2010 New York Code
PBH - Public Health
Article 28 - (2800 - 2822) HOSPITALS
2807-D - Hospital assessments.

§  2807-d.  Hospital assessments. 1. (a) Hospitals, as defined in this
  article,  excluding  hospitals  specified  in  paragraph  (b)  of   this
  subdivision,  are  charged  assessments on their gross receipts received
  from all patient care services and other operating income, less personal
  needs allowances and refunds, on a cash basis in the percentage  amounts
  and  for  the periods specified in subdivision two of this section. Such
  assessments shall be submitted by or  on  behalf  of  hospitals  to  the
  commissioner or his designee.
    (b)  Subject  to the provisions of subdivision twelve of this section,
  the following categories of hospitals shall not be  charged  assessments
  pursuant   to   this   section:  (i)  voluntary  nonprofit  and  private
  proprietary general hospitals which qualify for  distributions  made  in
  accordance  with  paragraph  (c)  of  subdivision  nineteen  of  section
  twenty-eight hundred seven-c of this article, or for assessments  during
  the period January first, nineteen hundred ninety-seven through December
  thirty-first,  nineteen  hundred  ninety-seven  voluntary  nonprofit and
  private proprietary general hospitals which qualified for  distributions
  made in accordance with paragraph (c) of subdivision nineteen of section
  twenty-eight   hundred   seven-c   of   this   article  as  of  December
  thirty-first, nineteen hundred  ninety-five;  (ii)  voluntary  nonprofit
  hospitals  totally financed by charitable contributions or by the income
  thereon dedicated to free care of low income  patients;  and  (iii)  any
  facility   dedicated  solely  to  the  care  of  police,   firefighters,
  volunteer firefighters, and emergency service personnel.
    (c) On and after December first, nineteen  hundred  ninety-seven,  the
  term  "general  hospital",  as  used in this section, includes specialty
  hospitals for persons who are developmentally disabled, licensed by  the
  office  of  mental  retardation and developmental disabilities and which
  are  also  issued  an  operating   certificate   pursuant   to   section
  twenty-eight hundred five of this article.
    2.  (a)  (i)  For  general  hospitals  the overall assessment shall be
  six-tenths of one percent and the assessment shall  vary  from  0.5%  to
  0.675%  of  each  general  hospital's  gross  receipts received from all
  patient care services and other operating income on a cash basis  during
  the  period  January  first,  nineteen  hundred ninety-one through March
  thirty-first, nineteen hundred ninety-two for hospital or health-related
  services, including but not limited  to  inpatient  service,  outpatient
  service,  emergency  service, referred ambulatory service and ambulatory
  surgical service. The assessment shall vary according to the  percentage
  of   nineteen  hundred  eighty-nine  medicaid  inpatient  revenues  as a
  percentage of total  nineteen hundred eighty-nine inpatient revenues  as
  reported  on  the  institutional cost report submitted to the department
  for  nineteen  hundred  eighty-nine  according  to  the  following:  for
  hospitals  with medicaid revenue up to and including 10%, the assessment
  shall be .5%,  for hospitals with medicaid revenue greater than  10%  up
  to  and including 15%, the assessment shall be .525%, for hospitals with
  medicaid  revenue  greater  than  15%  up  to  and  including  20%,  the
  assessment  shall  be .65%, and for hospitals with medicaid revenue over
  20%, the assessment shall be .675%. In the  event  that  the  provisions
  relating  to  the additional supplementary low income patient adjustment
  established  in  accordance  with  subdivision  fourteen-d  of   section
  twenty-eight  hundred  seven-c  of  this  article cannot be implemented,
  then the general hospital assessment established in accordance with this
  paragraph shall  be  calculated  without  variation  specified  in  this
  paragraph  and the assessment for each general hospital whose assessment
  was greater than six-tenths of one percent shall  become  six-tenths  of
  one percent.

(ii)  For  general hospitals the assessment shall be six-tenths of one
  percent of each general hospital's  gross  receipts  received  from  all
  patient  care  services  and  other  operating  income  on  a cash basis
  beginning April first,  nineteen  hundred  ninety-two  for  hospital  or
  health-related   services,  including,  but  not  limited  to  inpatient
  service, outpatient  service,  emergency  service,  referred  ambulatory
  service and ambulatory surgical service; provided, however, that for all
  such  gross  receipts  received  on  or  after  December first, nineteen
  hundred  ninety-eight,  such  assessment  shall  be  two-tenths  of  one
  percent,  and further provided that for all such gross receipts received
  on or after April first, nineteen hundred ninety-nine,  such  assessment
  shall  be  one-tenth  of  one  percent,  and  further provided that such
  assessment shall expire and be of no further effect for all  such  gross
  receipts received on or after January first, two thousand.
    (iii)   For  general  hospitals  an  additional  assessment  shall  be
  one-tenth of one percent  of  each  general  hospital's  gross  receipts
  received  from all patient care services and other operating income on a
  cash basis  beginning  April  first,  nineteen  hundred  ninety-two  for
  hospital  or  health-related  services,  including,  but  not limited to
  inpatient  service,  outpatient  service,  emergency  service,  referred
  ambulatory  service  and ambulatory surgical service; provided, however,
  that such additional assessment shall expire and be of no further effect
  for all such  gross  receipts  received  on  or  after  December  first,
  nineteen hundred ninety-seven.
