Utah Code 26B-3-507. Calculation of assessment
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Terms Used In Utah Code 26B-3-507
- Assessment: means the inpatient hospital assessment established by this part. See Utah Code 26B-3-501
- CMS: means the Centers for Medicare and Medicaid Services within the United States Department of Health and Human Services. See Utah Code 26B-3-501
- Discharges: means the number of total hospital discharges reported on:(3)(a) Worksheet S-3 Part I, column 15, lines 14, 16, and 17 of the 2552-10 Medicare cost report for the applicable assessment year; or(3)(b) a similar report adopted by the department by administrative rule, if the report under Subsection (3)(a) is no longer available. See Utah Code 26B-3-501
- Division: means the Division of Integrated Healthcare within the department. See Utah Code 26B-3-501
- Equal: means , with respect to biological sex, of the same value. See Utah Code 68-3-12.5
- Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
- Hospital share: means the hospital share described in Section 26B-3-505. See Utah Code 26B-3-501
- Medicare cost report: means CMS-2552-10, the cost report for electronic filing of hospitals. See Utah Code 26B-3-501
- Private hospital: means :
(12)(a)(i) a general acute hospital, as defined in Section 26B-2-201, that is privately owned and operating in the state; and(12)(a)(ii) a privately owned specialty hospital operating in the state, including a privately owned hospital whose inpatient admissions are predominantly for:(12)(a)(ii)(A) rehabilitation;(12)(a)(ii)(B) psychiatric care;(12)(a)(ii)(C) chemical dependency services; or(12)(a)(ii)(D) long-term acute care services. See Utah Code 26B-3-501- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(1)(a) Except as provided in Subsection (1)(b), an annual assessment is payable on a quarterly basis for each private hospital in an amount calculated by the division at a uniform assessment rate for each hospital discharge, in accordance with this section.(1)(b) A private teaching hospital with more than 425 beds and 60 residents shall pay an assessment rate 2.5 times the uniform rate established under Subsection (1)(c).(1)(c) The division shall calculate the uniform assessment rate described in Subsection (1)(a) by dividing the hospital share for assessed private hospitals, described in Subsections 26B-3-506(1) and (3), by the sum of:(1)(c)(i) the total number of discharges for assessed private hospitals that are not a private teaching hospital; and(1)(c)(ii) 2.5 times the number of discharges for a private teaching hospital, described in Subsection (1)(b).(1)(d) The division may, by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, adjust the formula described in Subsection (1)(c) to address unforeseen circumstances in the administration of the assessment under this part.(1)(e) Any quarterly changes to the uniform assessment rate shall be applied uniformly to all assessed private hospitals.(2) Except as provided in Subsection (3), for each state fiscal year, the division shall determine a hospital’s discharges as follows:(2)(a) for state fiscal year 2017, the hospital’s cost report data for the hospital’s fiscal year ending between July 1, 2013, and June 30, 2014; and(2)(b) for each subsequent state fiscal year, the hospital’s cost report data for the hospital’s fiscal year that ended in the state fiscal year two years before the assessment fiscal year.(3)(3)(a) If a hospital’s fiscal year Medicare cost report is not contained in the CMS Healthcare Cost Report Information System file:(3)(a)(i) the hospital shall submit to the division a copy of the hospital’s Medicare cost report applicable to the assessment year; and(3)(a)(ii) the division shall determine the hospital’s discharges.(3)(b) If a hospital is not certified by the Medicare program and is not required to file a Medicare cost report:(3)(b)(i) the hospital shall submit to the division the hospital’s applicable fiscal year discharges with supporting documentation;(3)(b)(ii) the division shall determine the hospital’s discharges from the information submitted under Subsection (3)(b)(i); and(3)(b)(iii) failure to submit discharge information shall result in an audit of the hospital’s records and a penalty equal to 5% of the calculated assessment.(4) Except as provided in Subsection (5), if a hospital is owned by an organization that owns more than one hospital in the state:(4)(a) the assessment for each hospital shall be separately calculated by the department; and(4)(b) each separate hospital shall pay the assessment imposed by this part.(5) If multiple hospitals use the same Medicaid provider number:(5)(a) the department shall calculate the assessment in the aggregate for the hospitals using the same Medicaid provider number; and(5)(b) the hospitals may pay the assessment in the aggregate.