1     
REAUTHORIZATION OF HOSPITAL PROVIDER

2     
ASSESSMENT ACT

3     
2016 GENERAL SESSION

4     
STATE OF UTAH

5     
Chief Sponsor: Brian E. Shiozawa

6     
House Sponsor: James A. Dunnigan

7     

8     LONG TITLE
9     General Description:
10          This bill reauthorizes the Hospital Provider Assessment Act.
11     Highlighted Provisions:
12          This bill:
13          ▸     amends the repeal of the assessment;
14          ▸     extends the sunset of the assessment; and
15          ▸     makes technical amendments.
16     Money Appropriated in this Bill:
17          None
18     Other Special Clauses:
19          None
20     Utah Code Sections Affected:
21     AMENDS:
22          26-36a-203, as last amended by Laws of Utah 2013, Chapter 32
23          26-36a-208, as last amended by Laws of Utah 2013, Chapter 32
24          63I-1-226, as last amended by Laws of Utah 2015, Chapters 16, 31, and 258
25     

26     Be it enacted by the Legislature of the state of Utah:
27          Section 1. Section 26-36a-203 is amended to read:
28          26-36a-203. Calculation of assessment.
29          (1) (a) An annual assessment is payable on a quarterly basis for each hospital in an

30     amount calculated at a uniform assessment rate for each hospital discharge, in accordance with
31     this section.
32          (b) The uniform assessment rate shall be determined using the total number of hospital
33     discharges for assessed hospitals divided into the total non-federal portion in an amount
34     consistent with Section 26-36a-205 that is needed to support capitated rates for accountable
35     care organizations for purposes of hospital services provided to Medicaid enrollees.
36          (c) Any quarterly changes to the uniform assessment rate shall be applied uniformly to
37     all assessed hospitals.
38          (d) The annual uniform assessment rate may not generate more than:
39          (i) $1,000,000 to offset Medicaid mandatory expenditures; and
40          (ii) the non-federal share to seed amounts needed to support capitated rates for
41     accountable care organizations as provided for in Subsection (1)(b).
42          (2) (a) For each state fiscal year, discharges shall be determined using the data from
43     each hospital's Medicare Cost Report contained in the Centers for Medicare and Medicaid
44     Services' Healthcare Cost Report Information System file. The hospital's discharge data will be
45     derived as follows:
46          (i) for state fiscal year 2013, the hospital's cost report data for the hospital's fiscal year
47     ending between July 1, 2009, and June 30, 2010;
48          (ii) for state fiscal year 2014, the hospital's cost report data for the hospital's fiscal year
49     ending between July 1, 2010, and June 30, 2011;
50          (iii) for state fiscal year 2015, the hospital's cost report data for the hospital's fiscal year
51     ending between July 1, 2011, and June 30, 2012; [and]
52          (iv) for state fiscal year 2016, the hospital's cost report data for the hospital's fiscal year
53     ending between July 1, 2012, and June 30, 2013[.]; and
54          (v) for each subsequent state fiscal year, the hospital's cost report data for the hospital's
55     fiscal year that ended in the state fiscal year two years prior to the assessment fiscal year.
56          (b) If a hospital's fiscal year Medicare Cost Report is not contained in the Centers for
57     Medicare and Medicaid Services' Healthcare Cost Report Information System file:

58          (i) the hospital shall submit to the division a copy of the hospital's Medicare Cost
59     Report applicable to the assessment year; and
60          (ii) the division shall determine the hospital's discharges.
61          (c) If a hospital is not certified by the Medicare program and is not required to file a
62     Medicare Cost Report:
63          (i) the hospital shall submit to the division its applicable fiscal year discharges with
64     supporting documentation;
65          (ii) the division shall determine the hospital's discharges from the information
66     submitted under Subsection (2)(c)(i); and
67          (iii) the failure to submit discharge information shall result in an audit of the hospital's
68     records and a penalty equal to 5% of the calculated assessment.
69          (3) Except as provided in Subsection (4), if a hospital is owned by an organization that
70     owns more than one hospital in the state:
71          (a) the assessment for each hospital shall be separately calculated by the department;
72     and
73          (b) each separate hospital shall pay the assessment imposed by this chapter.
74          (4) Notwithstanding the requirement of Subsection (3), if multiple hospitals use the
75     same Medicaid provider number:
76          (a) the department shall calculate the assessment in the aggregate for the hospitals
77     using the same Medicaid provider number; and
78          (b) the hospitals may pay the assessment in the aggregate.
79          Section 2. Section 26-36a-208 is amended to read:
80          26-36a-208. Repeal of assessment.
81          (1) The repeal of the assessment imposed by this chapter shall occur upon the
82     certification by the executive director of the department that the sooner of the following has
83     occurred:
84          (a) the effective date of any action by Congress that would disqualify the assessment
85     imposed by this chapter from counting towards state Medicaid funds available to be used to

86     determine the federal financial participation;
87          (b) the effective date of any decision, enactment, or other determination by the
88     Legislature or by any court, officer, department, or agency of the state, or of the federal
89     government that has the effect of:
90          (i) disqualifying the assessment from counting towards state Medicaid funds available
91     to be used to determine federal financial participation for Medicaid matching funds; or
92          (ii) creating for any reason a failure of the state to use the assessments for the Medicaid
93     program as described in this chapter;
94          (c) the effective date of:
95          (i) an appropriation for any state fiscal year from the General Fund for hospital
96     payments under the state Medicaid program that is less than the amount appropriated for state
97     fiscal year 2012;
98          (ii) the annual revenues of the state General Fund budget return to the level that was
99     appropriated for fiscal year 2008;
100          [(iii) approval of any change in the state Medicaid plan that requires a greater
101     percentage of Medicaid patients to enroll in Medicaid managed care plans than what is
102     required:]
103          [(A) to implement accountable care organizations in the state plan; and]
104          [(B) by other managed care enrollment requirements in effect on or before January 1,
105     2012;]
106          [(iv)] (iii) a division change in rules that reduces any of the following below July 1,
107     2011 payments:
108          (A) aggregate hospital inpatient payments;
109          (B) adjustment payment rates; or
110          (C) any cost settlement protocol; or
111          [(v)] (iv) a division change in rules that reduces the aggregate outpatient payments
112     below July 1, 2011 payments; and
113          (d) the sunset of this chapter in accordance with Section 63I-1-226.

114          (2) If the assessment is repealed under Subsection (1), money in the fund that was
115     derived from assessments imposed by this chapter, before the determination made under
116     Subsection (1), shall be disbursed under Section 26-36a-205 to the extent federal matching is
117     not reduced due to the impermissibility of the assessments. Any funds remaining in the special
118     revenue fund shall be refunded to the hospitals in proportion to the amount paid by each
119     hospital.
120          Section 3. Section 63I-1-226 is amended to read:
121          63I-1-226. Repeal dates, Title 26.
122          (1) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
123     1, 2025.
124          (2) Section 26-10-11 is repealed July 1, 2020.
125          (3) Section 26-21-23, Licensing of non-Medicaid nursing care facility beds, is repealed
126     July 1, 2018.
127          (4) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1, 2024.
128          (5) Title 26, Chapter 36a, Hospital Provider Assessment Act, is repealed July 1, [2016]
129     2019.
130          (6) Section 26-38-2.5 is repealed July 1, 2017.
131          (7) Section 26-38-2.6 is repealed July 1, 2017.
132          (8) Title 26, Chapter 56, Hemp Extract Registration Act, is repealed July 1, 2016.