    (iv)  Subject to the provisions of subdivision twelve of this section,
  the assessment and additional assessment pursuant to subparagraphs  (ii)
  and  (iii)  of  this paragraph during the period January first, nineteen
  hundred ninety-eight through  December  thirty-first,  nineteen  hundred
  ninety-eight  for  voluntary  nonprofit  and private proprietary general
  hospitals which qualified for  distributions  made  in  accordance  with
  paragraph  (c)  of  subdivision nineteen of section twenty-eight hundred
  seven-c of this article as of December  thirty-first,  nineteen  hundred
  ninety-five  shall  be  abated  by  seventy-five percent, and during the
  period January first,  nineteen  hundred  ninety-nine  through  December
  thirty-first,   nineteen   hundred   ninety-nine   shall  be  abated  by
  twenty-five percent.
    (v) Notwithstanding any contrary provisions of this paragraph  or  any
  other  provision  of  law  or  regulation,  for  general  hospitals  the
  assessment shall be  thirty-five  hundredths  of  one  percent  of  each
  general  hospital's  gross  receipts  received  from  all  patient  care
  services and other operating income on a cash basis for the period April
  first, two thousand five through March thirty-first two  thousand  seven
  for  hospital  or health-related services, including, but not limited to
  inpatient  service,  outpatient  service,  emergency  service,  referred
  ambulatory  service  and ambulatory surgical services, but not including
  residential  health  care  facilities  services  or  home  health   care
  services.
    (vi)  Notwithstanding any contrary provisions of this paragraph or any
  other  provision  of  law  or  regulation,  for  general  hospitals  the
  assessment  shall  be  thirty-five  hundredths  of  one  percent of each
  general  hospital's  gross  receipts  received  from  all  patient  care
  services  and  other operating income on a cash basis for periods on and
  after April first, two thousand nine,  for  hospital  or  health-related
  services,  including,  but not limited to inpatient services, outpatient
  services,  emergency  services,   referred   ambulatory   services   and
  ambulatory  surgical services, but not including residential health care
  facilities services or home health care services.

(b) (i) For residential health care facilities the assessment shall be
  six-tenths of one percent of each  residential  health  care  facility's
  gross  receipts  received  from  all  patient  care  services  and other
  operating income on a cash basis beginning April first, nineteen hundred
  ninety-one  for hospital or health-related services, including adult day
  services; provided, however, that for all such gross  receipts  received
  on   or  after  September  first,  nineteen  hundred  ninety-seven  such
  assessment shall be three-tenths of one percent,  and  further  provided
  that  such  assessment  shall expire and be of no further effect for all
  such gross receipts  received  on  or  after  December  first,  nineteen
  hundred ninety-eight.
    (ii)  For  residential health care facilities an additional assessment
  shall be one and two-tenths percent  of  each  residential  health  care
  facility's  gross  receipts  received from all patient care services and
  other operating income on a cash basis beginning April  first,  nineteen
  hundred  ninety-two  for  hospital or health-related services, including
  adult day services; provided, however, that such  additional  assessment
  shall  expire  and  be  of no further effect for all such gross receipts
  received on or after April first, nineteen hundred ninety-nine.
    (iii) For residential health  care  facilities  a  further  additional
  assessment  shall  be three and eight tenths percent of each residential
  health care facility's gross receipts received  from  all  patient  care
  services  and  other  operating income on a cash basis for the period of
  July first, nineteen hundred  ninety-five  through  March  thirty-first,
  nineteen  hundred  ninety-six  for  hospital or health-related services,
  including adult day services. The residential health care facility shall
  file the assessment return with any balance due or any refund claimed by
  May first, nineteen hundred ninety-six. Notwithstanding any inconsistent
  provision of this section, the residential health  care  facility  shall
  make  estimated payments to the commissioner on a monthly basis starting
  August fifteenth, nineteen hundred ninety-five  and  continuing  on  the
  fifteenth  of  each  month  through  March  fifteenth,  nineteen hundred
  ninety-six equal to one-eighth of the total estimated for  this  further
  additional  assessment  for the further additional assessment period. If
  the total of estimated payments is less than ninety-five percent of  the
  actual  payment  due,  the residential health care facility shall pay to
  the commissioner a penalty of fifteen percent of the difference due  for
  each  month  in  addition to the amount due. The commissioner may recoup
  deficiencies and penalties pursuant to paragraph (c) of subdivision  six
  of this section.
    * (iv)  For  residential  health  care facilities a further additional
  assessment shall be one and  nine-tenths  percent  of  each  residential
  health  care  facility's  gross  receipts received from all patient care
  services and other operating income on a cash basis for  the  period  of
  April  first,  nineteen  hundred  ninety-six through March thirty-first,
  nineteen hundred ninety-seven for hospital or  health-related  services,
  including adult day services. The residential health care facility shall
  file the assessment return with any balance due or any refund claimed by
  May   first,   nineteen   hundred   ninety-seven.   Notwithstanding  any
  inconsistent provision of this  section,  the  residential  health  care
  facility  shall make estimated payments to the commissioner on a monthly
  basis starting May fifteenth, and continuing on the  fifteenth  of  each
  month  through  March  fifteenth  equal  to  one-eleventh  of  the total
  estimated for this further additional assessment for  the  period  April
  first,  nineteen  hundred ninety-six through March thirty-first nineteen
  hundred ninety-seven. If the total of estimated payments  is  less  than
  ninety-five  percent  of  the actual payment due, the residential health
  care facility shall pay to the commissioner a penalty of fifteen percent

of the difference due each month in addition  to  the  amount  due.  The
  commissioner may recoup deficiencies and penalties pursuant to paragraph
  (c) of subdivision six of this section.
