2019 Connecticut General Statutes
Title 12 - Taxation
Chapter 211c - Hospitals Tax and Nursing Home and Intermediate Care Facility Users Fees
Section 12-263q - Tax on net revenue from provision of inpatient hospital services and outpatient hospital services. Exemption request and approval.
(a)(1) For each calendar quarter commencing on or after July 1, 2017, each hospital shall pay a tax on the total net revenue received by such hospital for the provision of inpatient hospital services and outpatient hospital services.
(A) On and after July 1, 2017, and prior to July 1, 2019, the rate of tax for the provision of inpatient hospital services shall be six per cent of each hospital’s audited net revenue for fiscal year 2016 attributable to inpatient hospital services.
(B) On and after July 1, 2017, and prior to July 1, 2019, the rate of tax for the provision of outpatient hospital services shall be nine hundred million dollars less the total tax imposed on all hospitals for the provision of inpatient hospital services, which sum shall be divided by the total audited net revenue for fiscal year 2016 attributable to outpatient hospital services, of all hospitals that are required to pay such tax.
(C) On and after July 1, 2019, the rate of tax for the provision of inpatient hospital services and outpatient hospital services shall be three hundred eighty-four million dollars divided by the total audited net revenue for fiscal year 2016, of all hospitals that are required to pay such tax.
(2) Except as provided in subdivision (3) of this subsection, each such hospital shall be required to pay the total amount due in four quarterly payments consistent with section 12-263s, with the first quarter commencing with the first day of each state fiscal year and the last quarter ending on the last day of each state fiscal year.
(3) (A) For the state fiscal year commencing July 1, 2017, each hospital required to pay tax on inpatient hospital services or outpatient hospital services shall make an estimated tax payment on December 15, 2017, which estimated payment shall be equal to one hundred thirty-three per cent of the tax due under chapter 211a for the period ending June 30, 2017. If a hospital was not required to pay tax under said chapter 211a on either inpatient hospital services or outpatient hospital services, such hospital shall make its estimated payment based on its unaudited net patient revenue.
(B) Each hospital required to pay tax pursuant to this subdivision on inpatient hospital services or outpatient hospital services shall pay the remaining balance determined to be due in two equal payments, which shall be due on April 30, 2018, and July 31, 2018, respectively.
(C) For each state fiscal year commencing on or after July 1, 2017, each hospital required to pay tax on inpatient hospital services or outpatient hospital services shall calculate the amount of tax due on forms prescribed by the commissioner by multiplying the applicable rate set forth in subdivision (1) of this subsection by its audited net revenue for fiscal year 2016. Hospitals shall make all payments required under this section in accordance with procedures established by and on forms provided by the commissioner.
(D) The commissioner shall apply any payment made by a hospital in connection with the tax under chapter 211a for the period ending September 30, 2017, as a partial payment of such hospital’s estimated tax payment due on December 15, 2017, under subparagraph (A) of this subdivision. The commissioner shall return to a hospital any credit claimed by such hospital in connection with the tax imposed under said chapter 211a for the period ending September 30, 2017, for assignment as provided under section 12-263s.
(4) (A) Each hospital required to pay tax on inpatient hospital services or outpatient hospital services shall submit to the commissioner such information as the commissioner requires in order to calculate the audited net inpatient revenue for fiscal year 2016, the audited net outpatient revenue for fiscal year 2016 and the audited net revenue for fiscal year 2016 of all such health care providers. Such information shall be provided to the commissioner not later than January 1, 2018. The commissioner shall make additional requests for information as necessary to fully audit each hospital’s net revenue. Upon completion of the commissioner’s examination, the commissioner shall notify, prior to February 28, 2018, each hospital of its audited net inpatient revenue for fiscal year 2016, audited net outpatient revenue for fiscal year 2016 and audited net revenue for fiscal year 2016.
(B) Any hospital that fails to provide the requested information prior to January 1, 2018, or fails to comply with a request for additional information made under this subdivision shall be subject to a penalty of one thousand dollars per day for each day the hospital fails to provide the requested information or additional information.
(C) The commissioner may engage an independent auditor to assist in the performance of the commissioner’s duties and responsibilities under this subdivision.
(5) Net revenue derived from providing a health care item or service to a patient shall be taxed only one time under this section.
(6) (A) For purposes of this section:
(i) “Audited net inpatient revenue for fiscal year 2016” means the amount of revenue that the commissioner determines, in accordance with federal law, that a hospital received for the provision of inpatient hospital services during the 2016 federal fiscal year;
(ii) “Audited net outpatient revenue for fiscal year 2016” means the amount of revenue that the commissioner determines, in accordance with federal law, that a hospital received for the provision of outpatient hospital services during the 2016 federal fiscal year; and
(iii) “Audited net revenue for fiscal year 2016” means net revenue, as reported in each hospital’s audited financial statement, less the amount of revenue that the commissioner determines, in accordance with federal law, that a hospital received from other than the provision of inpatient hospital services and outpatient hospital services. The total audited net revenue for fiscal year 2016 shall be the sum of all audited net revenue for fiscal year 2016 for all hospitals required to pay tax on inpatient hospital services and outpatient hospital services.
