist the United States Fish and Wildlife Service or any other
678     person to list or attempt to have listed a species as threatened or endangered under the

679     Endangered Species Act of 1973, 16 U.S.C. Sec. 1531 et seq.
680          (iii) At the end of each fiscal year:
681          (A) 50% of any unexpended dedicated credits shall lapse to the Water Resources
682     Conservation and Development Fund created in Section 73-10-24;
683          (B) 25% of any unexpended dedicated credits shall lapse to the Utah Wastewater Loan
684     Program Subaccount created in Section 73-10c-5; and
685          (C) 25% of any unexpended dedicated credits shall lapse to the Drinking Water Loan
686     Program Subaccount created in Section 73-10c-5.
687          (c) For a fiscal year beginning on or after July 1, 2003, 3% of the amount described in
688     Subsection (4)(a) shall be deposited each year in the Agriculture Resource Development Fund
689     created in Section 4-18-106.
690          (d) (i) For a fiscal year beginning on or after July 1, 2003, 1% of the amount described
691     in Subsection (4)(a) shall be transferred each year as dedicated credits to the Division of Water
692     Rights to cover the costs incurred in hiring legal and technical staff for the adjudication of
693     water rights.
694          (ii) At the end of each fiscal year:
695          (A) 50% of any unexpended dedicated credits shall lapse to the Water Resources
696     Conservation and Development Fund created in Section 73-10-24;
697          (B) 25% of any unexpended dedicated credits shall lapse to the Utah Wastewater Loan
698     Program Subaccount created in Section 73-10c-5; and
699          (C) 25% of any unexpended dedicated credits shall lapse to the Drinking Water Loan
700     Program Subaccount created in Section 73-10c-5.
701          (e) (i) For a fiscal year beginning on or after July 1, 2003, 41% of the amount described
702     in Subsection (4)(a) shall be deposited into the Water Resources Conservation and
703     Development Fund created in Section 73-10-24 for use by the Division of Water Resources.
704          (ii) In addition to the uses allowed of the Water Resources Conservation and
705     Development Fund under Section 73-10-24, the Water Resources Conservation and
706     Development Fund may also be used to:
707          (A) conduct hydrologic and geotechnical investigations by the Division of Water
708     Resources in a cooperative effort with other state, federal, or local entities, for the purpose of
709     quantifying surface and ground water resources and describing the hydrologic systems of an

710     area in sufficient detail so as to enable local and state resource managers to plan for and
711     accommodate growth in water use without jeopardizing the resource;
712          (B) fund state required dam safety improvements; and
713          (C) protect the state's interest in interstate water compact allocations, including the
714     hiring of technical and legal staff.
715          (f) For a fiscal year beginning on or after July 1, 2003, 20.5% of the amount described
716     in Subsection (4)(a) shall be deposited into the Utah Wastewater Loan Program Subaccount
717     created in Section 73-10c-5 for use by the Water Quality Board to fund wastewater projects.
718          (g) For a fiscal year beginning on or after July 1, 2003, 20.5% of the amount described
719     in Subsection (4)(a) shall be deposited into the Drinking Water Loan Program Subaccount
720     created in Section 73-10c-5 for use by the Division of Drinking Water to:
721          (i) provide for the installation and repair of collection, treatment, storage, and
722     distribution facilities for any public water system, as defined in Section 19-4-102;
723          (ii) develop underground sources of water, including springs and wells; and
724          (iii) develop surface water sources.
725          (5) (a) Notwithstanding Subsection (3)(a), for a fiscal year beginning on or after July 1,
726     2006, the difference between the following amounts shall be expended as provided in this
727     Subsection (5), if that difference is greater than $1:
728          (i) for taxes listed under Subsection (3)(a), the amount of tax revenue generated for the
729     fiscal year by a 1/16% tax rate on the transactions described in Subsection (1); and
730          (ii) $17,500,000.
731          (b) (i) The first $500,000 of the difference described in Subsection (5)(a) shall be:
732          (A) transferred each fiscal year to the Department of Natural Resources as dedicated
733     credits; and
734          (B) expended by the Department of Natural Resources for watershed rehabilitation or
735     restoration.
736          (ii) At the end of each fiscal year, 100% of any unexpended dedicated credits described
737     in Subsection (5)(b)(i) shall lapse to the Water Resources Conservation and Development Fund
738     created in Section 73-10-24.
739          (c) (i) After making the transfer required by Subsection (5)(b)(i), $150,000 of the
740     remaining difference described in Subsection (5)(a) shall be:

