2013 Indiana Code TITLE 16. HEALTH ARTICLE 21. HOSPITALS CHAPTER 10. HOSPITAL ASSESSMENT FEE
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IC 16-21-10
Chapter 10. Hospital Assessment Fee
IC 16-21-10-1
"Committee"
Sec. 1. As used in this chapter, "committee" refers to the hospital
assessment fee committee established by section 7 of this chapter.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-2
"Fee"
Sec. 2. As used in this chapter, "fee" refers to the hospital
assessment fee authorized by this chapter.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-3
"Fee period"
Sec. 3. As used in this chapter, "fee period" means the period
during which a fee is collected under this chapter.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-4
"Hospital"
Sec. 4. (a) As used in this chapter, "hospital" means either of the
following:
(1) A hospital (as defined in IC 16-18-2-179(b)) licensed under
this article.
(2) A private psychiatric hospital licensed under IC 12-25.
(b) The term does not include the following:
(1) A state mental health institution operated under
IC 12-24-1-3.
(2) A hospital:
(A) designated by the Medicaid program as a long term care
hospital;
(B) that has an average inpatient length of stay that is greater
than twenty-five (25) days, as determined by the office of
Medicaid policy and planning under the Medicaid program;
(C) that is a Medicare certified, freestanding rehabilitation
hospital; or
(D) that is a hospital operated by the federal government.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-5
"Office"
Sec. 5. As used in this chapter, "office" refers to the office of
Medicaid policy and planning established by IC 12-8-6.5-1.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-6
Authority to assess hospital assessment fee; prerequisites;
conditions for terminating the fee; records and reports
Sec. 6. (a) Subject to subsection (b) and section 8(b) of this
chapter, the office may assess a hospital assessment fee to hospitals
during the fee period if the following conditions are met:
(1) The fee may be used only for the purposes described in the
following:
(A) Section 8(c)(1) of this chapter.
(B) Section 9 of this chapter.
(C) Section 11 of this chapter.
(D) Section 14 of this chapter.
(2) The Medicaid state plan amendments and waiver requests
required for the implementation of this chapter are submitted by
the office to the United States Department of Health and Human
Services before October 1, 2013.
(3) The United States Department of Health and Human
Services approves the Medicaid state plan amendments and
waiver requests, or revisions of the Medicaid state plan
amendments and waiver requests, described in subdivision (2):
(A) not later than October 1, 2014; or
(B) after October 1, 2014, if a date is established by the
committee.
(4) The funds generated from the fee do not revert to the state
general fund.
(b) The office shall stop collecting a fee, the programs described
in section 8(a) of this chapter shall be reconciled and terminated
subject to section 9(c) of this chapter, and the operation of section 11
of this chapter ends subject to section 9(c) of this chapter, if any of
the following occurs:
(1) An appellate court makes a final determination that either:
(A) the fee; or
(B) any of the programs described in section 8(a) of this
chapter;
cannot be implemented or maintained.
(2) The United States Department of Health and Human
Services makes a final determination that the Medicaid state
plan amendments or waivers submitted under this chapter are
not approved or cannot be validly implemented.
(3) The fee is not collected because of circumstances described
in section 8(d) of this chapter.
(c) The office shall keep records of the fees collected by the office
and report the amount of fees collected under this chapter to the
budget committee.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-7
Hospital assessment fee committee established; membership;
meeting requirements
Sec. 7. (a) The hospital assessment fee committee is established.
The committee consists of the following four (4) voting members:
(1) The secretary of family and social services established by
IC 12-8-1.5-1, or the secretary's designee, who shall serve as the
chair of the committee.
(2) The budget director or the budget director's designee.
(3) Two (2) individuals appointed by the governor from a list of
at least four (4) individuals submitted by the Indiana Hospital
Association.
If a vacancy occurs among the members appointed under subdivision
(3), the governor shall appoint a replacement committee member
from a list of at least two (2) individuals submitted by the Indiana
Hospital Association.
(b) The committee shall review any Medicaid state plan
amendments, waiver requests, or revisions to any Medicaid state plan
amendments or waiver requests, to implement or continue the
implementation of this chapter for the purpose of establishing
favorable review of the amendments, requests, and revisions by the
United States Department of Health and Human Services.
(c) The committee shall meet at the call of the chair. The members
serve without compensation.
(d) A quorum consists of at least three (3) members. An
affirmative vote of at least three (3) members of the committee is
necessary to approve Medicaid state plan amendments, waiver
requests, or revisions to the Medicaid state plan or waiver requests.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-8
Mandatory programs for increasing Medicaid reimbursement;
committee review of state plan amendments, waivers, or revisions;
report to budget committee; state share dollars; termination of fee
Sec. 8. (a) Subject to subsection (b), the office shall develop the
following programs designed to increase, to the extent allowable
under federal law, Medicaid reimbursement for inpatient and
outpatient hospital services provided by a hospital to Medicaid
recipients:
(1) A program concerning reimbursement for the Medicaid
fee-for-service program that, in the aggregate, will result in
payments equivalent to the level of payment that would be paid
under federal Medicare payment principles.