(B) Audited net inpatient revenue and audited net outpatient revenue shall be based on information provided by each hospital required to pay tax on inpatient hospital services or outpatient hospital services.
(b) (1) The Commissioner of Social Services shall seek approval from the Centers for Medicare and Medicaid Services to exempt from the net revenue tax imposed under subsection (a) of this section the following: (A) Specialty hospitals; (B) children’s general hospitals; and (C) hospitals operated exclusively by the state other than a short-term acute hospital operated by the state as a receiver pursuant to chapter 920. Any hospital for which the Centers for Medicare and Medicaid Services grants an exemption shall be exempt from the net revenue tax imposed under subsection (a) of this section. Any hospital for which the Centers for Medicare and Medicaid Services denies an exemption shall be deemed to be a hospital for purposes of this section and shall be required to pay the net revenue tax imposed under subsection (a) of this section on inpatient hospital services and outpatient hospital services.
(2) Each hospital shall provide to the Commissioner of Social Services, upon request, such information as said commissioner may require to make any computations necessary to seek approval for exemption under this subsection.
(3) As used in this subsection, (A) “specialty hospital” means a health care facility, as defined in section 19a-630, other than a facility licensed by the Department of Public Health as a short-term general hospital or a short-term children’s hospital. “Specialty hospital” includes, but is not limited to, a psychiatric hospital or a chronic disease hospital, and (B) “children’s general hospital” means a health care facility, as defined in section 19a-630, that is licensed by the Department of Public Health as a short-term children’s hospital. “Children’s general hospital” does not include a specialty hospital.
(c) Prior to January 1, 2018, and every three years thereafter, the Commissioner of Social Services shall seek approval from the Centers for Medicare and Medicaid Services to exempt financially distressed hospitals from the net revenue tax imposed on outpatient hospital services. Any such hospital for which the Centers for Medicare and Medicaid Services grants an exemption shall be exempt from the net revenue tax imposed on outpatient hospital services under subsection (a) of this section. Any hospital for which the Centers for Medicare and Medicaid Services denies an exemption shall be required to pay the net revenue tax imposed on outpatient hospital services under subsection (a) of this section. For purposes of this subsection, “financially distressed hospital” means a hospital that has experienced over a five-year period an average net loss of more than five per cent of aggregate revenue. A hospital has an average net loss of more than five per cent of aggregate revenue if such a loss is reflected in the five most recent years of financial reporting that have been made available by the Office of Health Care Access for such hospital in accordance with section 19a-670 as of the effective date of the request for approval which effective date shall be July first of the year in which the request is made.
(d) The commissioner shall issue guidance regarding the administration of the tax on inpatient hospital services and outpatient hospital services. Such guidance shall be issued upon completion of a study of the applicable federal law governing the administration of tax on inpatient hospital services and outpatient hospital services. The commissioner shall conduct such study in collaboration with the Commissioner of Social Services, the Secretary of the Office of Policy and Management, the Connecticut Hospital Association and the hospitals subject to the tax imposed on inpatient hospital services and outpatient hospital services.
(e) (1) The commissioner shall determine, in consultation with the Commissioner of Social Services, the Secretary of the Office of Policy and Management, the Connecticut Hospital Association and the hospitals subject to the tax imposed on inpatient hospital services and outpatient hospital services, if there is any underreporting of revenue on hospitals’ audited financial statements. Such consultation shall only be as authorized under section 12-15. The commissioner shall issue guidance, if necessary, to address any such underreporting.
(2) If the commissioner determines, in accordance with this subsection, that a hospital underreported net revenue on its audited financial statement, the amount of underreported net revenue shall be added to the amount of net revenue reported on such hospital’s audited financial statement so as to comply with federal law and the revised net revenue amount shall be used for purposes of calculating the amount of tax owed by such hospital under this section. For purposes of this subsection, “underreported net revenue” means any revenue of a hospital subject to the tax imposed under this section that is required to be included in net revenue from the provision of inpatient hospital services and net revenue from the provision of outpatient hospital services to comply with 42 CFR 433.56, as amended from time to time, 42 CFR 433.68, as amended from time to time, and Section 1903(w) of the Social Security Act, as amended from time to time, but that was not reported on such hospital’s audited financial statement. Underreported net revenue shall only include revenue of the hospital subject to such tax.
(f) Nothing in this section shall affect the commissioner’s obligations under section 12-15 regarding disclosure and inspection of returns and return information.
(g) The provisions of section 17b-8 shall not apply to any exemption or exemptions sought by the Department of Social Services from the Centers for Medicare and Medicaid Services under this section.
(June Sp. Sess. P.A. 17-4, S. 2.)
History: June Sp. Sess. P.A. 17-4 effective November 21, 2017.
