09 LC 33
2841-EC
House
Bill 307
By:
Representatives Cole of the
125th
and Ramsey of the
72nd
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Chapter 8 of Title 31 of the Official Code of Georgia Annotated, relating
to the care and protection of indigent and elderly patients, so as to provide
for a fee to be imposed on hospitals to be used to obtain federal financial
participation for medical assistance payments under Medicaid; to provide for
definitions; to establish a segregated account within the Indigent Care Trust
Fund for the deposit of provider fees; to provide for a method for calculating
and collecting the provider fee; to authorize the Department of Community Health
to inspect hospital records for purposes of auditing provider fees; to provide
for penalties for failure to pay a provider fee; to authorize the department to
withhold Medicaid payments equal to amounts owed as a provider fee and penalty;
to provide for the collection of fees by civil action and tax liens; to provide
for the appropriation of funds in the segregated account for medical assistance
payments; to provide for application of the "Georgia Medical Assistance Act of
1977"; to revise definitions relating to quality assessment fees on care
management organizations; to revise language relating to the maximum aggregate
quality assessment fees which may be imposed; to provide for related matters; to
provide for an effective date; to repeal conflicting laws; and for other
purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Chapter
8 of Title 31 of the Official Code of Georgia Annotated, relating to the care
and protection of indigent and elderly patients, is amended by adding a new
article to read as follows:
"ARTICLE
6C
31-8-179.
This
article is enacted pursuant to the authority of Article III, Section IX,
Paragraph VI(i) of the Constitution.
31-8-179.1.
As
used in this article, the term:
(1)
'Department' means the Department of Community Health.
(2)
'Hospital' means an institution licensed pursuant to Chapter 7 of this title
which is primarily engaged in providing to inpatients, by or under the
supervision of physicians, diagnostic services and therapeutic services for
medical diagnosis, treatment, and care of injured, disabled, or sick persons or
rehabilitation services for the rehabilitation of injured, disabled, or sick
persons. Such term includes public, private, rehabilitative, geriatric,
osteopathic, and other specialty hospitals but shall not include psychiatric
hospitals as defined in paragraph (7) of Code Section 37-3-1 or any state owned
or state operated hospitals.
(3)
'Net patient revenue' means the total gross patient revenue of a hospital less
contractual adjustments; charity care; bad debt; Hill-Burton commitments; and
indigent care as defined by and calculated in accordance with department
guidelines.
(4)
'Provider fee' means the fee imposed pursuant to this article for the privilege
of operating a hospital.
(5)
'Segregated account' means an account for the dedication and deposit of provider
fees which is established within the Indigent Care Trust Fund created pursuant
to Code Section 31-8-152.
(6)
'Trust fund' means the Indigent Care Trust Fund created pursuant to Code Section
31-8-152.
31-8-179.2.
There
is established within the trust fund a segregated account for revenues raised
through the imposition of the provider fee. All revenues raised through
provider fees shall be credited to the segregated account within the trust fund,
except as otherwise provided for in Code Section 31-8-179.4, and shall be
invested in the same manner as authorized for investing other moneys in the
state treasury. Contributions and transfers to the trust fund pursuant to Code
Sections 31-8-153 and 31-8-153.1 shall not be deposited into the segregated
account.
31-8-179.3.
(a)
Each hospital shall be assessed a provider fee, assessed uniformly upon all
hospitals, in the amount of the lesser of 1.6 percent of the net patient revenue
of the hospital or the maximum amount that may be assessed pursuant to the
percentage limitation of the first prong of the test for an indirect guarantee
set out in 42 C.F.R. Section 433.68(f)(3)(i).
(b)
The provider fee shall be paid quarterly by each hospital to the department.
The assessment shall be based on the most recent completed annual financial
report prepared by the department. Payment of the provider fee shall be due no
later than the thirtieth day following the end of each calendar quarter; the
first payment shall be due on September 1, 2009, and the final payment of the
first year shall be due no later than May 31, 2010.
31-8-179.4.
(a)
The department shall collect the provider fees imposed pursuant to Code Section
31-8-179.3. No less than 90 percent of revenues raised pursuant to this article
shall be deposited into the segregated account. Such funds shall be dedicated
and used for the sole purpose of obtaining federal financial participation for
medical assistance payments to providers on behalf of Medicaid recipients
pursuant to Article 7 of Chapter 4 of Title 49. Up to 10 percent of revenues
raised pursuant to this article may be deposited into the general treasury with
the intent that such funds be used for trauma care.
