10 LC 33
3733-ECS
The
House Committee on Appropriations offers the following substitute to HB
307:
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 payment to be imposed on hospitals to be used to obtain federal financial
participation for medical assistance payments under Medicaid; to provide for a
short title; to provide for definitions; to establish two segregated accounts
within the Indigent Care Trust Fund for the deposit of provider payments; to
provide for a method for calculating and collecting the provider payment; to
authorize the Department of Revenue to inspect hospital records for purposes of
auditing provider payments; to provide for penalties for failure to pay a
provider payment; to authorize the Department of Revenue to recommend
withholding of Medicaid payments equal to amounts owed as a provider payment and
penalty; to provide for the collection of payments 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 provide for automatic repeal; 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.
This
Act shall be known and may be cited as the "Provider Payment Agreement
Act."
SECTION
2.
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)
'Ambulatory surgical center' means any institution licensed pursuant to Chapter
7 of this title, which is a public or private facility, not part of a hospital,
which provides surgical treatment performed under general or regional anesthesia
in an operating room environment to patients not requiring
hospitalization.
(2)
'Department' means the Department of Revenue.
(3)
'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 and freestanding ambulatory surgical
centers, but shall not include psychiatric hospitals as defined in paragraph (7)
of Code Section 37-3-1, critical access hospitals as defined in paragraph (3) of
Code Section 33-21A-2, hospitals not authorized by law to accept Medicaid
payments, or any state owned or state operated hospitals.
(4)
'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 available audited Medicaid and
medicare cost reports provided to the Department of Community Health, the
Disproportionate Share Hospital Survey, or the Department of Community Health's
annual financial survey.
(5)
'Provider payment' means the payment imposed pursuant to this article for the
privilege of operating a hospital.
(6)
'Segregated account' means an account for the dedication and deposit of provider
payments which is established within the Indigent Care Trust Fund created
pursuant to Code Section 31-8-152.
(7)
'Trust fund' means the Indigent Care Trust Fund created pursuant to Code Section
31-8-152.
31-8-179.2.
There
are established within the trust fund two segregated accounts for revenues
raised through the imposition of the provider payment. All revenues raised
through provider payments from hospitals other than ambulatory surgical centers
shall be credited to one segregated account within the trust fund and all
revenues raised through provider payments from ambulatory surgical centers shall
be credited to a second segregated account. All funds 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 accounts.
31-8-179.3.
(a)
Each hospital shall be assessed a provider payment, assessed uniformly upon all
hospitals, in the amount of 1.45 percent of the net patient revenue of the
hospital.
(b)
The provider payment shall be paid quarterly by each hospital to the department.
The assessment shall be based on the hospital's most recent completed,
available, and audited Medicaid and medicare cost reports as submitted to the
Department of Community Health; provided, however, that for ambulatory surgical
centers, the assessment shall be based on the annual financial survey submitted
to the Department of Community Health. Payment of the provider payment shall be
due at end of each calendar quarter; the first payment shall be due on September
30.
31-8-179.4.
(a)
The department shall collect the provider payments imposed pursuant to Code
Section 31-8-179.3. All 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.
(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
payment. 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 payment, the department shall notify the hospital of the balance of
the provider payment 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 payment pursuant to this article
within the time required by this article shall pay, in addition to the
outstanding provider payment, a 6 percent penalty for each month or fraction
thereof that the payment is overdue. If a provider payment has not been
received by the department by the last day of the month, the department shall
recommend that the Department of Community Health withhold an amount equal to
the provider payment and penalty owed from any medical assistance payment due
such hospital under the Medicaid program. The provider payment 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.
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 of Community Health
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 of Community Health 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 of Community Health
shall not lapse to the general fund at the end of the fiscal year.
31-8-179.6.
The
Department of Community Health shall report annually to the General Assembly on
its use of revenues deposited into the segregated account and appropriated to
the Department of Community Health 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 and the Department of Community Health in carrying out the purposes
of this article.
31-8-179.8.
This
article shall stand repealed on June 30,
2013."
SECTION
3.
This
Act shall become effective July 1, 2010.
SECTION
4.
All
laws and parts of laws in conflict with this Act are repealed.