CHAPTER 211a

AMBULATORY SURGICAL
CENTERS TAX

Table of Contents

Sec. 12-263a. Definitions.

Sec. 12-263b. Tax on hospital net patient revenue. Sunset.

Sec. 12-263c. Failure to pay tax when due. Penalty. Waiver. Withholding of amounts payable by Department of Social Services.

Sec. 12-263d. Examination of records. Penalties related to deficiency assessments. Delegation of authority to Commissioner of Social Services.

Sec. 12-263e. Claims for refunds. Hearings and appeals. State lien against real estate as security for tax.

Secs. 12-263f to 12-263h. Reserved

Sec. 12-263i. Tax on ambulatory surgical center gross receipts. Sunset.

Secs. 12-263j to 12-263l. Reserved


Sec. 12-263a. Definitions. As used in sections 12-263a to 12-263e, inclusive:

(1) “Hospital” means any health care facility or institution, as defined in section 19a-630, which is licensed as a short-term general hospital by the Department of Public Health but does not include (A) any hospital which, on October 1, 1997, is within the class of hospitals licensed by the department as children's general hospitals, or (B) a short-term acute hospital operated exclusively by the state other than a short-term acute hospital operated by the state as a receiver pursuant to chapter 920;

(2) “Net patient revenue” means the amount of accrued payments earned by a hospital for the provision of inpatient and outpatient services;

(3) “Commissioner” means the Commissioner of Revenue Services;

(4) “Department” means the Department of Revenue Services.

(P.A. 94-9, S. 21, 41; P.A. 95-257, S. 12, 21, 39, 58; P.A. 97-2, S. 2, 8; P.A. 99-173, S. 31, 65; P.A. 00-174, S. 68, 83; P.A. 10-179, S. 95; P.A. 11-6, S. 145; 11-44, S. 102.)

History: P.A. 94-9 effective April 1, 1994; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health and replaced Commission on Hospitals and Health Care with Office of Health Care Access, effective July 1, 1995; P.A. 97-2 amended definition of hospital in Subdiv. (1) to exclude children's general hospitals, effective the later of October 1, 1997, or upon the date of federal approval or federal determination that no approval is required pursuant to Sec. 19a-670a (actual effective date was October 1, 1997); P.A. 99-173 amended Subdiv. (1) to exclude short-term acute care hospitals run by the state, effective June 23, 1999, and applicable to calendar quarters commencing on or after July 1, 1999; P.A. 00-174 added Subdiv. (8) defining “patient care services”, effective May 26, 2000, and applicable to all tax periods open on said date; P.A. 10-179 amended Subdivs. (4) and (5) by replacing “Office of Health Care Access” with “Office of Health Care Access division of the Department of Public Health”; P.A. 11-6 deleted former Subdivs. (2) to (8) and added definitions of “net patient revenue”, “commissioner” and “department” in new Subdivs. (2) to (4), respectively, effective July 1, 2011, and applicable to calendar quarters commencing on or after that date; P.A. 11-44 amended Subdiv. (2) by redefining “net patient revenue”, effective July 1, 2011, and applicable to calendar quarters commencing on or after that date.

P.A. 00-174, enacted after plaintiff's appeal was filed, clarified former Subdiv. (2) to provide that term “patient care services” included tangible personal property transferred in connection with rendering of such services; legislative history indicated that relevant provisions of act were intended to be clarifying and nonsubstantive, therefore court affirmed applicability of such clarification to pending case determining that tax on hospital's gross earnings applied to charges for tangible personal property used in the course of providing patient care services. 265 C. 511.

Sec. 12-263b. Tax on hospital net patient revenue. Sunset. (a) For each calendar quarter commencing on or after July 1, 2011, and prior to July 1, 2017, there is hereby imposed a tax on the net patient revenue of each hospital in this state to be paid each calendar quarter. The rate of such tax shall be up to the maximum rate allowed under federal law and in conformance with the state budget adopted by the General Assembly. Each hospital shall be promptly notified of the amount of tax due by the Commissioner of Social Services. The Commissioner of Social Services shall determine the base year on which such tax shall be assessed in order to ensure conformance with the state budget adopted by the General Assembly. The Commissioner of Social Services may, in consultation with the Secretary of the Office of Policy and Management and in accordance with federal law, exempt a hospital from the tax on payment earned for the provision of outpatient services based on financial hardship. Effective July 1, 2012, and for the succeeding fifteen months, the rates of such tax, the base year on which such tax shall be assessed, and the hospitals exempt from the outpatient portion of the tax based on financial hardship shall be the same tax rates, base year and outpatient exemption for hardship in effect on January 1, 2012.

