SB 17 HEALTH CARE DELIVERY & ACCESS ACT

Sen Elizabeth "Liz" Stefanics

Actions: [4] SCC/SHPAC/SFC-SCC-germane-SHPAC [6] DP-SFC [7] DP - PASSED/S (40-0) [11] HAFC-HAFC [14] DP - PASSED/H (59-1) SGND BY GOV (Mar. 1) Ch. 41.

Scheduled: Not Scheduled

 Senate Bill 17 (SB 17) enacts the Health Care Delivery and Access Act (HCDAA); imposes the health care delivery and access assessment on certain hospitals; creates the Health Care Delivery and Access Fund (HCDAF); creates the Health Care Delivery and Access Medicaid-Directed Payment Program (HCMPP); provides for revenue from the assessment be used as additional reimbursement to certain hospitals; provides a distribution to the HCDAF; states that the Tax Administration Act applies to and governs the HCDAA; provides a delayed repeal; provides a contingent effective date. 

 Senate Bill 17 (SB 17) enacts the Health Care Delivery and Access Act (HCDAA). Definitions are provided for various terms related to assessments (e.g., “assessed days,” meaning the number of inpatient hospital days); types of services; types of hospitals; “secretary” (meaning the Secretary of the Health Care Authority), and other pertinent terms.

An assessment, to be called the “Health Care Delivery and Access Assessment” (HCAAS) is imposed on certain inpatient and outpatient hospital services. The Taxation and Revenue Department (TRD) is to collect such assessments.

Reduced rates are established for selected types of hospitals.

The Health Care Authority (HCA) is charged with annually calculating all assessments and with notifications to the TRD and the hospitals affected.
The funds from the assessments are to support:

•	the non-federal share of Medicaid directed payment program payments for inpatient and outpatient hospital services for eligible hospitals at a level such that the total reimbursement for Medicaid managed care patients, including any other inpatient or outpatient hospital directed payments, is equivalent to the average commercial rate or other maximum level as may be set by the centers for Medicare and Medicaid services; and 
•	the purposes of the HCDAF; or the amount specified in the federal Social Security Act.

The Health Care Delivery and Access Fund (HCDAF) is created. Money in the HCDAF must be used only as follows:

•	at least ninety percent for the nonfederal share of the Medicaid-directed payment program; 
•	not more than ten percent for the non-federal share of costs incurred by the authority to administer the HCDAA; and 
•	for refunds to eligible hospitals, in proportion to the assessment amounts paid by the hospitals, if specified conditions are met.

The Health Care Delivery and Access Medicaid Directed Payment Program Medicaid Directed Payment Program (HCMPP) is created. The HCMPP is to:

•	direct an appropriate amount of funds to support the Medicaid-directed payment program;
•	determine the total funding for the Medicaid-directed payment program; 
•	set aside forty percent of the Medicaid-directed payment program funding for quality incentive payments for eligible hospitals; 
•	establish quality measurements and performance evaluation criteria based on hospital grouping classifications; 
•	ensure that quality incentive payments are based on quality measurements;
•	structure payments to hospitals for the portion of the funding not used for the quality incentive payments as a uniform rate increase; and
•	to the extent permitted by federal law, require, no more frequently than annually, that each eligible hospital submit a report regarding the impact of the HCMPP on their investment/improvement capabilities.

Due dates for assessments are established, and it is stated that the Tax Administration Act (TAA) applies to and governs the HCDAA. Those who may receive related information are listed.

A distribution is to be made to the HCDAF in an amount equal to the net receipts attributable to the health care delivery and access assessment imposed on hospitals according to the HCDAA, and any associated interest or penalties collected from eligible hospitals.

A delayed repeal is provided, as well as a contingent effective date.
 

 If the bill does not pass, the assessments and related fund will not be established, nor will they be available for the purposes described. 

 House Bill 7 (HB 7) – Health Care Affordability Fund Distribution
House Bill 33 (HB 33) – Prescription Drug Price Transparency Act
Senate Bill 146 (SB 146) – Hospital Acceptance of Health Plans
Senate Joint Resolution 5 (SJR 5) – Public Employees Retiree Health Care Fund