(b)
The department shall prepare and distribute a form upon which each hospital
shall submit information to comply with this article.
(c)
Each hospital shall keep and preserve for a period of three years such books and
records as may be necessary to determine the amount for which it is liable under
this article. The department shall have the authority to inspect and copy the
records of a hospital for purposes of auditing the calculation of the provider
fee. All information obtained by the department pursuant to this article shall
be confidential and shall not constitute a public record.
(d)
In the event the department determines that a hospital has underpaid or overpaid
the provider fee, the department shall notify the hospital of the balance of the
provider fee or refund that is due. Such payment or refund shall be due within
30 days of the department's notice.
(e)
Any hospital that fails to pay the provider fee pursuant to this article within
the time required by this article shall pay, in addition to the outstanding
provider fee, a 6 percent penalty for each month or fraction thereof that the
payment is overdue. If a provider fee has not been received by the department
by the last day of the month, the department shall withhold an amount equal to
the provider fee and penalty owed from any medical assistance payment due such
hospital under the Medicaid program. The provider fee levied by this article
shall constitute a debt due the state and may be collected by civil action and
the filing of tax liens in addition to such methods provided for in this
article. Any penalty that accrues pursuant to this subsection shall be credited
to the segregated account.
(f)
The Governor may suspend the collection of the provider fees, or any part
thereof, imposed pursuant to this article due the state until no later than the
meeting of the next General Assembly, but the Governor shall not otherwise
interfere with the collection of such fees.
31-8-179.5.
(a)
Notwithstanding any other provision of this chapter, the General Assembly is
authorized to appropriate as state funds to the department for use in any fiscal
year all revenues dedicated and deposited into the segregated account. Such
appropriations shall be made for the sole purpose of obtaining federal financial
participation for medical assistance payments to providers on behalf of Medicaid
recipients pursuant to Article 7 of Chapter 4 of Title 49. Any appropriation
from the segregated account for any purpose other than such medical assistance
payments shall be void.
(b)
Revenues appropriated to the department pursuant to this Code section shall be
used to match federal funds that are available for the purpose for which such
trust funds have been appropriated.
(c)
Appropriations from the segregated account to the department shall not lapse to
the general fund at the end of the fiscal year.
31-8-179.6.
The
department shall report annually to the General Assembly on its use of revenues
deposited into the segregated account and appropriated to the department
pursuant to this article.
31-8-179.7.
Except
where inconsistent with this article, the provisions of Article 7 of Chapter 4
of Title 49, the 'Georgia Medical Assistance Act of 1977,' shall apply to the
department in carrying out the purposes of this
article."
SECTION
2.
Said
chapter is further amended in Code Section 31-8-171, relating to definitions
relative to quality assessment fees on care management organizations, by
revising paragraph (1) as follows:
"(1)
'Care management organization' means an entity granted a certificate of
authority under Chapter 21 of Title 33
of the
Official Code of Georgia
Annotated, an
entity offering an accident and sickness policy as defined in Code Section
33-29-1, and an entity operating as a preferred provider pursuant to Chapter 30
of Title 33 and which meets the definition
found in 42 U.S.C. Sec. 1396b(w)(7)(A)(viii) as it
now exists
or as it may be amended in the future
exists on July
1, 2009; provided however, that the term shall not include a health benefit
policy as defined in paragraph (1.1) of Code Section
33-1-2."
SECTION
3.
Said
chapter is further amended in Code Section 31-8-173, relating to the assessment,
calculation, and payment of quality assessment fees on care management
organizations, by revising subsection (a) as follows:
"(a)
Each care management organization shall be assessed a quality assessment fee, in
an amount to be determined by the department based on anticipated revenue
estimates included in the state budget report, with respect to its gross direct
premiums. The quality assessment fee shall be assessed uniformly upon all care
management organizations. The aggregate quality assessment fees imposed under
this article shall not exceed
the lesser of
1.6 percent of the gross direct premium of the care management organization
or the maximum amount that may be assessed
pursuant to 42 C.F.R. Section 433.68(f)(3)(I).
The Governor
may suspend the collection of the quality assessment fees, or any part thereof,
imposed pursuant to this article due the state until no later than the meeting
of the next General Assembly, but the Governor shall not otherwise interfere
with the collection of such
fees."
SECTION
4.
This
Act shall become effective upon its approval by the Governor or upon its
becoming law without such approval.
SECTION
5.
All
laws and parts of laws in conflict with this Act are repealed.