SENATE, No. 2466

STATE OF NEW JERSEY

215th LEGISLATURE

 

INTRODUCED JANUARY 14, 2013

 


 

Sponsored by:

Senator  PAUL A. SARLO

District 36 (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 a county in this State which: has two or more general hospitals within its borders; a population of (1) not less than 250,000 but not more than 275,000, or (2) not less than 500,000 but not more than 510,000, according to the 2010 federal census; and chooses to participate in the pilot program.

     “Pilot program” means the “Local Hospital Fee Pilot Program” established pursuant to this act.

 

     3.  a.  There is established the five-year “Local Hospital Fee Pilot Program” in the Department of Human Services.   

     b.  The purpose of the pilot program is to increase funding to certain cities and counties and federal financial resources through the Medicaid program to support local safety net hospitals and 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.          

     c.  No more than seven cities or 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. 

     e.  A hospital subject to the fee authorized pursuant to this act shall not be guaranteed a repayment of its fee in derogation of 42 C.F.R. s.433.68(f), except that, in each fiscal year in which a fee is imposed, the department may use a portion of the funds received  for the purposes of this act, to the extent permissible under federal and State law.

     f.  (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, hospital-related Medicaid payments, or payments to Medicaid managed care organizations; and the respective parties’ responsibilities.

     (2) In order to ensure that safety net 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 safety net 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; 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.

     g.  (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 and 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 and Medicaid Services for a State plan amendment or a waiver, as applicable.

 

     4.  a.  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.

 

     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 five years after the effective date. 

 

STATEMENT

 

 

     This bill would establish a five-year “Local Hospital Fee Pilot Program” in the Department of Human Services (DHS).  The purpose of the pilot program is to increase funding to certain cities and counties and federal financial resources through the Medicaid program to support local safety net 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.

     No more than seven cities or counties would be authorized to participate in the pilot program.  The program would be limited to cities with two or more general hospitals within their borders and to those counties with two or more general hospitals within their borders and a population of (1) not less than 250,000 but not more than 275,000, or (2) not less than 500,000 but not more than 510,000, that choose to participate in the pilot program.

     A participating city or county would be authorized to adopt an ordinance or resolution to impose a fee on general 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 and 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), which addresses waivers of the broad-based and uniform tax requirements under federal law.