Bill Text: NJ A4027 | 2018-2019 | Regular Session | Introduced
Bill Title: Revises criteria for payment of charity care to certain hospitals.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2018-05-24 - Introduced, Referred to Assembly Health and Senior Services Committee [A4027 Detail]
Download: New_Jersey-2018-A4027-Introduced.html
Sponsored by:
Assemblywoman ELIANA PINTOR MARIN
District 29 (Essex)
SYNOPSIS
Revises criteria for payment of charity care to certain hospitals.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning charity care payments to hospitals, and amending P.L.2004, c.113.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 3 of P.L.2004, c.113 (C.26:2H-18.59i) is amended to read as follows:
3. a. Beginning July 1, 2004 and each year thereafter:
(1) Reimbursed documented charity care shall be equal to the Medicaid-priced amounts of charity care claims submitted to the Department of Health for the most recent calendar year, adjusted, as necessary, to reflect the annual audit results. These amounts shall be augmented to reflect payments to hospitals by the Medicaid program for Graduate Medical Education and Indirect Medical Education based on the most recent Graduate Medical Education and Indirect Medical Education formulas utilized by the federal Medicare program.
(2) Hospital-specific reimbursed documented charity care shall be equal to the Medicaid-priced dollar amount of charity care provided by a hospital as submitted to the Department of Health for the most recent calendar year. A sample of the claims submitted by the hospital to the department shall be subject to an annual audit conducted pursuant to applicable charity care eligibility criteria.
b. Beginning July 1, 2004 and each year thereafter, the charity care subsidy shall be determined according to the following methodology:
(1) Each hospital shall be ranked in order of its hospital-specific, relative charity care percentage, or RCCP, by dividing the amount of hospital-specific gross revenue for charity care patients by the hospital's total gross revenue for all patients.
(2) The nine hospitals with the highest RCCPs shall receive a charity care payment equal to 96[%] percent of each hospital's hospital-specific reimbursed documented charity care. The hospital ranked number 10 shall receive a charity care payment equal to 94[%] percent of its hospital-specific reimbursed documented charity care, and each hospital ranked number 11 and below shall receive two percentage points less than the hospital ranked immediately above that hospital.
(3) Notwithstanding the provisions of paragraph (2) of this subsection to the contrary, commencing in the fiscal year next following the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), each of the hospitals located in the 10 municipalities in the State with a population of at least 20,000 residents with the lowest median annual household income according to the most recent census data, shall be ranked from the hospital with the highest hospital-specific reimbursed documented charity care to the hospital with the lowest hospital-specific reimbursed documented charity care. The top two [hospital] hospitals in each of the 10 municipalities, if any, with the highest documented hospital-specific charity care shall receive a charity care payment equal to 96[%] percent of [its] their hospital-specific reimbursed documented charity care.
(4) Notwithstanding the provisions of this subsection to the contrary, no hospital shall receive reimbursement for less than 43[%] percent of its hospital-specific reimbursed documented charity care.
c. To ensure that charity care subsidy payments remain viable and appropriate, the State shall maintain the charity care subsidy at an amount not less than 75[%] percent of the Medicaid-priced amounts of charity care provided by hospitals in the State. In addition, these amounts shall be augmented to reflect payments to hospitals by the Medicaid program for Graduate Medical Education and Indirect Medical Education based on the most recent Graduate Medical Education and Indirect Medical Education formulas utilized by the federal Medicare program.
d. Notwithstanding any other provisions of this section to the contrary, in the event that the change from the charity care subsidy formula in effect for fiscal year 2004 to the formula established pursuant to this section in effect for fiscal year 2005, reduces, for any reason, the amount of the charity care subsidy payment to a hospital below the amount that the hospital received under the formula in effect in fiscal year 2004, the hospital shall receive a payment equal to the amount it would have received under the formula in effect for fiscal year 2004.
(cf: P.L.2012, c.17, s.229)
2. This act shall take effect immediately.
STATEMENT
This bill revises the law concerning the payment of charity care to hospitals, to provide that, commencing in the fiscal year next following the effective date of the bill, the required ranking of hospitals located in the 10 municipalities in the State with the lowest median annual household income according to the most recent census data, from the hospital with the highest hospital-specific reimbursed documented charity care to the hospital with the lowest hospital-specific reimbursed documented charity care, shall only apply to municipalities with a population of at least 20,000 residents. Current law does not limit the ranking to cities with a certain population.
The bill provides that the top two hospitals in each of these 10 municipalities, if any, with the highest documented hospital-specific charity care shall receive a charity care payment equal to 96 percent of their hospital-specific reimbursed documented charity care. Current law limits the charity care payment to the top hospital, if any, in each of the 10 municipalities.
This bill is not intended to interfere with language in the annual appropriations act that supersedes the statutory formula in order to contain overall program costs.