(2) A program concerning reimbursement for the Medicaid risk
based managed care program that, in the aggregate, will result
in payments equivalent to the level of payment that would be
paid under federal Medicare payment principles.
(b) The office shall not submit to the United States Department of
Health and Human Services any Medicaid state plan amendments,
waiver requests, or revisions to any Medicaid state plan amendments
or waiver requests, to implement or continue the implementation of
this chapter until the committee has reviewed and approved the
amendments, waivers, or revisions described in this subsection and
has submitted a written report to the budget committee concerning
the amendments, waivers, or revisions described in this subsection,
including the following:
(1) The methodology to be used by the office in calculating the
increased Medicaid reimbursement under the programs
described in subsection (a).
(2) The methodology to be used by the office in calculating,
imposing, or collecting the fee, or any other matter relating to
the fee.
(3) The determination of Medicaid disproportionate share
allotments under section 11 of this chapter that are to be funded
by the fee, including the formula for distributing the Medicaid
disproportionate share allotments.
(4) The distribution to private psychiatric institutions under
section 13 of this chapter.
(c) This subsection applies to the programs described in
subsection (a). The state share dollars for the programs must consist
of the following:
(1) Fees paid under this chapter.
(2) The hospital care for the indigent funds allocated under
section 10 of this chapter.
(3) Other sources of state share dollars available to the office,
excluding intergovernmental transfers of funds made by or on
behalf of a hospital.
The money described in subdivisions (1) and (2) may be used only
to fund the part of the payments that exceed the Medicaid
reimbursement rates in effect on June 30, 2011.
(d) This subsection applies to the programs described in
subsection (a). If the state is unable to maintain the funding under
subsection (c)(3) for the payments at Medicaid reimbursement levels
in effect on June 30, 2011, because of budgetary constraints, the
office shall reduce inpatient and outpatient hospital Medicaid
reimbursement rates under subsection (a)(1) or (a)(2) or request
approval from the committee and the United States Department of
Health and Human Services to increase the fee to prevent a decrease
in Medicaid reimbursement for hospital services. If:
(1) the committee:
(A) does not approve a reimbursement reduction; or
(B) does not approve an increase in the fee; or
(2) the United States Department of Health and Human Services
does not approve an increase in the fee;
the office shall cease to collect the fee and the programs described in
subsection (a) are terminated.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-9
Hospital Medicaid fund established; purposes; distribution of
excess if fee is terminated
Sec. 9. (a) This section is effective upon implementation of the
fee. The hospital Medicaid fee fund is established for the purpose of
holding fees collected under this chapter that are not necessary to
match federal funds.
(b) The office shall administer the fund.
(c) Money in the fund at the end of a state fiscal year does not
revert to the state general fund. However, money remaining in the
fund after the cessation of the collection of the fee under section 6(b)
of this chapter shall be used for the payments described in sections
8(a) and 11 of this chapter. Any money not required for the payments
described in sections 8(a) and 11 of this chapter after the cessation
of the collection of the fee under section 6(b) of this chapter shall be
distributed to the hospitals on a pro rata basis based upon the fees
paid by each hospital for the state fiscal year that ended immediately
before the cessation of the collection of the fee under section 6(b) of
this chapter.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-10
Use of hospital care for the indigent funds as state share dollars
Sec. 10. This section:
(1) is effective upon implementation of the fee; and
(2) does not apply to funds under IC 12-16-17.
Notwithstanding any other law, the part of the amounts appropriated
for or transferred to the hospital care for the indigent program for the
state fiscal year beginning July 1, 2013, and each state fiscal year
thereafter that are not required to be paid to the office by law shall
be used exclusively as state share dollars for the payments described
in sections 8(a) and 11 of this chapter. Any hospital care for the
indigent funds that are not required for the payments described in
sections 8(a) and 11 of this chapter after the cessation of the
collection of the fee under section 6(b) of this chapter shall be used
for the state share dollars of the payments in IC 12-15-20-2(8)(G)(ii)
through IC 12-15-20-2(8)(G)(x).
As added by P.L.205-2013, SEC.214.
IC 16-21-10-11
Disproportionate share payments; allocations of federal Medicaid
disproportionate share allotments
Sec. 11. (a) This section:
(1) is effective upon the implementation of the fee; and
(2) applies to the Medicaid disproportionate share payments for
the state fiscal year beginning July 1, 2013, and each state fiscal
year thereafter.
(b) The state share dollars used to fund disproportionate share
payments to acute care hospitals licensed under IC 16-21-2 that
qualify as disproportionate share providers or municipal
disproportionate share providers under IC 12-15-16-1(a) or
IC 12-15-16-1(b) shall be paid with money collected through the fee
and the hospital care for the indigent dollars described in section 10
of this chapter.