741          (A) transferred each fiscal year to the Division of Water Resources as dedicated
742     credits; and
743          (B) expended by the Division of Water Resources for cloud-seeding projects
744     authorized by Title 73, Chapter 15, Modification of Weather.
745          (ii) At the end of each fiscal year, 100% of any unexpended dedicated credits described
746     in Subsection (5)(c)(i) shall lapse to the Water Resources Conservation and Development Fund
747     created in Section 73-10-24.
748          (d) After making the transfers required by Subsections (5)(b) and (c), 85% of the
749     remaining difference described in Subsection (5)(a) shall be deposited into the Water
750     Resources Conservation and Development Fund created in Section 73-10-24 for use by the
751     Division of Water Resources for:
752          (i) preconstruction costs:
753          (A) as defined in Subsection 73-26-103(6) for projects authorized by Title 73, Chapter
754     26, Bear River Development Act; and
755          (B) as defined in Subsection 73-28-103(8) for the Lake Powell Pipeline project
756     authorized by Title 73, Chapter 28, Lake Powell Pipeline Development Act;
757          (ii) the cost of employing a civil engineer to oversee any project authorized by Title 73,
758     Chapter 26, Bear River Development Act;
759          (iii) the cost of employing a civil engineer to oversee the Lake Powell Pipeline project
760     authorized by Title 73, Chapter 28, Lake Powell Pipeline Development Act; and
761          (iv) other uses authorized under Sections 73-10-24, 73-10-25.1, and 73-10-30, and
762     Subsection (4)(e)(ii) after funding the uses specified in Subsections (5)(d)(i) through (iii).
763          (e) After making the transfers required by Subsections (5)(b) and (c) and subject to
764     Subsection (5)(f), 15% of the remaining difference described in Subsection (5)(a) shall be
765     transferred each year as dedicated credits to the Division of Water Rights to cover the costs
766     incurred for employing additional technical staff for the administration of water rights.
767          (f) At the end of each fiscal year, any unexpended dedicated credits described in
768     Subsection (5)(e) over $150,000 lapse to the Water Resources Conservation and Development
769     Fund created in Section 73-10-24.
770          (6) Notwithstanding Subsection (3)(a) and for taxes listed under Subsection (3)(a), the
771     amount of revenue generated by a 1/16% tax rate on the transactions described in Subsection

772     (1) for the fiscal year shall be deposited as follows:
773          (a) for fiscal year 2016-17 only, 100% of the revenue described in this Subsection (6)
774     shall be deposited into the Transportation Investment Fund of 2005 created by Section
775     72-2-124;
776          (b) for fiscal year 2017-18 only:
777          (i) 80% of the revenue described in this Subsection (6) shall be deposited into the
778     Transportation Investment Fund of 2005 created by Section 72-2-124; and
779          (ii) 20% of the revenue described in this Subsection (6) shall be deposited into the
780     Water Infrastructure Restricted Account created by Section 73-10g-103;
781          (c) for fiscal year 2018-19 only:
782          (i) 60% of the revenue described in this Subsection (6) shall be deposited into the
783     Transportation Investment Fund of 2005 created by Section 72-2-124; and
784          (ii) 40% of the revenue described in this Subsection (6) shall be deposited into the
785     Water Infrastructure Restricted Account created by Section 73-10g-103;
786          (d) for fiscal year 2019-20 only:
787          (i) 40% of the revenue described in this Subsection (6) shall be deposited into the
788     Transportation Investment Fund of 2005 created by Section 72-2-124; and
789          (ii) 60% of the revenue described in this Subsection (6) shall be deposited into the
790     Water Infrastructure Restricted Account created by Section 73-10g-103;
791          (e) for fiscal year 2020-21 only:
792          (i) 20% of the revenue described in this Subsection (6) shall be deposited into the
793     Transportation Investment Fund of 2005 created by Section 72-2-124; and
794          (ii) 80% of the revenue described in this Subsection (6) shall be deposited into the
795     Water Infrastructure Restricted Account created by Section 73-10g-103; and
796          (f) for a fiscal year beginning on or after July 1, 2021, 100% of the revenue described
797     in this Subsection (6) shall be deposited into the Water Infrastructure Restricted Account
798     created by Section 73-10g-103.
799          (7) (a) Notwithstanding Subsection (3)(a), in addition to the amounts deposited in
800     Subsection (6), and subject to Subsection (7)(b), for a fiscal year beginning on or after July 1,
801     2012, the Division of Finance shall deposit into the Transportation Investment Fund of 2005
802     created by Section 72-2-124:

803          (i) a portion of the taxes listed under Subsection (3)(a) in an amount equal to 8.3% of
804     the revenues collected from the following taxes, which represents a portion of the
805     approximately 17% of sales and use tax revenues generated annually by the sales and use tax
806     on vehicles and vehicle-related products:
807          (A) the tax imposed by Subsection (2)(a)(i)(A) at a 4.7% rate;
808          (B) the tax imposed by Subsection (2)(b)(i);
809          (C) the tax imposed by Subsection (2)(c)(i); and
810          (D) the tax imposed by Subsection (2)(d)(i)(A)(I); plus
811          (ii) an amount equal to 30% of the growth in the amount of revenues collected in the
812     current fiscal year from the sales and use taxes described in Subsections (7)(a)(i)(A) through
813     (D) that exceeds the amount collected from the sales and use taxes described in Subsections
814     (7)(a)(i)(A) through (D) in the 2010-11 fiscal year.
815          (b) (i) Subject to Subsections (7)(b)(ii) and (iii), in any fiscal year that the portion of
816     the sales and use taxes deposited under Subsection (7)(a) represents an amount that is a total
817     lower percentage of the sales and use taxes described in Subsections (7)(a)(i)(A) through (D)
818     generated in the current fiscal year than the total percentage of sales and use taxes deposited in
819     the previous fiscal year, the Division of Finance shall deposit an amount under Subsection
820     (7)(a) equal to the product of:
821          (A) the total percentage of sales and use taxes deposited under Subsection (7)(a) in the
822     previous fiscal year; and
823          (B) the total sales and use tax revenue generated by the taxes described in Subsections
824     (7)(a)(i)(A) through (D) in the current fiscal year.
825          (ii) In any fiscal year in which the portion of the sales and use taxes deposited under
826     Subsection (7)(a) would exceed 17% of the revenues collected from the sales and use taxes
827     described in Subsections (7)(a)(i)(A) through (D) in the current fiscal year, the Division of
828     Finance shall deposit 17% of the revenues collected from the sales and use taxes described in
829     Subsections (7)(a)(i)(A) through (D) for the current fiscal year under Subsection (7)(a).
830          (iii) In all subsequent fiscal years after a year in which 17% of the revenues collected
831     from the sales and use taxes described in Subsections (7)(a)(i)(A) through (D) was deposited
832     under Subsection (7)(a), the Division of Finance shall annually deposit 17% of the revenues
833     collected from the sales and use taxes described in Subsections (7)(a)(i)(A) through (D) in the

834     current fiscal year under Subsection (7)(a).
835          (8) (a) Notwithstanding Subsection (3)(a), and in addition to the amounts deposited
836     under Subsections (6) and (7), for the 2016-17 fiscal year only, the Division of Finance shall
837     deposit $64,000,000 of the revenues generated by the taxes listed under Subsection (3)(a) into
838     the Transportation Investment Fund of 2005 created by Section 72-2-124.
839          (b) Notwithstanding Subsection (3)(a), and in addition to the amounts deposited under
840     Subsections (6) and (7), for the 2017-18 fiscal year only, the Division of Finance shall deposit
841     $63,000,000 of the revenues generated by the taxes listed under Subsection (3)(a) into the
842     Transportation Investment Fund of 2005 created by Section 72-2-124.
843          (c) (i) Notwithstanding Subsection (3)(a), in addition to the amounts deposited under
844     Subsections (6) and (7), and subject to Subsection (8)(c)(ii), for a fiscal year beginning on or
845     after July 1, 2018, the commission shall annually deposit into the Transportation Investment
846     Fund of 2005 created by Section 72-2-124 a portion of the taxes listed under Subsection (3)(a)
847     in an amount equal to 3.68% of the revenues collected from the following taxes:
848          (A) the tax imposed by Subsection (2)(a)(i)(A) at a 4.7% rate;
849          (B) the tax imposed by Subsection (2)(b)(i);
850          (C) the tax imposed by Subsection (2)(c)(i); and
851          (D) the tax imposed by Subsection (2)(d)(i)(A)(I).
852          (ii) For a fiscal year beginning on or after July 1, 2019, the commission shall annually
853     reduce the deposit into the Transportation Investment Fund of 2005 under Subsection (8)(c)(i)
854     by an amount that is equal to 35% of the amount of revenue generated in the current fiscal year
855     by the portion of the tax imposed on motor and special fuel that is sold, used, or received for
856     sale or use in this state that exceeds 29.4 cents per gallon.
857          (iii) The commission shall annually deposit the amount described in Subsection
858     (8)(c)(ii) into the Transit and Transportation Investment Fund created in Section 72-2-124.
859          (9) Notwithstanding Subsection (3)(a), for each fiscal year beginning with fiscal year
860     2009-10, $533,750 shall be deposited into the Qualified Emergency Food Agencies Fund
861     created by Section 35A-8-1009 and expended as provided in Section 35A-8-1009.
862          (10) (a) Notwithstanding Subsection (3)(a), except as provided in Subsection (10)(c),
863     in addition to any amounts deposited under Subsections (6), (7), and (8), and for the 2016-17
864     fiscal year only, the Division of Finance shall deposit into the Transportation Investment Fund

