This weekly Checkpoint Content from Thompson Reuters, highlights the Governor of Georgia signing into law the “Hospital Medicaid Financial Program Act.” Effective on February 13, 2013, Georgia Governor Nathan Deal on signed into law the “Hospital Medicaid Financing Program Act” authorizing the Department of Community Health to assess and collect a hospital provider fee so the state can take advantage of the federal matching program for Medicaid. (L. 2013, S24, effective 07/01/2013.)
Hospital provider fee. Effective July 1, 2013 until June 30, 2017, the Board of Community Health is authorized to establish and assess, by Board rule, one or more provider payments on hospitals for the privilege of operating a hospital. The Board will also determine if provider payments are to be credited for indigent or charity care requirements or considered a community benefit.
Limits on assessment. The General Assembly may override any provider payment assessed by the Board. Provider payment assessments must comply with 42 CFR 433.68 (Permissible health care related taxes); must not exceed federal financial participation limits under the Social Security Act; must not exceed percentages of net patient revenues in the General Appropriations Act; and must be solely for obtaining federal financial participation on behalf of Medicaid recipients.
Discontinuance. The Board must discontinue any provider payment assessed, if: (1) the provider payments are not eligible for federal matching funds; (2) the Department of Community Health reduces June 30, 2012 Medicaid payment rates to hospitals; reduces provider payment rate adjustment factors used in developing Fiscal Year 2013 Medicaid capitated rates; alters any payment methodology, administrative rule, or payment policy in effect as of June 30, 2012; or creates any new methodology, rule, or policy that reduces Medicaid payments to hospitals.
Records and inspection. Hospitals must keep and preserve books and records necessary to determine provider payment assessment amounts for seven years. The books and records may be inspected and copied for audit purposes and for calculation of the provider payment. All information so obtained will be confidential and will not constitute a public record.
Penalties. A penalty of up to 6% may be imposed on any hospital that fails to pay a provider payment within the time required for each month or fraction that the payment is overdue. If a required provider payment is not received within set time lines, an equal amount may be withheld from any medical assistance payment due such hospital under the Medicaid program. Provider payment assessments are a debt due the state and may be collected by civil action and the filing of tax liens.