    * NB There are 2 subpar (iv)'s
    * (iv)  For  residential  health  care facilities a further additional
  assessment shall be one and  nine-tenths  percent  of  each  residential
  health  care  facility's  gross  receipts received from all patient care
  services and other operating income on a cash basis for  the  period  of
  April  first,  nineteen  hundred ninety-six through  March thirty-first,
  nineteen hundred ninety-seven for hospital or  health-related  services,
  including adult day services. The residential health care facility shall
  file the assessment return with any balance due or any refund claimed by
  May   first,   nineteen   hundred   ninety-seven.   Notwithstanding  any
  inconsistent provision of this  section,  the  residential  health  care
  facility  shall make estimated payments to the commissioner on a monthly
  basis starting May fifteenth, and continuing on the  fifteenth  of  each
  month  through  March  fifteenth,  equal  to  one-eleventh of the  total
  estimated  for  this  further  additional  assessment  for  the   period
  beginning  April  first  of nineteen hundred ninety-six and ending March
  thirty-first, nineteen hundred ninety-seven. If the total of the  eleven
  required  estimated  payments  is  less  than ninety-five percent of the
  actual payment due, the residential health care facility  shall  pay  to
  the commissioner a penalty of fifteen  percent of the difference due for
  each  month  in  addition to the amount due. The commissioner may recoup
  deficiencies and penalties pursuant  to paragraph (c) of subdivision six
  of this section.
    * NB There are 2 subpar (iv)'s
    * (v) For residential health care facilities  in  addition  a  further
  additional  assessment shall be (a) two and three-tenths percent of each
  residential care facility's gross receipts  received  from  all  patient
  care  services  and other operating income on a cash basis beginning May
  first,  nineteen  hundred  ninety-six  through   December  thirty-first,
  nineteen  hundred  ninety-six  for  hospital or health-related services,
  including adult day services and (b) one and nine-tenths percent of each
  residential care facility's gross receipts  received  from  all  patient
  care  services  and  other  operating  income on a cash basis  beginning
  January  first,  nineteen  hundred  ninety-seven  and  ending  February
  twenty-eighth,   nineteen   hundred   ninety-seven   for   hospital   or
  health-related services, including adult day services.
    * NB There are 2 subpar (v)'s
    * (v) For residential health care facilities  in  addition  a  further
  additional  assessment shall be (a) two and three-tenths percent of each
  residential care facility's gross receipts  received  from  all  patient
  care  services  and other operating income on a cash basis beginning May
  first, nineteen hundred ninety-six  and  ending  December  thirty-first,
  nineteen  hundred  ninety-six  for  hospital or health-related services,
  including adult day services and (b) one and nine-tenths percent of each
  residential care facility's gross receipts  received  from  all  patient
  care  services  and  other  operating  income  on a cash basis beginning
  January  first,  nineteen  hundred  ninety-seven  and  ending   February
  twenty-eighth,   nineteen   hundred   ninety-seven   for   hospital   or
  health-related  services,  including  adult  day   services;   provided,
  however,  that  for  all  such gross receipts received on or after April
  first, nineteen hundred ninety-seven, such further additional assessment
  shall be three and six-tenths percent, and further provided that for all
  such gross receipts received on or after April first,  nineteen  hundred
  ninety-nine,  such  further  additional  assessment  shall  be  two  and
  four-tenths percent, and further provided that such  further  additional

assessment  shall  expire and be of no further effect for all such gross
  receipts received on or after January first, two thousand.
    * NB There are 2 subpar (v)'s
    (vi)  Notwithstanding  any contrary provision of this paragraph or any
  other provision of law or regulation to the  contrary,  for  residential
  health  care  facilities  the  assessment  shall  be six percent of each
  residential health care facility's  gross  receipts  received  from  all
  patient care services and other operating income on a cash basis for the
  period  April  first,  two  thousand two through March thirty-first, two
  thousand three for hospital or health-related services, including  adult
  day   services;   provided,   however,   that  residential  health  care
  facilities' gross receipts attributable to payments received pursuant to
  title XVIII of the federal  social  security  act  (medicare)  shall  be
  excluded from the assessment; provided, however, that for all such gross
  receipts  received  on  or after April first, two thousand three through
  March thirty-first, two thousand five, such  assessment  shall  be  five
  percent,  and further provided that for all such gross receipts received
  on or after April first, two thousand five through  March  thirty-first,
  two  thousand  nine,  and  on  or  after  April first, two thousand nine
  through March thirty-first, two thousand eleven such assessment shall be
  six percent.
    (c) For all other facilities issued an operating certificate  pursuant
  to   section  twenty-eight  hundred  five  of  this  article,  including
  diagnostic and treatment centers, the assessment shall be six-tenths  of
  one  percent of each facility's gross receipts received from all patient
  care services and other operating  income  on  a  cash  basis  beginning
  January   first,   nineteen   hundred   ninety-one   for   hospital   or
  health-related  services,  including  diagnostic  and  treatment  center
  services;  provided,  however, that for all such gross receipts received
  on or after April first, nineteen hundred ninety-nine,  such  assessment
  shall  be  two-tenths  of  one  percent,  and further provided that such
  assessment shall expire and be of no further effect for all  such  gross
  receipts received on or after January first, two thousand.