(b) Each hospital shall, on or before the last day of January, April, July and October of each year, render to the Commissioner of Revenue Services a return, on forms prescribed or furnished by the Commissioner of Revenue Services and signed by one of its principal officers, stating specifically the name and location of such hospital, and the amount of its net patient revenue as determined by the Commissioner of Social Services. Payment shall be made with such return. Each hospital shall file such return electronically with the department and make such payment by electronic funds transfer in the manner provided by chapter 228g, irrespective of whether the hospital would otherwise have been required to file such return electronically or to make such payment by electronic funds transfer under the provisions of chapter 228g.

(c) Notwithstanding any other provision of law, for each calendar quarter commencing on or after July 1, 2015, and prior to January 1, 2016, the amount of tax credit or credits otherwise allowable against the taxes imposed under sections 12-263a to 12-263e, inclusive, and 12-263i shall not exceed fifty and one one-hundredths per cent of the amount of tax due under sections 12-263a to 12-263e, inclusive, and 12-263i with respect to such calendar quarter prior to the application of such credit or credits. For each calendar quarter commencing on or after January 1, 2016, and prior to January 1, 2017, the amount of tax credit or credits otherwise allowable against the taxes imposed under sections 12-263a to 12-263e, inclusive, and 12-263i shall not exceed fifty-five per cent of the amount of tax due under sections 12-263a to 12-263e, inclusive, and 12-263i with respect to such calendar quarter prior to the application of such credit or credits. For each calendar quarter commencing on or after January 1, 2017, and prior to January 1, 2018, the amount of tax credit or credits otherwise allowable against the taxes imposed under sections 12-263a to 12-263e, inclusive, and 12-263i shall not exceed sixty per cent of the amount of tax due under sections 12-263a to 12-263e, inclusive, and 12-263i with respect to such calendar quarter prior to the application of such credit or credits. For each calendar quarter commencing on or after January 1, 2018, and prior to January 1, 2019, the amount of tax credit or credits otherwise allowable against the taxes imposed under sections 12-263a to 12-263e, inclusive, and 12-263i shall not exceed sixty-five per cent of the amount of tax due under sections 12-263a to 12-263e, inclusive, and 12-263i with respect to such calendar quarter prior to the application of such credit or credits. For each calendar quarter commencing on or after January 1, 2019, the amount of tax credit or credits otherwise allowable against the taxes imposed under sections 12-263a to 12-263e, inclusive, and 12-263i shall not exceed seventy per cent of the amount of tax due under sections 12-263a to 12-263e, inclusive, and 12-263i with respect to such calendar quarter prior to the application of such credit or credits.

(P.A. 94-9, S. 22, 41; P.A. 96-144, S. 2, 5; P.A. 98-244, S. 12, 35; P.A. 99-173, S. 32, 65; P.A. 00-170, S. 9, 42; P.A. 11-6, S. 146; 11-44, S. 103; 11-61, S. 79; June 12 Sp. Sess. P.A. 12-1, S. 4; P.A. 15-244, S. 89; Dec. Sp. Sess. P.A. 15-1, S. 30; May Sp. Sess. P.A. 16-3, S. 120; June Sp. Sess. P.A. 17-2, S. 611.)

