Bill Text: NJ A4092 | 2012-2013 | Regular Session | Introduced
Bill Title: "Local Hospital Fee Pilot Program Act"*
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Introduced - Dead) 2013-06-20 - Assembly Floor Amendment Passed (Spencer) [A4092 Detail]
Download: New_Jersey-2012-A4092-Introduced.html
Sponsored by:
Assemblywoman L. GRACE SPENCER
District 29 (Essex)
Assemblyman BENJIE E. WIMBERLY
District 35 (Bergen and Passaic)
SYNOPSIS
"Local Hospital Fee Pilot Program."
CURRENT VERSION OF TEXT
As introduced.
An Act establishing a "Local Hospital Fee Pilot Program" in the Department of Human Services.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. This act shall be known and may be cited as the "Local Hospital Fee Pilot Program Act."
2. As used in this act:
"Commissioner" means the Commissioner of Human Services.
"Department" means the Department of Human Services.
"Fee" means the local health care-related fee authorized pursuant to this act.
"Hospital" means a hospital that is licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and is located within the borders of a participating city or participating county.
"Medicaid program" means the "New Jersey Medical Assistance and Health Services Program" established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Participating city" means a municipality in this State which has two or more general hospitals within its borders and which chooses to participate in the pilot program.
"Participating county" means Atlantic, Camden, Essex, and Passaic counties.
"Pilot program" means the "Local Hospital Fee Pilot Program" established pursuant to this act.
3. a. There is established a "Local Hospital Fee Pilot Program" in the Department of Human Services.
b. The purpose of the pilot program is: (1) primarily to increase federal financial resources through the Medicaid program to support local acute care hospitals and to ensure that they continue to provide necessary services to low-income citizens by authorizing the imposition of a local health care-related fee on hospitals within their borders; and (2) secondarily to provide participating cities and counties with new fiscal resources.
c. No more than five cities and four counties may participate in the pilot program.
d. The fee authorized pursuant to this act may be collected only to the extent, and for the period, that the commissioner determines that the revenues generated qualify as the State share of Medicaid program expenditures eligible for federal financial participation pursuant to 42 C.F.R. s.433.68.
e. (1) Notwithstanding any other law to the contrary, the Commissioner of Human Services is authorized to enter into an intergovernmental transfer agreement with a participating city or county and take all actions and make payments in connection with the completion of the intergovernmental transfer agreement. The terms of the agreement shall include, but not be limited to: the amount that the State will dedicate for increased fee-for-service hospital payments, hospital-related Medicaid payments, or payments to Medicaid managed care organizations; and the respective parties' responsibilities.
(2) In order to ensure that acute care hospitals in the jurisdiction can continue to provide needed services to low-income individuals, the commissioner shall only use the funds received pursuant to an intergovernmental transfer agreement authorized by this act for the following purposes: to increase Medicaid payments to hospitals in the jurisdiction from which the funds are received; for payments to Medicaid managed care organizations serving the jurisdiction from which the funds are received for increased hospital or hospital-related payments; or for administrative purposes to implement the pilot program.
(3) The commissioner shall seek to minimize the length of time between the collection of the fee authorized pursuant to this act and the increased payments to the Medicaid managed care organizations.
(4) (a) To ensure that hospital services are available to low-income individuals, prior to the approval by a city or county of a local hospital fee and prior to the execution of the intergovernmental transfer agreement authorized pursuant to paragraph (1) of this subsection, a participating city or county shall submit a proposed expenditure of hospital fee revenue report to the commissioner for approval that describes how the funds will be used by the participating city or county, including the amount and services the participating city or county plans to provide with the funding, and how the plan satisfies the requirements of subsection b. of this section.
(b) No single hospital shall be subject to more than one local fee authorized by this act. Where there is a participating city located within the geographic boundary of a participating county, the city and county shall mutually consent to the imposition of a local health care-related fee on all hospitals within the county's borders or the city's borders.
f. (1) Prior to the collection of a fee authorized pursuant to section 4 of this act, the commissioner shall apply to, and receive approval from, the federal Centers for Medicare & Medicaid Services to increase hospital or hospital-related fee-for-service payments or to increase payments to Medicaid managed care organizations operating in a participating city or county using the fees from the pilot program.