    3.  Gross  receipts  received from all patient care services and other
  operating income for purposes of the assessment pursuant to this section
  shall include, but not be limited to:
    (a) for general hospitals, all monies received for or  on  account  of
  inpatient  hospital  service,  outpatient  service,  emergency  service,
  referred ambulatory service and ambulatory surgical  service,  or  other
  hospital   or   health-related   services,  excluding,  subject  to  the
  provisions of subdivision twelve of this section: distributions from bad
  debt and charity care  regional  pools,  primary  health  care  services
  regional  pools,  bad  debt  and charity care for financially distressed
  hospitals statewide pools and bad debt  and  charity  care  and  capital
  statewide  pools created in accordance with section twenty-eight hundred
  seven-c of this article and  the  components  of  rates  of  payment  or
  charges   related   to   the  allowances  provided  in  accordance  with
  subdivisions  fourteen,  fourteen-b  and  fourteen-c,   the   adjustment
  provided  in  accordance  with  subdivision  fourteen-a,  the adjustment
  provided in accordance with subdivision fourteen-d, the  adjustment  for
  health   maintenance   organization   reimbursement  rates  provided  in
  accordance with section twenty-eight hundred seven-f  of  this  article,
  the  adjustment  for  commercial insurer reimbursement rates provided in
  accordance  with  paragraph  (i)  of  subdivision  eleven   of   section
  twenty-eight  hundred  seven-c  of  this  article  or, if effective, the
  adjustment provided in accordance with subdivision  fifteen  of  section
  twenty-eight  hundred seven-c of this article or the adjustment provided
  in accordance with section eighteen of chapter two hundred sixty-six  of

the  laws  of  nineteen  hundred  eighty-six  as  amended  and physician
  practice or faculty practice plan revenue received by a general hospital
  based on discrete billings for private  practicing  physician  services,
  revenue  received  by a general hospital from a public hospital pursuant
  to an affiliation agreement contract for the  delivery  of  health  care
  services to such public hospital, revenue received pursuant to paragraph
  (i)  of  subdivision thirty-five of section twenty-eight hundred seven-c
  of this article,  revenue  received  pursuant  to  section  twenty-eight
  hundred   seven-w   of   this   article,   all   revenue   received   as
  disproportionate share  hospital  payments,  in  accordance  with  title
  nineteen  of  the federal Social Security Act, revenue received pursuant
  to sections eleven, twelve, thirteen and fourteen of part A  of  chapter
  one  of  the  laws  of  two  thousand  two, revenue received pursuant to
  sections thirteen and fourteen of part B of chapter one of the  laws  of
  two thousand two, revenue from patient personal fund allowances, revenue
  from  income  earned on patient funds, investment income from externally
  restricted funds, revenue from investment sinking  funds,  revenue  from
  investment  operating  escrow  accounts,  investment  income from funded
  depreciation, investment income from mortgage repayment escrow accounts,
  revenue derived from the operation of schools leading to licensure,  and
  revenue from the collection of sales and excise taxes;
    (b) for residential health care facilities, all monies received for or
  on  account  of  hospital or health-related service, including adult day
  services, excluding subject to the provisions of subdivision  twelve  of
  this section the component of rates of payment related to the adjustment
  provided  in  accordance with subdivision twelve of section twenty-eight
  hundred eight of this article;
    (c) for all other facilities issued an operating certificate  pursuant
  to   section  twenty-eight  hundred  five  of  this  article,  including
  diagnostic and treatment centers, all monies received for or on  account
  of   hospital  or  health-related  services,  however,  subject  to  the
  provisions  of  subdivision  twelve  of  this  section,  excluding   the
  component  of  rates  of  payment  related  to the allowance provided in
  accordance with paragraph (f) of subdivision two of section twenty-eight
  hundred seven of this article, excluding for a diagnostic and  treatment
  center  operated  by  a  health  maintenance  organization  operating in
  accordance with the provisions of article forty-four of this chapter  or
  article  forty-three  of  the  insurance  law  monies received for or on
  account of services provided to subscribers of such  health  maintenance
  organization  and  excluding  patient care services which if provided to
  persons eligible for medical assistance  pursuant  to  title  eleven  of
  article  five  of  the  social services law would be eligible for ninety
  percent federal funds as set forth in section nineteen hundred three  of
  the federal social security act; and
    (d)  for  all  hospitals,  excluding  diagnostic and treatment centers
  operated by a health maintenance organization  operating  in  accordance
  with  the  provisions  of  article forty-four of this chapter or article
  forty-three of the insurance law, shall include monies received  for  or
  on  account  of such revenue sources as investment income, parking lots,
  cafeterias, gift  shops  and  rental  income,  provided,  however,  that
  subject  to  the provisions of subdivision twelve of this section income
  received from grants, charitable contributions, donations  and  bequests
  and governmental deficit financing and the component of rates of payment
  reflecting   any   cost  of  the  assessment  reimbursable  pursuant  to
  subdivision  ten of this section shall not be included.
    4. For  periods  prior  to  January  first,  two  thousand  five,  the
  commissioner  is  authorized  to  contract  with the article forty-three
  insurance law plans, or if not available such  other  administrators  as

the  commissioner  shall  designate,  to receive and distribute hospital
  assessment funds. In the event contracts with the  article   forty-three
  insurance  law  plans or other commissioner's designees are effectuated,
  the  commissioner  shall  conduct  annual  audits  of  the  receipt  and
  distribution of the assessment funds. The reasonable costs and  expenses
  of  an  administrator as approved by the commissioner, not to exceed for
  personnel services on an annual basis four hundred thousand dollars  for
  all assessments established pursuant to this section, shall be paid from
  the assessment funds.
    5. Estimated payments by or on behalf of hospitals to the commissioner
  or   his  designee  of  funds  due  from  the  assessments  pursuant  to
  subdivision two of this section  shall  be  made  on  a  monthly  basis.
  Estimated payments shall be due on or before the fifteenth day following
  the end of a calendar month to which an assessment applies.
    6. (a) If an estimated payment made for a month to which an assessment
  applies  is  less  than  seventy  percent  of an amount the commissioner
  determines is due, based on evidence of prior period moneys received  by
  a  hospital  or  evidence  of  moneys received by such hospital for that
  month, the commissioner may estimate the amount due from  such  hospital
  and  may  collect  the  deficiency  pursuant  to  paragraph  (c) of this
  subdivision.