865     of 2005 created by Section 72-2-124 the amount of tax revenue generated by a .05% tax rate on
866     the transactions described in Subsection (1).
867          (b) Notwithstanding Subsection (3)(a), except as provided in Subsection (10)(c), and in
868     addition to any amounts deposited under Subsections (6), (7), and (8), the Division of Finance
869     shall deposit into the Transportation Investment Fund of 2005 created by Section 72-2-124 the
870     amount of revenue described as follows:
871          (i) for fiscal year 2017-18 only, 83.33% of the amount of revenue generated by a .05%
872     tax rate on the transactions described in Subsection (1);
873          (ii) for fiscal year 2018-19 only, 66.67% of the amount of revenue generated by a .05%
874     tax rate on the transactions described in Subsection (1);
875          (iii) for fiscal year 2019-20 only, 50% of the amount of revenue generated by a .05%
876     tax rate on the transactions described in Subsection (1);
877          (iv) for fiscal year 2020-21 only, 33.33% of the amount of revenue generated by a
878     .05% tax rate on the transactions described in Subsection (1); and
879          (v) for fiscal year 2021-22 only, 16.67% of the amount of revenue generated by a .05%
880     tax rate on the transactions described in Subsection (1).
881          (c) For purposes of Subsections (10)(a) and (b), the Division of Finance may not
882     deposit into the Transportation Investment Fund of 2005 any tax revenue generated by amounts
883     paid or charged for food and food ingredients, except for tax revenue generated by a bundled
884     transaction attributable to food and food ingredients and tangible personal property other than
885     food and food ingredients described in Subsection (2)(d).
886          (11) Notwithstanding Subsection (3)(a), beginning the second fiscal year after the
887     fiscal year during which the Division of Finance receives notice under Section 63N-2-510 that
888     construction on a qualified hotel, as defined in Section 63N-2-502, has begun, the Division of
889     Finance shall, for two consecutive fiscal years, annually deposit $1,900,000 of the revenue
890     generated by the taxes listed under Subsection (3)(a) into the Hotel Impact Mitigation Fund,
891     created in Section 63N-2-512.
892          (12) (a) Notwithstanding Subsection (3)(a), for the 2016-17 fiscal year only, the
893     Division of Finance shall deposit $26,000,000 of the revenues generated by the taxes listed
894     under Subsection (3)(a) into the Throughput Infrastructure Fund created by Section 35A-8-308.
895          (b) Notwithstanding Subsection (3)(a), for the 2017-18 fiscal year only, the Division of

896     Finance shall deposit $27,000,000 of the revenues generated by the taxes listed under
897     Subsection (3)(a) into the Throughput Infrastructure Fund created by Section 35A-8-308.
898          (13) Notwithstanding Subsections (4) through (12) and (14), an amount required to be
899     expended or deposited in accordance with Subsections (4) through (12) and (14) may not
900     include an amount the Division of Finance deposits in accordance with Section 59-12-103.2.
901          (14) (a) The rate specified in this subsection is 0.15%.
902          (b) Notwithstanding Subsection (3)(a), the Division of Finance shall:
903          (i) on or before September 30, 2019, transfer the amount of revenue [generated by]
904     collected from a 0.15% tax rate imposed beginning on April 1, 2019, and ending on June 30,
905     2019, on the transactions that are subject to the sales and use tax under Subsection (2)(a)(i)(A)
906     [as dedicated credits to the Division of Health Care Financing] to the Medicaid Expansion
907     Fund created in Section 26-36b-208; and
908          (ii) for a fiscal year beginning on or after fiscal year 2019-20, annually transfer the
909     amount of revenue [generated by] collected from a 0.15% tax rate on the transactions that are
910     subject to the sales and use tax under Subsection (2)(a)(i)(A) [as dedicated credits to the
911     Division of Health Care Financing] to the Medicaid Expansion Fund created in Section
912     26-36b-208.
913          (c) The revenue described in Subsection (14)(b) [that the Division of Finance transfers
914     to the Division of Health Care Financing as dedicated credits] shall be expended for the
915     following uses:
916          (i) implementation of the Medicaid expansion described in Sections 26-18-3.1(4) and
917     26-18-3.9(2)(b);
918          (ii) if revenue remains after the use specified in Subsection (14)(c)(i), other measures
919     required by Section 26-18-3.9; and
920          (iii) if revenue remains after the uses specified in Subsections (14)(c)(i) and (ii), other
921     measures described in Title 26, Chapter 18, Medical Assistance Act.