(2) If a State plan amendment is required to effectuate the purposes of this act or if a waiver is required pursuant to 42 C.F.R. s.433.68(e), the commissioner shall apply to the federal Centers for Medicare & Medicaid Services for a State plan amendment or a waiver, as applicable, and shall receive approval prior to collection of a fee authorized pursuant to section 4 of this act.
g. Funds from this program shall not supplant or offset any funds paid to acute care hospitals through other State or federal funding mechanisms or pools.
4. a. For purposes of satisfying paragraph (1) of subsection b. of section 3 of this act, the governing body of a participating city or the board of chosen freeholders of a participating county may adopt a resolution or ordinance, as applicable, providing for the imposition of a local health care-related fee on all hospitals located within its borders and for appropriate administrative provisions, including, but not limited to, provisions for the collection of interest and penalties. Notwithstanding the provisions of any other law to the contrary, the governing body of a participating city or the board of chosen freeholders of a participating county is authorized to participate in the intergovernmental transfer program and take all actions necessary to achieve the purposes of the intergovernmental transfer agreement pursuant to this act.
b. The fee authorized pursuant to this act shall be implemented in accordance with the provisions of 42 U.S.C. s.1396b(w)(3)(A), and shall be subject to the maximum aggregate amount that may be assessed pursuant to 42 C.F.R. s.433.68(f)(3), or any subsequent maximum amount as may be established by federal law. The participating city or county may exempt a hospital within its jurisdiction from the fee, provided that the exemption complies with the requirements of 42 C.F.R. s.433.68.
c. Prior to the collection of the fee authorized pursuant to this act, the participating city or county shall enter into the intergovernmental transfer agreement.
d. The fee shall not be imposed in relation to health care items or services provided prior to the effective date of this act or after December 31, 2017.
e. Upon collection of the funds generated by the fee, the participating city or county shall remit that portion of the funds that it does not retain to the department.
f. The Commissioner of Community Affairs shall allow for the inclusion of the revenues generated by the local health care-related fee collected pursuant to this section in the fiscal year in which the city, municipality, or county adopts the resolution or ordinance, as applicable, providing for the imposition of the fee.
g. No hospital subject to the fee imposed pursuant to this act shall pass on the cost of the fee to any patient, insurer or self-insured employer program, or other responsible party, nor list it separately on any invoice or statement sent to a patient, insurer, self-insured employer program, or other responsible party.
h. Revenues generated by the local health care-related fee shall not supplant or offset any current or future State funds allocated to cities or counties participating in the pilot program.
5. This act shall take effect immediately, subject to such actions by the federal government as are necessary to effectuate the purposes of this act, and shall expire December 31, 2017.
STATEMENT
This bill would establish a "Local Hospital Fee Pilot Program" in the Department of Human Services (DHS). The purpose of the pilot program is to increase federal financial resources through the Medicaid program to support local acute care hospitals and ensure that they continue to provide necessary services to low-income citizens by authorizing these cities and counties to impose a local health care-related fee on hospitals within their borders. The purpose of the bill is primarily to benefit acute care hospitals within the participating cities or counties, although participating cities and counties may benefit by retaining a portion of the fees authorized to be collected pursuant to the bill.
The program would be limited to cities with two or more general hospitals within their borders and to the following counties, should they elect to participate in the program: Atlantic, Camden, Essex, and Passaic counties. No more than five cities and four counties may participate in the pilot program.
A participating city or county would be authorized to adopt an ordinance or resolution to impose a fee on hospitals located within its borders, consistent with federal Medicaid regulations, and to enter into an intergovernmental transfer agreement with DHS.
The Commissioner of Community Affairs would be required to allow for the inclusion of revenues generated by the local health care related fee in the fiscal year in which the city, municipality, or county adopts the resolution or ordinance, as applicable, providing for the imposition of the fee. No fee under the bill would be imposed prior to the effective date of the bill or after December 31, 2017.
The Commissioner of Human Services is directed to apply to the federal Centers for Medicare & Medicaid Services for any needed approvals, a State plan amendment, if needed, and a waiver if required pursuant to 42 C.F.R. s.433.68(e).