    (b) If an estimated payment made for a month to  which  an  assessment
  applies  is  less  than  ninety  percent  of  an amount the commissioner
  determines is due, based on evidence of prior period moneys received  by
  a  hospital  or  evidence  of  moneys received by such hospital for that
  month, and at least two previous estimated payments within the preceding
  six months were less than ninety percent of the  amount  due,  based  on
  similar evidence, the commissioner may estimate the amount due from such
  hospital  and  may  collect  the deficiency pursuant to paragraph (c) of
  this subdivision.
    (c) Upon receipt of notification from the commissioner of a hospital's
  deficiency under this section, the comptroller or a fiscal  intermediary
  designated  by the director of the budget, or the commissioner of social
  services, or a corporation organized and operating  in  accordance  with
  article  forty-three  of the insurance law, or an organization operating
  in accordance with article forty-four of  this  chapter  shall  withhold
  from  the  amount  of  any  payment  to  be made by the state or by such
  article forty-three corporation or article  forty-four  organization  to
  the hospital the amount of the deficiency determined under paragraph (a)
  or (b) of this subdivision or paragraph (e) of subdivision seven of this
  section.  Upon  withholding such amount, the comptroller or a designated
  fiscal  intermediary,  or  the  commissioner  of  social  services,   or
  corporation   organized   and   operating  in  accordance  with  article
  forty-three of the insurance law or organization operating in accordance
  with article forty-four of this chapter shall pay the  commissioner,  or
  his designee, such amount withheld on behalf of the hospital.
    (d)  The  commissioner  shall  provide  a  hospital with notice of any
  estimate of an amount due for an assessment pursuant to paragraph (a) or
  (b) of this subdivision or paragraph (e) of subdivision  seven  of  this
  section  at  least  three days prior to collection of such amount by the
  commissioner. Such notice shall contain  the  financial  basis  for  the
  commissioner's estimate.
    (e) In the event a hospital objects to an estimate by the commissioner
  pursuant to paragraph (a) or (b) of this subdivision or paragraph (e) of
  subdivision  seven  of this section of the amount due for an assessment,
  the hospital, within sixty days of notice of an amount due, may  request
  a  public  hearing.  If  a  hearing is requested, the commissioner shall
  provide the hospital an opportunity to be heard and to present  evidence

bearing  on  the  amount  due for an assessment within thirty days after
  collection of an amount due or receipt  of  a  request  for  a  hearing,
  whichever  is  later. An administrative hearing is not a prerequisite to
  seeking judicial relief.
    (f)  The  commissioner  may  direct that a hearing be held without any
  request by a hospital.
    7. (a) Every hospital shall submit reports on a cash basis  of  actual
  gross  receipts  received  from  all patient care services and operating
  income for each month as follows:
    (i) for the period January first, nineteen hundred ninety-one  through
  January  thirty-first,  nineteen hundred ninety-one, the report shall be
  filed on or before March fifteenth, nineteen hundred ninety-one; and
    (ii) for the quarter year ending March thirty-first, nineteen  hundred
  ninety-one and for each quarter thereafter, the report shall be filed on
  or before the forty-fifth day after the end of such quarter.
    (b)  Every  hospital  shall submit a certified annual report on a cash
  basis of gross receipts received in such calendar year from all  patient
  care services and operating income.
    (c)  The  reports  shall  be  in such form as may be prescribed by the
  commissioner to accurately disclose information  required  to  implement
  this section.
    (d)  Final payments shall be due for all hospitals for the assessments
  pursuant to subdivision two of  this  section  upon  the  due  date  for
  submission of the applicable quarterly report.
    (e)  The  commissioner  may  recoup  deficiencies  in  final  payments
  pursuant to paragraph (c) of subdivision six of this section. Delinquent
  amounts which have been referred for recoupment or  offset  pursuant  to
  paragraph  (c)  of  subdivision  six of this section, or which have been
  referred to the office of the attorney general for collection, shall  be
  deemed  final  and  not subject to further revision or reconciliation by
  the commissioner based on any additional reports  or  other  information
  submitted  by  the  hospital, provided, however, that such delinquencies
  shall not be referred for such recoupment or for such  collection  based
  on   estimated   amounts   unless  the  hospital  has  received  written
  notification of such delinquencies and  has  been  given  no  less  than
  thirty days in which to submit delinquent reports.
    8. (a) If an estimated payment made for a month to which an assessment
  applies  is  less  than ninety percent of the actual amount due for such
  month, interest shall be due and payable  to  the  commissioner  on  the
  difference  between  the  amount paid and the amount due from the day of
  the month the estimated payment was due until the date of  payment.  The
  rate  of  interest  shall  be twelve percent per annum or at the rate of
  interest set by the commissioner of taxation and finance with respect to
  underpayments of tax pursuant to subsection (e) of section one  thousand
  ninety-six  of  the tax law minus four percentage points. Interest under
  this paragraph shall not be paid if the amount thereof is less than  one
  dollar.  Interest,  if not paid by the due date of the following month's
  estimated payment, may be collected  by  the  commissioner  pursuant  to
  paragraph  (c)  of subdivision six of this section in the same manner as
  an assessment pursuant to subdivision two of this section.
    (b) If an estimated payment made for a month to  which  an  assessment
  applies  is  less than seventy percent of the actual amount due for such
  month, a penalty shall be due and payable  to the commissioner  of  five
  percent   of  the  difference between the amount paid and the amount due
  for such month when the failure to pay is for a  duration  of  not  more
  than  one  month  after  the due date of the payment with  an additional
  five percent for each additional month or  fraction thereof during which
  such  failure  continues,  not  exceeding  twenty-five  percent  in  the

aggregate.  A  penalty may be collected by  the commissioner pursuant to
  paragraph (c) of subdivision six of this section in the same  manner  as
  an assessment pursuant to subdivision two of this section.
