The State of Oregon desires to assist and enable the poor to achieve maximum feasible economic self-sufficiency. It shall be a state goal to eliminate or alleviate the causes and conditions of poverty in Oregon. The state shall assist community action agencies to stimulate a better focusing of all available local, state, federal and private resources upon the goal. [Formerly 184.801]
HOSPITAL TAXES
Note: Sections 1 to 10 and 12 to 14, chapter 736, Oregon Laws 2003, provide:
Sec. 1. As used in sections 1 to 9 of this 2003 Act:
(1) “Charity care” means costs for providing inpatient or outpatient care services free of charge or at a reduced charge because of the indigence or lack of health insurance of the patient receiving the care services.
(2) “Contractual adjustments” means the difference between the amounts charged based on the hospital’s full established charges and the amount received or due from the payor.
(3) “Hospital” has the meaning given that term in ORS 442.015 but does not include special inpatient care facilities.
(4) “Net revenue”:
(a) Means the total amount of charges for inpatient or outpatient care provided by the hospital to patients, less charity care, bad debts and contractual adjustments;
(b) Does not include revenue derived from sources other than inpatient or outpatient operations, including but not limited to interest and guest meals; and
(c) Does not include any revenue that is taken into account in computing a long term care facility assessment under sections 15 to 22 of this 2003 Act.
(5) “Waivered hospital” means a type A or type B hospital, as described in ORS 442.470, a hospital that provides only psychiatric care or a hospital identified by the Department of Human Services as appropriate for inclusion in the application described in section 4 of this 2003 Act. [2003 c.736 §1]
Sec. 2. (1) An assessment is imposed on each hospital in this state that is not a waivered hospital. The assessment shall be imposed at a rate determined by the Director of Human Services by rule that is the director’s best estimate of the rate needed to fund the services and costs identified in section 9, chapter 736, Oregon Laws 2003. The rate of assessment shall be imposed on the net revenue of each hospital subject to assessment. The director shall consult with representatives of hospitals before setting the assessment.
(2) Notwithstanding subsection (1) of this section, the rate of assessment may not exceed 1.5 percent.
(3) The assessment shall be reported on a form prescribed by the Department of Human Services and shall contain the information required to be reported by the department. The assessment form shall be filed with the department on or before the 75th day following the end of the calendar quarter for which the assessment is being reported. Except as provided in subsection (7) of this section, the hospital shall pay the assessment at the time the hospital files the assessment report. The payment shall accompany the report.
(4) To the extent permitted by federal law, aggregate taxes levied under this section may not exceed payments under section 9 (2), chapter 736, Oregon Laws 2003.
(5) Notwithstanding subsection (4) of this section, a hospital is not guaranteed that any additional moneys paid to the hospital in the form of payments for services shall equal or exceed the amount of the assessment paid by the hospital.
(6) Hospitals operated by the United States Department of Veterans Affairs and pediatric specialty hospitals providing care to children at no charge are exempt from the assessment imposed under this section.
(7)(a) The Department of Human Services shall develop a schedule for collection of the assessment for the calendar quarter ending September 30, 2009, that will result in the collection occurring between December 15, 2009, and the time all Medicaid cost settlements are finalized for that calendar quarter.
(b) The Department of Human Services shall prescribe by rule criteria for late payment of assessments. [2003 c.736 §2; 2007 c.780 §1]
Sec. 3. Notwithstanding section 2 of this 2003 Act, the Director of Human Services shall reduce the rate of assessment imposed under section 2 of this 2003 Act to the maximum rate allowed under federal law if the reduction is required to comply with federal law. [2003 c.736 §3]
Sec. 4. (1) On or before January 1, 2004, the Department of Human Services shall submit an application to the Centers for Medicare and Medicaid Services to request a waiver of the broad-based tax requirement pursuant to 42 C.F.R. 433.68(e) to exempt waivered facilities from the assessment imposed under section 2 of this 2003 Act. The department shall ensure that the application requesting a waiver meets the requirements of 42 C.F.R. 433.68(e)(1).
(2) The Director of Human Services may include in the application requesting a waiver any hospital operated exclusively for a prepaid group practice health plan that serves at least 200,000 members in this state and that has been issued a certificate of authority by the Department of Consumer and Business Services as a health care service contractor if the application requesting a waiver meets the requirements of 42 C.F.R. 433.68(e)(1).
(3) The department shall notify waivered facilities that the department has submitted the application to the Centers for Medicare and Medicaid Services to request a waiver of the broad-based tax requirement pursuant to 42 C.F.R. 433.68(e) to exempt waivered facilities from the assessment imposed under section 2 of this 2003 Act.
