2
3
4
5
6
7
8 LONG TITLE
9 Committee Note:
10 The Health and Human Services Interim Committee recommended this bill.
11 General Description:
12 This bill reauthorizes the Hospital Provider Assessment Act.
13 Highlighted Provisions:
14 This bill:
15 ▸ amends the repeal of the assessment;
16 ▸ extends the sunset of the assessment; and
17 ▸ makes technical amendments.
18 Money Appropriated in this Bill:
19 None
20 Other Special Clauses:
21 None
22 Utah Code Sections Affected:
23 AMENDS:
24 26-36a-203, as last amended by Laws of Utah 2013, Chapter 32
25 26-36a-208, as last amended by Laws of Utah 2013, Chapter 32
26 63I-1-226, as last amended by Laws of Utah 2015, Chapters 16, 31, and 258
27
28 Be it enacted by the Legislature of the state of Utah:
29 Section 1. Section 26-36a-203 is amended to read:
30 26-36a-203. Calculation of assessment.
31 (1) (a) An annual assessment is payable on a quarterly basis for each hospital in an
32 amount calculated at a uniform assessment rate for each hospital discharge, in accordance with
33 this section.
34 (b) The uniform assessment rate shall be determined using the total number of hospital
35 discharges for assessed hospitals divided into the total non-federal portion in an amount
36 consistent with Section 26-36a-205 that is needed to support capitated rates for accountable
37 care organizations for purposes of hospital services provided to Medicaid enrollees.
38 (c) Any quarterly changes to the uniform assessment rate shall be applied uniformly to
39 all assessed hospitals.
40 (d) The annual uniform assessment rate may not generate more than:
41 (i) $1,000,000 to offset Medicaid mandatory expenditures; and
42 (ii) the non-federal share to seed amounts needed to support capitated rates for
43 accountable care organizations as provided for in Subsection (1)(b).
44 (2) (a) For each state fiscal year, discharges shall be determined using the data from
45 each hospital's Medicare Cost Report contained in the Centers for Medicare and Medicaid
46 Services' Healthcare Cost Report Information System file. The hospital's discharge data will be
47 derived as follows:
48 (i) for state fiscal year 2013, the hospital's cost report data for the hospital's fiscal year
49 ending between July 1, 2009, and June 30, 2010;
50 (ii) for state fiscal year 2014, the hospital's cost report data for the hospital's fiscal year
51 ending between July 1, 2010, and June 30, 2011;
52 (iii) for state fiscal year 2015, the hospital's cost report data for the hospital's fiscal year
53 ending between July 1, 2011, and June 30, 2012; [
54 (iv) for state fiscal year 2016, the hospital's cost report data for the hospital's fiscal year
55 ending between July 1, 2012, and June 30, 2013[
56 (v) for each subsequent state fiscal year, the hospital's cost report data for the hospital's
57 fiscal year that ended in the state fiscal year two years prior to the assessment fiscal year.
58 (b) If a hospital's fiscal year Medicare Cost Report is not contained in the Centers for
59 Medicare and Medicaid Services' Healthcare Cost Report Information System file:
60 (i) the hospital shall submit to the division a copy of the hospital's Medicare Cost
61 Report applicable to the assessment year; and
62 (ii) the division shall determine the hospital's discharges.
63 (c) If a hospital is not certified by the Medicare program and is not required to file a
64 Medicare Cost Report:
65 (i) the hospital shall submit to the division its applicable fiscal year discharges with
66 supporting documentation;
67 (ii) the division shall determine the hospital's discharges from the information
68 submitted under Subsection (2)(c)(i); and
69 (iii) the failure to submit discharge information shall result in an audit of the hospital's
70 records and a penalty equal to 5% of the calculated assessment.
71 (3) Except as provided in Subsection (4), if a hospital is owned by an organization that
72 owns more than one hospital in the state:
73 (a) the assessment for each hospital shall be separately calculated by the department;
74 and
75 (b) each separate hospital shall pay the assessment imposed by this chapter.
76 (4) Notwithstanding the requirement of Subsection (3), if multiple hospitals use the
77 same Medicaid provider number:
78 (a) the department shall calculate the assessment in the aggregate for the hospitals
79 using the same Medicaid provider number; and
80 (b) the hospitals may pay the assessment in the aggregate.
81 Section 2. Section 26-36a-208 is amended to read:
82 26-36a-208. Repeal of assessment.
83 (1) The repeal of the assessment imposed by this chapter shall occur upon the
84 certification by the executive director of the department that the sooner of the following has
85 occurred:
86 (a) the effective date of any action by Congress that would disqualify the assessment
87 imposed by this chapter from counting towards state Medicaid funds available to be used to
88 determine the federal financial participation;
89 (b) the effective date of any decision, enactment, or other determination by the
90 Legislature or by any court, officer, department, or agency of the state, or of the federal
91 government that has the effect of:
92 (i) disqualifying the assessment from counting towards state Medicaid funds available
93 to be used to determine federal financial participation for Medicaid matching funds; or
94 (ii) creating for any reason a failure of the state to use the assessments for the Medicaid
95 program as described in this chapter;
96 (c) the effective date of:
97 (i) an appropriation for any state fiscal year from the General Fund for hospital
98 payments under the state Medicaid program that is less than the amount appropriated for state
99 fiscal year 2012;
100 (ii) the annual revenues of the state General Fund budget return to the level that was
101 appropriated for fiscal year 2008;
102 [
103
104
105 [
106 [
107
108 [
109 2011 payments:
110 (A) aggregate hospital inpatient payments;
111 (B) adjustment payment rates; or
112 (C) any cost settlement protocol; or
113 [
114 below July 1, 2011 payments; and
115 (d) the sunset of this chapter in accordance with Section 63I-1-226.
116 (2) If the assessment is repealed under Subsection (1), money in the fund that was
117 derived from assessments imposed by this chapter, before the determination made under
118 Subsection (1), shall be disbursed under Section 26-36a-205 to the extent federal matching is
119 not reduced due to the impermissibility of the assessments. Any funds remaining in the special
120 revenue fund shall be refunded to the hospitals in proportion to the amount paid by each
121 hospital.
122 Section 3. Section 63I-1-226 is amended to read:
123 63I-1-226. Repeal dates, Title 26.
124 (1) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
125 1, 2025.
126 (2) Section 26-10-11 is repealed July 1, 2020.
127 (3) Section 26-21-23, Licensing of non-Medicaid nursing care facility beds, is repealed
128 July 1, 2018.
129 (4) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1, 2024.
130 (5) Title 26, Chapter 36a, Hospital Provider Assessment Act, is repealed July 1, [
131 2019.
132 (6) Section 26-38-2.5 is repealed July 1, 2017.
133 (7) Section 26-38-2.6 is repealed July 1, 2017.
134 (8) Title 26, Chapter 56, Hemp Extract Registration Act, is repealed July 1, 2016.
Legislative Review Note
Office of Legislative Research and General Counsel