    (c) Overpayment by a hospital of an estimated payment shall be applied
  to any other payment due from the hospital pursuant to this section, or,
  if  no  payment is due, at the election of the hospital shall be applied
  to future estimated payments or refunded to the hospital. Interest shall
  be paid on overpayments from the date of  overpayment  to  the  date  of
  crediting  or refund at the rate determined in accordance with paragraph
  (a) of this subdivision if the overpayment was made at the direction  of
  the commissioner. Interest under this paragraph shall not be paid if the
  amount thereof is less than one dollar.
    9.  Funds  accumulated, including income from invested funds, from the
  assessments specified in this section, including interest and penalties,
  shall be deposited by the commissioner and:
    (a) credited to the general fund;
    (b) provided, however, that funds accumulated, including  income  from
  invested  funds,  from  the  assessments  provided  in  accordance  with
  subparagraph (v) of paragraph (a) and subparagraphs (iii), (iv), (v) and
  (vi) of paragraph (b) of subdivision  two  of  this  section,  including
  interest  and  penalties,  shall  be  deposited  by the commissioner and
  credited  to  the  special  revenue  fund-other,  miscellaneous  special
  revenue  fund  (339), medical assistance account. To the extent of funds
  appropriated therefor, funds shall be made available for payments  under
  the  medical  assistance  program  provided  pursuant to title eleven of
  article five of the social services law;
    (c) and provided further, however, that funds  accumulated,  including
  income  from  invested  funds,  for  a  period  from  the assessment and
  additional assessment provided in accordance with subparagraphs (ii) and
  (iii) of paragraph (a) of subdivision two  of  this  section,  including
  interest  and  penalties, on voluntary nonprofit and private proprietary
  general hospitals which qualified for distributions made  in  accordance
  with  paragraph  (c)  of  subdivision  nineteen  of section twenty-eight
  hundred seven-c of this article as of  December  thirty-first,  nineteen
  hundred  ninety-five  shall  be  transferred  by  the  commissioner  and
  consolidated with funds  accumulated  from  the  allowance  pursuant  to
  subdivision  two of section twenty-eight hundred seven-j of this article
  for such period and allocated in accordance  with  subdivision  nine  of
  section twenty-eight hundred seven-j of this article.
    10. Notwithstanding any inconsistent provision of law or regulation to
  the contrary:
    (a) the assessments pursuant to this section shall not be an allowable
  cost  in  the  determination  of  reimbursement  rates  pursuant to this
  article;
    (b) provided, however, that  for  purposes  of  determining  rates  of
  payment pursuant to this article for residential health care facilities,
  for  the period January first, nineteen hundred ninety-two through March
  thirty-first, nineteen hundred ninety-nine, the additional assessment of
  one and two-tenths percent, and for  the  period  July  first,  nineteen
  hundred   ninety-five   through  March  thirty-first,  nineteen  hundred
  ninety-six the further additional assessment of three  and  eight-tenths
  percent,  and  for  the  period April first, nineteen hundred ninety-six
  through March thirty-first, nineteen hundred  ninety-seven  the  further
  additional assessment of one and nine-tenths percent, and for the period
  May  first,  nineteen  hundred ninety-six through December thirty-first,
  nineteen hundred ninety-six the further additional assessment of two and
  three-tenths percent and for the period January first, nineteen  hundred
  ninety-seven    through   February   twenty-eighth,   nineteen   hundred

ninety-seven the further additional assessment of  one  and  nine-tenths
  percent,  and  for the period April first, nineteen hundred ninety-seven
  through March thirty-first, nineteen  hundred  ninety-nine  the  further
  additional  assessment  of  three  and  six-tenths  percent, and for the
  period  April  first,  nineteen  hundred  ninety-nine  through  December
  thirty-first,   nineteen  hundred  ninety-nine  the  further  additional
  assessment of two and four-tenths  percent,  imposed  pursuant  to  this
  section  shall  be  a  reimbursable  cost  to  be reflected as timely as
  practicable in rates of payment applicable within the assessment period,
  contingent, for  payments  by  governmental  agencies,  on  all  federal
  approvals necessary by federal law and regulations for federal financial
  participation  in  payments  made for beneficiaries eligible for medical
  assistance under title XIX of the federal social security act.
    (c) provided, however, that for the purposes of determining  rates  of
  payment pursuant to this article for residential health care facilities,
  the assessment imposed pursuant to subparagraph (vi) of paragraph (b) of
  subdivision  two  of  this  section  shall  be a reimbursable cost to be
  reflected as timely  as  practicable,  and  subsequently  reconciled  to
  actual  cost,  in  rates  of  payment  applicable  within the assessment
  period.
    (d) provided, however, that the adjustment to rates  of  payment  made
  pursuant  to  paragraph (c) of this subdivision shall be calculated on a
  per diem basis and based on total reported patient days  of  care  minus
  reported days attributable to title XVIII of the federal social security
  act (medicare) units of service.
    (e) the provisions of paragraphs (c) and (d) of this subdivision shall
  each  be  contingent  upon  receipt of all federal approvals required by
  federal law and  regulations  for  federal  financial  participation  in
  payments  made  in  accordance  with  paragraphs  (c)  and  (d)  of this
  subdivision.