History: P.A. 94-9 effective April 1, 1994; P.A. 96-144 reduced tax from 11% to 9.25% on October 1, 1996, to 8.25% on October 1, 1997, to 7.25% on October 1, 1998, and to 6.25% on and after October 1, 1999, effective May 29, 1996; P.A. 98-244 eliminated notarization requirement, effective June 8, 1998, and applicable to calendar quarters commencing on or after October 1, 1998; P.A. 99-173 reduced rate from 6.25% to 4.5% in Subdiv. (5), effective June 23, 1999, and applicable to calendar quarters commencing on or after October 1, 1999; P.A. 00-170 discontinued to the tax for calendar quarters commencing on or after April 1, 2000, effective May 26, 2000; P.A. 11-6 deleted provisions imposing tax on gross earnings and suspending said tax after April 1, 2000, added Subsec. (a) re tax on net patient revenue, designated existing provisions re timing and form of return as Subsec. (b), changed language therein re gross earnings to language re net patient revenue and added requirement re electronic filing and payment, effective July 1, 2011, and applicable to calendar quarters commencing on or after that date; P.A. 11-44 amended Subsec. (a) by replacing tax rate of 4.06% with provision requiring rate to be up to maximum allowed under federal law and adding provisions re base year and exemption from tax, effective July 1, 2011, and applicable to calendar quarters commencing on or after that date; P.A. 11-61 amended Subsec. (b) by changing “for the calendar quarter ending the last day of the preceding month” to “as determined by the Commissioner of Social Services” re statement of amount of net patient revenue on return, effective July 1, 2011, and applicable to calendar quarters commencing on or after that date; June 12 Sp. Sess. P.A. 12-1 amended Subsec. (a) by adding provision re tax rates, base year and outpatient exemption effective July 1, 2012, and for succeeding 15 months, effective June 15, 2012; P.A. 15-244 added Subsec. (c) re 50.01 per cent limit on allowable credits against tax imposed under chapter, effective July 1, 2015; Dec. Sp. Sess. P.A. 15-1 amended Subsec. (c) by adding references to taxes imposed under Secs. 12-263a to 12-263e and 12-263i, adding provisions re caps on allowable tax credits for calendar quarters commencing on or after January 1, 2016, January 1, 2017, January 1, 2018, and January 1, 2019, and making conforming changes, effective December 29, 2015, and applicable to calendar quarters commencing on or after January 1, 2016; May Sp. Sess. P.A. 16-3 amended Subsec. (a) by adding provisions re rate of tax to be in conformance with state budget, hospital to be promptly notified of amount of tax due by Commissioner of Social Services and commissioner to determine base year on which tax is to be assessed to ensure conformance with state budget, effective June 2, 2016, and applicable to calendar quarters commencing on or after July 1, 2011; June Sp. Sess. P.A. 17-2 amended Subsec. (a) by adding “and prior to July 1, 2017,” re imposition of tax, effective October 31, 2017.

See Ch. 211c re hospitals tax.

Sec. 12-263c. Failure to pay tax when due. Penalty. Waiver. Withholding of amounts payable by Department of Social Services. (a) If any hospital fails to pay the amount of tax reported to be due on its return within the time specified under the provisions of section 12-263b, there shall be imposed a penalty equal to ten per cent of such amount due and unpaid, or fifty dollars, whichever is greater. The tax shall bear interest at the rate of one per cent per month or fraction thereof, from the due date of such tax until the date of payment.

(b) If any hospital has not made its return within one month after the time specified in section 12-263b, the Commissioner of Revenue Services may make such return at any time thereafter, according to the best information obtainable and according to the form prescribed. To the tax imposed upon the basis of such return, there shall be added an amount equal to ten per cent of such tax, or fifty dollars, whichever is greater. The tax shall bear interest at the rate of one per cent per month or fraction thereof, from the due date of such tax until the date of payment.

(c) Subject to the provisions of section 12-3a, the commissioner may waive all or part of the penalties provided under this section when it is proven to his satisfaction that the failure to pay any tax on time was due to reasonable cause and was not intentional or due to neglect.

(d) The commissioner shall notify the Commissioner of Social Services of any amount delinquent under sections 12-263a to 12-263e, inclusive, and, upon receipt of such notice, the Commissioner of Social Services shall deduct and withhold such amount from amounts otherwise payable by the Department of Social Services to the delinquent hospital.

(P.A. 94-9, S. 23, 41; P.A. 95-359, S. 11, 19; P.A. 11-6, S. 147.)

History: P.A. 94-9 effective April 1, 1994; P.A. 95-359 amended Subsecs. (a) and (b) to change interest rate from 1.66% to 1%, effective July 1, 1995, and applicable to taxes due and owing on or after that date; P.A. 11-6 added Subsec. (d) re notice to Commissioner of Social Services of delinquent amounts, effective July 1, 2011, and applicable to calendar quarters commencing on or after that date.

Sec. 12-263d. Examination of records. Penalties related to deficiency assessments. Delegation of authority to Commissioner of Social Services. (a) The Commissioner of Revenue Services may examine the records of any hospital subject to a tax imposed under the provisions of sections 12-263a to 12-263e, inclusive, as he may deem necessary. If he shall determine therefrom that there is a deficiency with respect to the payment of any such tax due under the provisions of said sections 12-263a to 12-263e, inclusive, he shall assess the deficiency in tax, give notice of such deficiency assessment to the hospital and make demand thereupon for payment. Such amount shall bear interest at the rate of one per cent per month or fraction thereof from the date when the original tax was due and payable. When it appears that any part of the deficiency for which a deficiency assessment is made is due to negligence or intentional disregard of the provisions of said sections 12-263a to 12-263e, inclusive, or regulations adopted thereunder, there shall be imposed a penalty equal to ten per cent of the amount of such deficiency assessment, or fifty dollars, whichever is greater. When it appears that any part of the deficiency for which a deficiency assessment is made is due to fraud or intent to evade the provisions of sections 12-263a to 12-263e, inclusive, or regulations adopted thereunder, there shall be imposed a penalty equal to twenty-five per cent of the amount of such deficiency assessment. No hospital shall be subject to more than one penalty under this subsection in relation to the same tax period. Within thirty days of the mailing of such notice, the hospital shall pay to the commissioner, in cash, or by check, draft or money order drawn to the order of the Commissioner of Revenue Services, any additional amount of tax, penalty and interest shown to be due.

