House Bill No. 6522
House Bill No. 6522
PUBLIC ACT NO. 97-2
AN ACT CONCERNING HOSPITAL COMPLIANCE PAYMENTS AND
APPLICATION OF THE TAXES ON HOSPITAL CHARGES.
Be it enacted by the Senate and House of
Representatives in General Assembly convened:
Section 1. (NEW) (a) Notwithstanding the
provisions of section 19a-170c of the general
statutes, as amended by section 2 of public act
96-238, for the hospital fiscal year commencing
October 1, 1994, no amount due on or after January
31, 1997, for net revenue compliance shall be
assessed, collected, or deducted from any hospital
which has submitted a written release as specified
in this section and such hospital shall not be
liable for any such amount. The release required
by this section shall be in a form satisfactory to
the Secretary of the Office of Policy and
Management and shall release any and all claims
which have been brought or could have been brought
challenging the assessment or collection of any
amount of net revenue compliance due prior to
January 31, 1997. To be effective for purposes of
this section such release must be received by the
Secretary on or before January 30, 1997.
(b) Notwithstanding any provision of the
general statutes, the Office of Health Care Access
shall not assess, collect or deduct net revenue
compliance pursuant to said section 19a-170c of
the general statutes for hospital fiscal years
commencing on or after October 1, 1995.
Sec. 2. Section 12-263a of the general
statutes is repealed and the following is
substituted in lieu thereof:
As used in sections 12-263a to 12-263e,
inclusive:
(1) "Hospital" means any health care facility
or institution, as defined in section 19a-145,
which is licensed as a short-term general hospital
by the Department of Public Health BUT, DOES NOT
INCLUDE ANY HOSPITAL WHICH, ON THE EFFECTIVE DATE
OF THIS ACT, IS WITHIN THE CLASS OF HOSPITALS
LICENSED BY THE DEPARTMENT AS CHILDREN'S GENERAL
HOSPITALS;
(2) "Gross revenue" means the amount of a
hospital's total charges for all patient care
services minus any refunds resulting from errors
or overcharges;
(3) "Contractual allowance" means the
percentage amount of discounts that are provided
to nongovernmental payers pursuant to subsections
(c), (d) and (e) of section 19a-166;
(4) "Uncompensated care" means the cost of
care that is written off as a bad debt or provided
free under a free care policy that has been
approved by the Office of Health Care Access;
(5) "Other allowances" means any financial
requirements, as authorized by the Office of
Health Care Access, of a hospital resulting from
circumstances including, but not limited to, an
insurance settlement of a liability case or
satisfaction of a lien or encumbrance, any
difference between charges for employee
self-insurance and related expenses. For fiscal
years commencing on and after October 1, 1994,
"other allowances" means the amount of any
difference between charges for employee
self-insurance and related expenses determined
using the hospital's overall relationship of costs
to charges as determined by the Office of Health
Care Access;
(6) "Net revenue" means the amount of a
hospital's gross revenue minus the hospital's (A)
contractual allowances, (B) the difference between
government charges and government payments, (C)
uncompensated care and (D) other allowances;
(7) "Hospital gross earnings" means the
amount of a hospital's net revenue minus (A) the
amount that is projected to be received by the
hospital from the federal government for Medicare
patients, based on the hospital's budget
authorization, and (B) the amount that is
projected to be received by the hospital from the
Department of Social Services, based on the
hospital's budget authorization.
Sec. 3. Subdivision (28) of section 12-407 of
the general statutes, as amended by section 1 of
public act 96-165, is repealed and the following
is substituted in lieu thereof:
(28) "Hospital" means a hospital included
within the definition of health care facilities or
institutions under section 19a-145 and licensed as
a short-term general hospital by the Department of
Public Health and including John Dempsey Hospital
of The University of Connecticut Health Center
BUT, DOES NOT INCLUDE ANY HOSPITAL WHICH, ON THE
EFFECTIVE DATE OF THIS ACT, IS WITHIN THE CLASS OF
HOSPITALS LICENSED BY THE DEPARTMENT AS CHILDREN'S
GENERAL HOSPITALS.
Sec. 4. Subsection (a) of section 19a-169a of
the general statutes, as amended by section 57 of
public act 95-160, is repealed and the following
is substituted in lieu thereof:
(a) Within available appropriations, the
Department of Social Services may make semimonthly
payments to hospitals in an amount calculated
pursuant to section 19a-169b, provided the total
amount of payments made to individual hospitals
and to hospitals in the aggregate shall maximize
the amount qualifying for federal matching
payments under the medical assistance program and
the emergency assistance to families program as
determined by the Department of Social Services in
consultation with the Office of Policy and
Management. NO PAYMENTS SHALL BE MADE TO ANY
CHILDREN'S GENERAL HOSPITAL EXEMPT FROM TAXATION
UNDER CHAPTER 211a. The payments shall be medical
assistance disproportionate share payments,
including grants provided pursuant to section
19a-168k, to the extent allowable under federal
law. In addition payments may be made for
authorized emergency assistance to needy families
with dependent children in accordance with Title
IV-A of the Social Security Act to the extent
allowable under federal law. The payments shall
not be part of the routine medical assistance
inpatient hospital rate determined pursuant to
section 17b-239, except to the extent the
Commissioner of Social Services determines that
increasing those rates would be appropriate to
resolve any civil action pending on April 1, 1994,
in the United States District Court for the
district of Connecticut or the court orders such
increase. Payments shall be made on an interim
basis during each year and a final settlement
shall be calculated pursuant to section 19a-169b
by the office for each hospital after the year end
based on audited data for the hospitals. The
Commissioner of Social Services may withhold
payment to a hospital which is in arrears in
remitting its obligations to the state.
Sec. 5. (NEW) The Department of Social
Services shall promptly apply to the federal
Health Care Financing Administration for any
necessary federal approval or a federal
determination that no such approval is needed with
respect to the provisions of sections 12-263a and
19a-169a, as amended by sections 2 and 4 of this
act.
Sec. 6. (NEW) Nothing in this act shall be
construed as relieving any children's general
hospital from any prior year's disproportionate
share settlements or adjustments.
Sec. 7. The sum of eighteen thousand seven
hundred eighty-three dollars is appropriated from
the General Fund to the Office of Health Care
Access for the fiscal year ending June 30, 1997.
The funds shall be used by the office for payment
to Sharon Hospital for compliance payments
otherwise due January 31, 1997, and prepaid.
Sec. 8. This act shall take effect from its
passage, except that: (1) Section 3 shall be
applicable to sales occurring on or after February
1, 1997, and (2) sections 2 and 4 shall take
effect the later of, October 1, 1997, or upon the
date of federal approval or federal determination
that no approval is required pursuant to section 5
of this act.
Approved January 30, 1997