    11. (a) (ii) The assessment shall not be collected in  excess  of  one
  hundred  thirty-four million three hundred thousand dollars from general
  hospitals for the period of April first, nineteen  hundred  ninety-seven
  through March thirty-first, nineteen hundred ninety-eight. The amount of
  the assessment collected pursuant to paragraph (a) of subdivision two of
  this  section in excess of one hundred thirty-four million three hundred
  thousand dollars  for  the  period  of  April  first,  nineteen  hundred
  ninety-seven  through  March thirty-first, nineteen hundred ninety-eight
  shall be refunded to general hospitals by the commissioner based on  the
  ratio which a general hospital's assessment for such period bears to the
  total of the assessments for such period paid by general hospitals.
    (iii)  The  additional  assessment shall not be collected in excess of
  fourteen million nine hundred thousand dollars  from  general  hospitals
  for  the  period  of  April first, nineteen hundred ninety-seven through
  November thirtieth, nineteen hundred ninety-seven.  The  amount  of  the
  additional assessment collected pursuant to paragraph (a) of subdivision
  two  of this section in excess of fourteen million nine hundred thousand
  dollars for the period of April  first,  nineteen  hundred  ninety-seven
  through  November  thirtieth,  nineteen  hundred  ninety-seven  shall be
  refunded to general hospitals by the commissioner  based  on  the  ratio
  which  a  general hospital's additional assessment for such period bears
  to the total of the additional  assessments  for  such  period  paid  by
  general hospitals.
    (b)  (ii)  The  assessment shall not be collected in excess of fifteen
  million dollars from residential health care facilities for  the  period
  of   April   first,   nineteen   hundred   ninety-eight   through  March
  thirty-first, nineteen hundred ninety-nine. The amount of the assessment
  collected pursuant to paragraph (b) of subdivision two of  this  section

in  excess  of  fifteen  million  dollars for the period of April first,
  nineteen  hundred  ninety-eight  through  March  thirty-first,  nineteen
  hundred  ninety-nine  shall  be  refunded  to  residential  health  care
  facilities  by  the  commissioner based on the ratio which a residential
  health care facility's assessment for such period bears to the total  of
  the  assessments  for  such  period  paid  by  residential  health  care
  facilities.
    (iii) The additional assessment shall not be collected  in  excess  of
  eighty-nine  million  nine  hundred  thousand  dollars  from residential
  health care facilities for the period of April first,  nineteen  hundred
  ninety-eight  through  March thirty-first, nineteen hundred ninety-nine.
  The amount of the additional assessment collected pursuant to  paragraph
  (b)  of subdivision two of this section in excess of eighty-nine million
  nine hundred thousand dollars for the period of  April  first,  nineteen
  hundred   ninety-eight  through  March  thirty-first,  nineteen  hundred
  ninety-nine shall be refunded to residential health care  facilities  by
  the  commissioner  based  on  the  ratio which a residential health care
  facility's additional assessment for such period bears to the  total  of
  the  additional  assessments  for such period paid by residential health
  care facilities.
    (iv) The further additional  assessment  shall  not  be  collected  in
  excess  of one hundred sixty-four million seven hundred thousand dollars
  from residential health care  facilities  for  the  period  July  first,
  nineteen   hundred  ninety-five  through  March  thirty-first,  nineteen
  hundred ninety-six. The amount  of  the  further  additional  assessment
  collected  pursuant  to paragraph (b) of subdivision two of this section
  in excess of one  hundred  sixty-four  million  seven  hundred  thousand
  dollars  for  the  period  of  July  first, nineteen hundred ninety-five
  through  March  thirty-first,  nineteen  hundred  ninety-six  shall   be
  refunded to residential health care facilities by the commissioner based
  on  the  ratio  which  a  residential  health  care  facility's  further
  additional assessment for such period bears to the total of the  further
  additional  assessments  for such period paid by residential health care
  facilities.
    (v) The further additional assessment imposed pursuant to subparagraph
  (iv) of paragraph (b) of subdivision two of this section  shall  not  be
  collected   in  excess  of  one  hundred  twelve  million  dollars  from
  residential health care facilities for the period April first,  nineteen
  hundred   ninety-six   through   March  thirty-first,  nineteen  hundred
  ninety-seven. The amount of the further additional assessment  collected
  pursuant  to  subparagraph  (iv)  of paragraph (b) of subdivision two of
  this section in excess of one hundred twelve  million  dollars  for  the
  period  of  April  first,  nineteen  hundred  ninety-six  through  March
  thirty-first,  nineteen  hundred  ninety-seven  shall  be  refunded   to
  residential  health  care  facilities  by  the commissioner based on the
  ratio which a residential  health  care  facility's  further  additional
  assessment  for such period bears to the total of the further additional
  assessments for such period paid by residential health care facilities.
    (vi) The further additional  assessment  shall  not  be  collected  in
  excess  of  one hundred ten million dollars from residential health care
  facilities for  the  period  May  first,   nineteen  hundred  ninety-six
  through  February  twenty-eighth,  nineteen  hundred  ninety-seven.  The
  amount of  the  further  additional  assessment  collected  pursuant  to
  subparagraph  (v) of paragraph (b) of subdivision two of this section in
  excess  of  one  hundred  ten  million dollars for the period May first,
  nineteen hundred ninety-six  through  February  twenty-eighth,  nineteen
  hundred  ninety-seven  shall  be  refunded  to  residential  health care
  facilities by the commissioner based on the ratio  which  a  residential

health  care  facility's  further  additional assessment for such period
  bears to the total of  the  further  additional   assessments  for  such
  period paid by residential health care facilities.