(b) Except in the case of a wilfully false or fraudulent return with intent to evade the tax, no assessment of additional tax shall be made after the expiration of more than three years from the date of the filing of a return or from the original due date of a return, whichever is later. If no return has been filed as provided under the provisions of section 12-263b, the commissioner may make such return at any time thereafter, according to the best information obtainable and according to the form prescribed. Where, before the expiration of the period prescribed herein for the assessment of an additional tax, a hospital has consented in writing that such period may be extended, the amount of such additional tax due may be determined at any time within such extended period. The period so extended may be further extended by subsequent consents in writing before the expiration of the extended period.

(c) The commissioner may enter into an agreement with the Commissioner of Social Services delegating to the Commissioner of Social Services the authority to examine the records and returns of any hospital subject to the tax imposed under section 12-263b and to determine whether such tax has been underpaid or overpaid. If such authority is so delegated, examinations of such records and returns by the Commissioner of Social Services and determinations by the Commissioner of Social Services that such tax has been underpaid or overpaid shall have the same effect as similar examinations or determinations made by the Commissioner of Revenue Services.

(P.A. 94-9, S. 24, 41; P.A. 95-359, S. 12, 19; P.A. 11-6, S. 148.)

History: P.A. 94-9 effective April 1, 1994; P.A. 95-359 amended Subsec. (a) to reduce interest rate from 1.66 to 1%, effective July 1, 1995, and applicable to taxes due and owing on or after that date; P.A. 11-6 added Subsec. (c) re delegation of authority to Commissioner of Social Services, effective July 1, 2011, and applicable to calendar quarters commencing on or after that date.

Sec. 12-263e. Claims for refunds. Hearings and appeals. State lien against real estate as security for tax. The provisions of sections 12-550 to 12-554, inclusive, and section 12-555a shall apply to the provisions of sections 12-263a to 12-263e, inclusive, in the same manner and with the same force and effect as if the language of said sections 12-550 to 12-554, inclusive, and said section 12-555a had been incorporated in full into sections 12-263a to 12-263e, inclusive, and had expressly referred to the tax under said sections, except to the extent that any provision is inconsistent with a provision in said sections 12-263a to 12-263e, inclusive.

(P.A. 94-9, S. 25, 41.)

History: P.A. 94-9 effective April 1, 1994.

Secs. 12-263f to 12-263h. Reserved for future use.

Sec. 12-263i. Tax on ambulatory surgical center gross receipts. Sunset. (a) As used in this section:

(1) “Ambulatory surgical center” means an entity included within the definition of said term that is set forth in 42 CFR 416.2 and that is licensed by the Department of Public Health as an outpatient surgical facility, and any other ambulatory surgical center that is Medicare certified;

(2) “Commissioner” means the Commissioner of Revenue Services;

(3) “Department” means the Department of Revenue Services;

(4) “Medicaid” means the program operated by the Department of Social Services pursuant to section 17b-260 and authorized by Title XIX of the Social Security Act, as amended from time to time; and

(5) “Medicare” means the programs operated by the Centers for Medicare and Medicaid Services in accordance with Title XVIII of the Social Security Act, as amended from time to time, including, but not limited to, those programs established pursuant to Parts A, B and C of Title XVIII of said act, as amended from time to time.

(b) (1) For each calendar quarter commencing on or after October 1, 2015, but prior to July 1, 2022, there is hereby imposed a tax on each ambulatory surgical center in this state to be paid each calendar quarter. The tax imposed by this section shall be at the rate of six per cent of the gross receipts of each ambulatory surgical center, except that:

(A) Prior to July 1, 2019, such tax shall not be imposed on any amount of such gross receipts that constitutes either (i) the first million dollars of gross receipts of the ambulatory surgical center in the applicable fiscal year, or (ii) net revenue of a hospital that is subject to the tax imposed under section 12-263q; and

(B) On and after July 1, 2019, but prior to July 1, 2022, such tax shall not be imposed on any amount of such gross receipts that constitutes any of the following: (i) The first million dollars of gross receipts of the ambulatory surgical center in the applicable fiscal year, excluding Medicaid and Medicare payments, (ii) net revenue of a hospital that is subject to the tax imposed under section 12-263q, (iii) Medicaid payments received by the ambulatory surgical center, and (iv) Medicare payments received by the ambulatory surgical center.