(4) If an application to the Centers for Medicare and Medicaid Services for a waiver of the broad-based tax requirement pursuant to 42 C.F.R. 433.68(e) is denied, the Director of Human Services may resubmit the application with appropriate changes to receive a waiver of the broad-based tax requirement. [2003 c.736 §4]
Sec. 5. (1) A hospital that fails to file a report or pay an assessment under section 2 of this 2003 Act by the date the report or payment is due shall be subject to a penalty of $500 per day of delinquency. The total amount of penalties imposed under this section for each reporting period may not exceed five percent of the assessment for the reporting period for which penalties are being imposed.
(2) Penalties imposed under this section shall be collected by the Department of Human Services and deposited in the Department of Human Services Account established under ORS 409.060.
(3) Penalties paid under this section are in addition to and not in lieu of the assessment imposed under section 2 of this 2003 Act. [2003 c.736 §5]
Sec. 6. (1) Any hospital that has paid an amount that is not required under sections 1 to 9 of this 2003 Act may file a claim for refund with the Department of Human Services.
(2) Any hospital that is aggrieved by an action of the Department of Human Services or by an action of the Director of Human Services taken pursuant to subsection (1) of this section shall be entitled to notice and an opportunity for a contested case hearing under ORS chapter 183. [2003 c.736 §6]
Sec. 7. The Department of Human Services may audit the records of any hospital in this state to determine compliance with sections 1 to 9 of this 2003 Act. The department may audit records at any time for a period of five years following the date an assessment is due to be reported and paid under section 2 of this 2003 Act. [2003 c.736 §7]
Sec. 8. Amounts collected by the Department of Human Services from the assessments imposed under section 2, chapter 736, Oregon Laws 2003, shall be deposited in the Hospital Quality Assurance Fund established under section 9, chapter 736, Oregon Laws 2003. [2003 c.736 §8; 2005 c.757 §1]
Sec. 9. (1) The Hospital Quality Assurance Fund is established in the State Treasury, separate and distinct from the General Fund. Interest earned by the Hospital Quality Assurance Fund shall be credited to the Hospital Quality Assurance Fund.
(2) Amounts in the Hospital Quality Assurance Fund are continuously appropriated to the Department of Human Services for the purpose of paying refunds due under section 6, chapter 736, Oregon Laws 2003, and funding hospital services under ORS 414.705 to 414.750, including but not limited to:
(a) Increasing reimbursement rates for inpatient and outpatient hospital services under ORS 414.705 to 414.750 above the rates that were in effect for those services on February 29, 2004;
(b) Expanding, continuing or modifying hospital services for persons described in ORS 414.706 (5); and
(c) Paying administrative costs incurred by the department to administer the assessments imposed under section 2, chapter 736, Oregon Laws 2003.
(3) The department may not use moneys from the Hospital Quality Assurance Fund to supplant, directly or indirectly, other moneys made available to fund services described in subsection (2) of this section. [2003 c.736 §9; 2005 c.757 §2; 2007 c.780 §2]
Sec. 10. Sections 1 to 9, chapter 736, Oregon Laws 2003, apply to net revenues earned by hospitals on or after January 1, 2004, and before the earlier of October 1, 2009, or when the assessment described in sections 37 to 44, chapter 736, Oregon Laws 2003, no longer qualifies for federal matching funds under Title XIX of the Social Security Act. [2003 c.736 §10; 2007 c.780 §3]
Sec. 12. Sections 1 to 9, chapter 736, Oregon Laws 2003, are repealed on January 2, 2012. [2003 c.736 §12; 2007 c.780 §4]
Sec. 13. Nothing in the repeal of sections 1 to 9, chapter 736, Oregon Laws 2003, by section 12, chapter 736, Oregon Laws 2003, affects the imposition and collection of a hospital assessment under sections 1 to 9, chapter 736, Oregon Laws 2003, for a calendar quarter beginning before September 30, 2009. [2003 c.736 §13; 2007 c.780 §5]
Sec. 14. Any moneys remaining in the Hospital Quality Assurance Fund on December 31, 2013, are transferred to the General Fund. [2003 c.736 §14; 2007 c.780 §6]
LONG TERM CARE FACILITY TAXES
Note: Sections 15 to 24, 29 and 31, chapter 736, Oregon Laws 2003, provide:
Sec. 15. As used in sections 15 to 22, chapter 736, Oregon Laws 2003:
(1) “Assessment rate” means the rate established by the Director of Human Services under section 17, chapter 736, Oregon Laws 2003.
(2) “Assessment year” means a 12-month period, beginning July 1 and ending the following June 30, for which the assessment rate being determined is to apply.
(3) “Gross revenue”:
(a) Means the revenue paid to a long term care facility for patient care, room, board and services, less contractual adjustments; and
(b) Does not include:
(A) Revenue derived from sources other than long term care facility operations, including but not limited to donations, interest and guest meals, or any other revenue not attributable to patient care; and
(B) Hospital revenue or revenue derived from hospital operations.