    (vii)  The  further  additional  assessment  shall not be collected in
  excess of two hundred forty million dollars from residential health care
  facilities for the period April  first,  nineteen  hundred  ninety-seven
  through March thirty-first, nineteen hundred ninety-eight. The amount of
  the further additional assessment collected pursuant to subparagraph (v)
  of  paragraph  (b)  of  subdivision two of this section in excess of two
  hundred forty million dollars for the period of  April  first,  nineteen
  hundred   ninety-seven  through  March  thirty-first,  nineteen  hundred
  ninety-eight shall be refunded to residential health care facilities  by
  the  commissioner  based  on  the  ratio which a residential health care
  facility's further additional assessments for such a period bears to the
  total of the further additional assessments  for  such  period  paid  by
  residential health care facilities.
    (viii)  The  further  additional  assessment shall not be collected in
  excess of two hundred fifty-six million eight hundred  thousand  dollars
  from  residential  health  care  facilities  for the period April first,
  nineteen  hundred  ninety-eight  through  March  thirty-first,  nineteen
  hundred  ninety-nine.  The  amount  of the further additional assessment
  collected pursuant to subparagraph (v) of paragraph (b)  of  subdivision
  two  of  this  section  in excess of two hundred fifty-six million eight
  hundred thousand dollars for the period April  first,  nineteen  hundred
  ninety-eight  through  March  thirty-first, nineteen hundred ninety-nine
  shall  be  refunded  to  residential  health  care  facilities  by   the
  commissioner  based  on  the  ratio  which  a  residential  health  care
  facility's further additional assessments for such period bears  to  the
  total  of  the  further  additional  assessments for such period paid by
  residential health care facilities.
    (c) (ii) The assessment shall not be  collected  in  excess  of  seven
  million  four  hundred thousand dollars from all other facilities issued
  an operating certificate pursuant to section twenty-eight  hundred  five
  of  this  article  for  the  period  of  April  first,  nineteen hundred
  ninety-seven through March thirty-first, nineteen hundred  ninety-eight.
  The  amount  of  the  assessment  collected pursuant to paragraph (c) of
  subdivision two of this section in excess of seven million four  hundred
  thousand  dollars  for  the  period  of  April  first,  nineteen hundred
  ninety-seven through March thirty-first, nineteen  hundred  ninety-eight
  shall  be  refunded  by  the  commissioner  based  on  the ratio which a
  facility's assessment  for  such  period  bears  to  the  total  of  the
  assessments for such period paid by such facilities.
    12.  (a)  Each  exclusion  of  hospitals  or sources of gross receipts
  received from  the  assessments  effective  on  or  after  April  first,
  nineteen hundred ninety-two, and prior to April first, two thousand two,
  established  pursuant  to  this section shall be contingent upon either:
  (i) qualification of the assessments for waiver pursuant to federal  law
  and  regulation; or (ii) consistent with federal law and regulation, not
  requiring a waiver by the secretary of  the  department  of  health  and
  human  services  related to such exclusion; in order for the assessments
  under this section to be qualified as a broad-based health care  related
  tax  for  purposes of the revenues received by the state pursuant to the
  assessments not reducing the amount expended by  the  state  as  medical
  assistance   for   purposes  of  federal  financial  participation.  The
  commissioner shall collect the assessments relying on  such  exclusions,
  pending any contrary action by the secretary of the department of health
  and  human  services.  In  the  event the secretary of the department of
  health and human services determines that  the  assessments  do  not  so

qualify  based on any such exclusion, then the exclusion shall be deemed
  to have  been  null  and  void  as  of  April  first,  nineteen  hundred
  ninety-two,  and  the  commissioner shall collect any retroactive amount
  due  as a result, without interest or penalty provided the hospital pays
  the retroactive  amount due  within  ninety  days  of  notice  from  the
  commissioner   to  the  hospital  that  an  exclusion  is null and void.
  Interest and penalties shall be measured from the  due  date  of  ninety
  days following notice from the commissioner to the hospital.
    (b)  The  exclusion  of  the  hospitals  described in paragraph (b) of
  subdivision one of this section and the exclusion of  revenue  described
  in  subdivision  two  of  this section from the assessments set forth in
  subdivision two of this section for periods on and  after  April  first,
  two  thousand  two shall be contingent upon either: (i) qualification of
  the assessments for waiver pursuant to federal law  and  regulation;  or
  (ii)  consistent with federal law and regulation, not requiring a waiver
  by the secretary of the department of health and human services  related
  to such exclusion; in order for the assessments under this section to be
  qualified  as  a broad-based health care related tax for purposes of the
  revenues received by the state pursuant to the assessments not  reducing
  the  amount  expended by the state as medical assistance for purposes of
  federal financial participation. The  commissioner  shall  collect  such
  assessments  relying  on  such exclusion, pending any contrary action by
  the secretary of the department of health and  human  services.  In  the
  event  the  secretary  of  the  department  of health and human services
  determines that such  assessments  do  not  so  qualify  based  on  such
  exclusion,  then  the  commissioner  shall,  to  the extent necessary to
  achieve such qualification for  federal  financial  participation,  deem
  such  exclusions  null  and  void  as of the first day of the period for
  which such assessments apply, and the  commissioner  shall  collect  any
  retroactive amount due as a result, without interest or penalty provided
  the  hospital  pays  the  retroactive  amount  due within ninety days of
  notice from the commissioner to the hospital that such exclusion is null
  and void.
    (c) No hospital shall be obligated  to  pay  assessments  pursuant  to
  subparagraph  (v)  of  paragraph  (a) of subdivision two of this section
  prior to December first,  two  thousand  five.  The  commissioner  shall
  collect  payment  obligations  incurred  prior  to  December  first, two
  thousand five proportionally over the  remaining  months  in  the  state
  fiscal year.

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