(2) Nothing in this section shall prohibit an ambulatory surgical center from seeking remuneration for the tax imposed by this section.

(3) Each ambulatory surgical center shall, on or before January 31, 2016, and thereafter on or before the last day of January, April, July and October of each year until and including July 31, 2022, render to the commissioner a return, on forms prescribed or furnished by the commissioner, reporting the name and location of such ambulatory surgical center, the entire amount of gross receipts generated by such ambulatory surgical center during the calendar quarter ending on the last day of the preceding month and such other information as the commissioner deems necessary for the proper administration of this section. The tax imposed under this section shall be due and payable on the due date of such return. Each ambulatory surgical center shall be required to file such return electronically with the department and to make payment of such tax by electronic funds transfer in the manner provided by chapter 228g, regardless of whether such ambulatory surgical center would have otherwise been required to file such return electronically or to make such tax payment by electronic funds transfer under the provisions of chapter 228g.

(c) Whenever the tax imposed under this section is not paid when due, a penalty of ten per cent of the amount due and unpaid or fifty dollars, whichever is greater, shall be imposed and interest at the rate of one per cent per month or fraction thereof shall accrue on such tax from the due date of such tax until the date of payment.

(d) The provisions of sections 12-548, 12-550 to 12-554, inclusive, and 12-555a shall apply to the provisions of this section in the same manner and with the same force and effect as if the language of said sections had been incorporated in full into this section and had expressly referred to the tax imposed under this section, except to the extent that any provision is inconsistent with a provision in this section.

(e) For the fiscal years ending June 30, 2016, to June 30, 2022, inclusive, the Comptroller is authorized to record as revenue for each fiscal year the amount of tax imposed under the provisions of this section prior to the end of each fiscal year and which tax is received by the Commissioner of Revenue Services not later than five business days after the last day of July immediately following the end of each fiscal year.

(P.A. 15-244, S. 172; June Sp. Sess. P.A. 15-5, S. 130; June Sp. Sess. P.A. 17-2, S. 612; P.A. 18-26, S. 12; 18-170, S. 1; June Sp. Sess. P.A. 21-2, S. 462; P.A. 22-118, S. 436.)

History: June Sp. Sess. P.A. 15-5 amended Subsec. (b)(1) to add Subpara. (A) re exemption for first $1,000,000 of gross receipts in fiscal year and Subpara. (B) re exemption for net patient revenue of hospital subject to tax under chapter, and to add provision re nothing in section to prohibit ambulatory surgical center from seeking remuneration for tax imposed under section; June Sp. Sess. P.A. 17-2 amended Subsec. (b)(1)(B) to replace “net patient revenue of a hospital that is subject to the tax imposed under this chapter” with “net revenue of a hospital that is subject to the tax imposed under section 602 public act 17-2 of the June special session”, effective October 31, 2017; P.A. 18-26 replaced reference to Sec. 602 of P.A. 17-2 of the June special session with reference to Sec. 12-263q in Subsec. (b)(1); P.A. 18-170 amended Subsec. (b) to designate existing provision in Subdiv. (1) re exemptions of $1 million and for net revenue of hospital as new Subpara. (A), and amend same to add “Prior to July 1, 2019,”, replace reference to Sec. 602 of P.A. 17-2 of the June special session with reference to Sec. 12-263q, redesignate existing Subparas. (A) and (B) as clauses (i) and (ii), and made technical changes, add Subpara. (B) in Subdiv. (1) re exemptions on and after July 1, 2019, designate existing provision re remuneration for tax as new Subdiv. (2), and redesignate existing Subdiv. (2) re return and tax payment as Subdiv. (3), effective July 1, 2018; June Sp. Sess. P.A. 21-2 amended Subsec. (a) by adding definitions of “Medicaid” and “Medicare”, amended Subsec. (b) by adding “but prior to July 1, 2023,” re imposition of tax in Subdiv. (1) and adding reference to July 31, 2023, in Subdiv. (3), and amended Subsec. (e) by adding reference to June 30, 2023, and making conforming changes, effective July 1, 2021; P.A. 22-118 replaced “July 1, 2023” with “July 1, 2022” in Subsec. (b)(1), “July 31, 2023” with “July 31, 2022” in Subsec. (b)(3), and “June 30, 2023” with “June 30, 2022” in Subsec. (e), effective May 7, 2022.

Secs. 12-263j to 12-263l. Reserved for future use.