The purpose of this rule revision is to simplify and correct the calculations for the Public Medical Assistance Trust Fund (PMATF) assessments. Currently, any Chapter 395, F.S. regulated hospital must annually file financial reports with the Agency....

 

AGENCY FOR HEALTH CARE ADMINISTRATION
Hospital and Nursing Home Reporting Systems and Other Provisions Relating to Hospitals

RULE NO.:RULE TITLE:
59E-5.605Public Medical Assistance Trust Fund Assessments
PURPOSE AND EFFECT: The purpose of this rule revision is to simplify and correct the calculations for the Public Medical Assistance Trust Fund (PMATF) assessments. Currently, any Chapter 395, F.S. regulated hospital must annually file financial reports with the Agency. These reports, the Florida Hospital Uniform Reporting System (FHURS), are the basis for calculating assessments to hospitals for PMATF liability. Currently, when hospitals file a report for less than a full year, the partial year report is subject to annualization of the PMATF assessment. This annualization can create a situation whereby a hospital may be over-assessed. In addition, it places the Agency in a position of estimating PMATF liability. In addition to the removal of the annualization of the PMATF calculations, the rule amendment will clarify the methods by which the quarterly assessments are made, collected and adjusted. These changes significantly clarify the amount and methods for assessing and collecting PMATF funding for both the public and the Agency.
SUBJECT AREA TO BE ADDRESSED: Public Medical Assistance Trust Fund assessments, collections and reports.
RULEMAKING AUTHORITY: 395.7017, 408.061(2), 408.15(8) FS.
LAW IMPLEMENTED: 395.701 FS.
A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: April 9, 2013, 10:00 a.m. - 11:00 a.m.
PLACE: Agency for Health Care Administration, Conference Room B, 2727 Mahan Drive, Building #3, Tallahassee, FL 32308
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Mills Smith, Regulatory Analyst IV, Bureau of Central Services, (p) [phone] or email: [e-mail]

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

59E-5.605 Public Medical Assistance Trust Fund Assessments. 

(1) Within six months after the end of each hospital’s fiscal year, the Agency’s Division of Health Quality Assurance Bureau of Health Facility Regulation will certify to the Bureau of Finance and Accounting the amount of each hospital’s public medical assistance trust fund assessment. The amount certified shall be equal to the sum of 1.5 percent of the annual net inpatient revenue of each hospital and 1.0 percent of the annual net outpatient revenue of each hospital, based upon the actual data filed with the Agency for the reporting period.

(2) Each hospital shall be notified of the assessment amount being certified to the Bureau of Finance and Accounting.

(3) Within 21 days of receipt of notification of the assessment amount, a hospital may request a hearing pursuant to Section 120.57, F.S.

(4) If a hearing is timely requested, the Agency shall certify to the Bureau of Finance and Accounting an interim assessment amount which shall equal the assessment amount last certified to the Bureau of Finance and Accounting. Upon resolution of the issues regarding certification, the proper assessment amount shall be certified. The assessment amount for the year shall not be affected by the issuance of an interim assessment.

(5) The certified assessment amount is the total amount due to the Agency and shall be payable to and collected by the Agency in equal quarterly amounts, beginning the first full calendar quarter six months after the end of the hospital’s fiscal year. Initial assessments against new hospitals will be certified upon approval of the first Prior Year Report.

(6) In the event a hospital fails to file its Prior Year Report or the report is not accepted by the Agency, the quarterly assessment shall be based on the most recently filed Prior Year Report accepted by the Agency.

(7) Following the first quarterly assessment of the certified assessment amount, the Agency shall perform a reconciliation of the hospital’s total assessment amounts with the quarterly assessment amount due. If the data contained in the Prior Year Report is based upon a fiscal period of less than one calendar year, the data provided shall be annualized and the assessment will be calculated on an annualized basis.

(a) If the sum of the amounts collected is less than the sum of the certified assessments, then the Agency shall issue an invoice for and collect the difference.  The invoice for the assessment reconciliation shall be due and payable within 30 days of being issued.  Assessments not paid within thirty days of the due date shall be subject to an administrative fine of a minimum of $500.00 per day not to exceed $5,000 pursuant to Chapter 395.701(3) Florida Statutes.

(b) If the sum of the amounts collected is greater than the sum of the certified assessments, then the Agency shall issue a refund at the request of the hospital.

(8) Initial assessments of new hospitals will be certified upon approval of the first Prior Year Report. Assessments during the first year of operation under new ownership shall be based on the hospital’s net operating revenue for the last fiscal year under previous ownership.

(9) Hospitals that file a Prior Year Report of less than 12-months (Short Report) due to a change of fiscal year end or change of ownership shall be issued a quarterly invoice(s) for the certified assessment on the Short Report only after all four quarters of the previous 12-month period have been invoiced, and prior to the first quarterly invoice issued for the new full fiscal year.  Any difference between the certified assessment amounts and Agency collections will be reconciled as described in subsection (7) above. Assessments are made against facilities, accordingly the amount of the assessment and liability for the assessment remains with the facility regardless of any change in ownership.

(10) When a hospital closes or ceases operations, the total amount due to the Agency shall be the sum of the certified assessment amounts calculated on annual net patient revenue through the date operations cease, less the sum of quarterly and settlement payments received.  The Agency will base assessments on the most recently filed Prior Year Report accepted by the Agency prorated for the period from the last accepted report through the date operations cease if a hospital fails to file its Prior Year Report or the Report is not accepted by the Agency.

(11) (9) Assessments are made against facilities, accordingly the amount of the assessment and liability for the assessment remains with the facility regardless of any change in ownership.

Rulemaking Specific Authority 408.061(2), (3), (4)(a), (7), 408.15(8), 395.7017 FS., Chapter 2000-256, Laws of Florida. Law Implemented 395.701(2) FS. History–New 6-11-92, Formerly 10N-5.606, Amended 5-26-03,____________.