Bill Text: NJ S622 | 2014-2015 | Regular Session | Introduced
Bill Title: Implements measures to strengthen oversight of hospital charity care subsidies.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2014-01-14 - Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee [S622 Detail]
Download: New_Jersey-2014-S622-Introduced.html
STATE OF NEW JERSEY
216th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2014 SESSION
Sponsored by:
Senator SAMUEL D. THOMPSON
District 12 (Burlington, Middlesex, Monmouth and Ocean)
SYNOPSIS
Implements measures to strengthen oversight of hospital charity care subsidies.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel
An Act concerning oversight of the hospital charity care subsidy program and amending P.L.1992, c.160.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 10 of P.L.1992, c.160 (C.26:2H-18.60) is amended to read as follows:
10. a. The commissioner shall establish a uniform charity care eligibility and reimbursement claim form that a hospital shall be required to use in order to receive reimbursement for charity care [under this act] pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.), and shall require the use of such procedures by hospitals as are designed to ensure their uniform collection from persons applying for charity care and transmission to the department of such demographic and financial data as the commissioner requires pursuant to section 14 of P.L.1995, c.133 (C.26:2H-18.59c) and any other information that the commissioner deems appropriate to ensure the efficient, cost-effective provision of charity care and to deter and detect fraudulent charity care claims.
b. A person whose individual or, if applicable, family gross income is less than or equal to 300% of the poverty level shall be eligible for charity care or reduced charge charity care for necessary health care services provided at a hospital.
The commissioner shall establish:
(1) the maximum level of income at which a person is eligible for full charity care;
(2) a sliding scale based on income which specifies the percentage of hospital charges for which a person who is eligible for reduced charity care is responsible; and
(3) assets eligibility criteria for full charity care and reduced charge charity care, respectively.
c. The commissioner shall:
(1) establish an inter-agency agreement with the Office of the Inspector General established pursuant to P.L.2005, c.119 (C.52:15B-1 et seq.) to utilize the staff and resources of that office to: (a) investigate charity care claims, which the commissioner or that office reasonably believes may be fraudulent, with the same authority as that granted to the office to investigate complaints concerning alleged fraud, waste, abuse, or mismanagement of State funds pursuant to P.L.2005, c.119; and (b) recover monies from third party payers that were paid as charity care subsidies on the basis of fraudulent charity care claims; and
(2) ensure that any such recovered monies are deposited in the Health Care Subsidy Fund and used for the purposes of providing reimbursement for charity care pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.).
d. The commissioner shall establish a means, through the use of a toll-free telephone hotline or electronic mail, by which persons may confidentially report suspected instances of fraudulent charity care claims to the department.
(cf: P.L.1995, c.133, s.6)
2. The Commissioner of Health and Senior Services shall:
a. study the feasibility of establishing a centralized electronic registry of persons who have been determined eligible for charity care pursuant to section 10 of P.L.1992, c.160 (C.26:2H-18.60) and issuing distinctive identification numbers to those persons exclusively for the purposes of the registry, in order to enhance the operational capability of the department with respect to overall administration of the charity care subsidy program and specifically the detection of fraudulent charity care claims; and
b. report on the findings of that study to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), no later than the 180th day after the effective date of this act.
3. This act shall take effect on the 60th day after enactment, but the Commissioner of Health and Senior Services may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.
STATEMENT
The purpose of this bill is to enact into law certain recommendations made by the State Commission of Investigation in its April 2007 report, Charity Care: An Ailing System, which are intended to address real and potential waste, fraud, and abuse in the hospital charity care subsidy program.
The bill directs the Commissioner of Health and Senior Services to:
· require the use of such procedures by hospitals as are designed to ensure their uniform collection from charity care applicants and transmission to the Department of Health and Senior Services (DHSS) of such demographic and financial data as the commissioner requires pursuant to section 14 of P.L.1995, c.133 (C.26:2H-18.59c) and any other information that the commissioner deems appropriate to ensure the efficient, cost-effective provision of charity care and to deter and detect fraudulent charity care claims;
· establish an inter-agency agreement with the Office of the Inspector General to utilize the staff and resources of that office to: investigate charity care claims, which the commissioner or that office reasonably believes may be fraudulent, with the same authority as that granted to the office to investigate complaints concerning alleged fraud, waste, abuse, or mismanagement of State funds pursuant to P.L.2005, c.119 (C.52:15B-1 et seq.), and recover monies from third party payers that were paid as charity care subsidies on the basis of fraudulent charity care claims; and ensure that any such recovered monies are used for the purposes of providing charity care reimbursement;
· establish a means, through the use of a toll-free telephone hotline or e-mail, by which persons may confidentially report suspected instances of fraudulent charity care claims to DHSS; and
· study the feasibility of establishing a centralized electronic registry of persons who have been determined eligible for charity care and issuing distinctive identification numbers to those persons exclusively for the purposes of the registry, in order to enhance the operational capability of DHSS with respect to overall program administration and specifically the detection of fraudulent claims; and report on the findings of that study to the Governor and the Legislature no later than the 180th day after the effective date of the bill.
The bill takes effect on the 60th day after enactment, but authorizes the commissioner to take anticipatory administrative action in advance as necessary for its implementation.