(c) Subject to section 12 of this chapter and except as provided in
section 12 of this chapter, the federal Medicaid disproportionate
share allotments for the state fiscal years beginning July 1, 2013, and
each state fiscal year thereafter shall be allocated in their entirety to
acute care hospitals licensed under IC 16-21-2 that qualify as
disproportionate share providers or municipal disproportionate share
providers under IC 12-15-16-1(a) or IC 12-15-16-1(b). No part of the
federal disproportionate share allotments applicable for
disproportionate share payments for the state fiscal year beginning
July 1, 2013, and each state fiscal year thereafter may be allocated to
institutions for mental disease or other mental health facilities, as
defined by applicable federal law.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-12
Funds excluded from federal Medicaid disproportionate share
allotments
Sec. 12. For purposes of this chapter, the entire federal Medicaid
disproportionate share allotment for Indiana does not include the part
of allotments that are required to be diverted under the following:
(1) The federally approved Indiana "Special Terms and
Conditions" Medicaid demonstration project (Number
11-W-00237/5).
(2) Any extension after December 31, 2012, of the Indiana
check-up plan established under IC 12-15-44.2.
The office shall inform the committee and the budget committee
concerning any extension of the Indiana check-up plan after
December 31, 2013.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-13
Disproportionate share dollars that are unavailable to private
psychiatric institutions
Sec. 13. Notwithstanding IC 12-15-16-6(c), the annual two million
dollar ($2,000,000) pool of disproportionate share dollars under
IC 12-15-16-6(c) shall not be available to eligible private psychiatric
institutions. The office shall annually distribute two million dollars
($2,000,000) to eligible private psychiatric institutions that would
have been eligible for payment under IC 12-15-16-6(c).
As added by P.L.205-2013, SEC.214.
IC 16-21-10-14
Permissible uses of hospital assessment fees
Sec. 14. The fees collected under this chapter may be used only
as described in this chapter or to pay the state's share of the cost for
Medicaid services provided under the federal Medicaid program (42
U.S.C. 1396 et seq.) as follows:
(1) Twenty-eight and five-tenths percent (28.5%) may be used
by the office for Medicaid expenses.
(2) Seventy-one and five-tenths percent (71.5%) to hospitals.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-15
Rule of statutory construction; local fees, taxes, or assessments not
permitted
Sec. 15. This chapter may not be construed to authorize any
county, municipality, district, or authority to impose a fee, tax, or
assessment on a hospital.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-16
Rules
Sec. 16. Subject to section 8(b) of this chapter, the office may
adopt rules, including emergency rules adopted in the manner
provided under IC 4-22-2-37.1, necessary to implement this chapter.
Rules adopted under this section may be retroactive to the effective
date of the Medicaid state plan amendments or waivers approved
under this chapter.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-17
Installment agreements
Sec. 17. The office may enter into an agreement with a hospital to
pay the fee in installments.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-18
Interest on late payments; license revocations for payments at least
120 days overdue
Sec. 18. (a) A hospital shall pay to the office interest on any fee
that is paid eleven (11) or more days after the payment date. The
interest must be applied at the same rate as the rate determined under
IC 12-15-21-3(6)(A).
(b) The office shall report to the state department of health each
hospital that fails to pay the fee within one hundred twenty (120)
days after the payment date. The state department shall do the
following concerning a hospital described in this subsection:
(1) Notify the hospital that the hospital's license under IC 16-21
will be revoked if the fee is not paid.
(2) Revoke the hospital's license under IC 16-21 if the hospital
fails to pay the fee. IC 4-21.5-3-8 and IC 4-21.5-4 apply to this
subdivision.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-19
Program payments
Sec. 19. Payments for the programs described in section 8(a) of
this chapter are limited to claims for dates of services provided
during the fee period and that are timely filed with the office or a
contractor of the office. Payments for the programs described in
section 8(a) of this chapter and payments to hospitals in accordance
with section 11 of this chapter may occur at any time, including after
collection of the fee is stopped under section 6(b) of this chapter, to
the extent the funding provided for the payments by this chapter is
available under section 9(c) of this chapter. Payments for the
program described in section 13 of this chapter may occur at any
time, including after the collection of the fee is stopped under section
6(b) of this chapter, subject to the reconciliation and termination of
the program required by section 6(b) of this chapter.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-20
Collection of unpaid fees; refunds
Sec. 20. The office may collect unpaid fees owed by a hospital
under this chapter and may refund fees paid by a hospital under this
chapter at any time, including after the cessation of the collection of
a fee under this chapter.
As added by P.L.205-2013, SEC.214.
IC 16-21-10-21
Expiration date
Sec. 21. This chapter expires June 30, 2017.
As added by P.L.205-2013, SEC.214.
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