(4) “Long term care facility” has the meaning given that term in ORS 442.015, but does not include an intermediate care facility for persons with mental retardation.
(5) “Medicaid patient days” means patient days attributable to patients who receive medical assistance under a plan described in 42 U.S.C. 1396a et seq.
(6) “Patient days” means the total number of patients occupying beds in a long term care facility for all days in the calendar period for which an assessment is being reported and paid. For purposes of this subsection, if a long term care facility patient is admitted and discharged on the same day, the patient shall be deemed to occupy a bed for one day. [2003 c.736 §15; 2005 c.757 §3; 2007 c.70 §358; 2007 c.780 §7]
Sec. 16. (1) A long term care facility assessment is imposed on each long term care facility in this state.
(2) The amount of the assessment equals the assessment rate times the number of patient days, including Medicaid patient days, at the long term care facility for a calendar quarter.
(3) The assessment shall be reported on a form prescribed by the Department of Human Services and shall contain the information required to be reported by the department. The assessment form shall be filed with the department on or before the last day of the month following the end of the calendar quarter for which the assessment is being reported. The long term care facility shall pay the assessment at the time the facility files the assessment report. The payment shall accompany the report unless the payment is transmitted electronically or unless the department permits a later payment under criteria prescribed by the department by rule.
(4) A long term care facility is not guaranteed that any additional moneys paid to the facility in the form of reimbursements calculated according to the methodology described in section 24 (4), chapter 736, Oregon Laws 2003, shall equal or exceed the amount of the long term care facility assessment paid by the facility. [2003 c.736 §16; 2005 c.757 §4; 2007 c.780 §8]
Sec. 17. (1) On or before June 15 of each year, the Director of Human Services shall establish an assessment rate for long term care facilities that are not exempt for the assessment year from the assessment imposed under section 16, chapter 736, Oregon Laws 2003. The assessment rate shall apply prospectively to the assessment year. The assessment rate shall be a rate estimated to collect an amount that does not exceed six percent of the annual gross revenue of all long term care facilities in this state, as determined from the financial statements or revenue reports, prescribed by the director by rule, filed by long term care facilities for the period ending June 30 of the previous year. For purposes of establishing an assessment rate pursuant to this subsection, the director shall exclude the annual gross revenue of long term care facilities that are exempt from the assessment imposed under section 16, chapter 736, Oregon Laws 2003.
(2) On or before October 15 of each year, the Department of Human Services shall refund any overage in tax dollars collected under section 16, chapter 736, Oregon Laws 2003, that exceeds the maximum percentage of the projected annual gross revenue of all long term care facilities in this state as described in subsection (1) of this section. The department shall refund any overage described in this subsection by crediting the percentage of the overage attributable to each long term care facility subject to the assessment described in section 16, chapter 736, Oregon Laws 2003, against taxes owed by that facility in succeeding assessment periods. The department may collect any delinquent assessments, but may not collect any underages in actual collections through an adjustment in assessment rates. [2003 c.736 §17; 2005 c.757 §5; 2007 c.780 §9]
Sec. 18. (1) The Oregon Veterans’ Home is exempt from the assessment imposed under section 16, chapter 736, Oregon Laws 2003.
(2) A waivered long term care facility is exempt from the long term care facility assessment imposed under section 16, chapter 736, Oregon Laws 2003.
(3) As used in this section, “waivered long term care facility” means:
(a) A long term care facility operated by a continuing care retirement community that is registered under ORS 101.030 and that admits:
(A) Residents of the continuing care retirement community; or
(B) Residents of the continuing care retirement community and nonresidents; or
(b) A long term care facility that is annually identified by the Department of Human Services as having a Medicaid recipient census that exceeds the census level established by the department for the year for which the facility is identified. [2003 c.736 §18; 2003 c.736 §34; 2005 c.757 §7; 2007 c.780 §10]
Sec. 19. (1) A long term care facility that fails to file a report or pay an assessment under section 16 of this 2003 Act by the date the report or payment is due shall be subject to a penalty of $500 per day of delinquency. The total amount of penalties imposed under this section for each reporting period may not exceed five percent of the assessment for the reporting period for which penalties are being imposed.
(2) Penalties imposed under this section shall be collected by the Department of Human Services and deposited in the Department of Human Services Account established under ORS 409.060.
(3) Penalties paid under this section are in addition to and not in lieu of the assessment imposed under section 16 of this 2003 Act. [2003 c.736 §19]
Sec. 20. (1) A long term care facility that has paid an amount that is not required under sections 15 to 22 of this 2003 Act may file a claim for refund with the Department of Human Services.
(2) Any long term care facility aggrieved by an action of the Department of Human Services or by an action of the Director of Human Services taken under sections 15 to 22 of this 2003 Act shall be entitled to notice and an opportunity for a contested case hearing under ORS chapter 183. [2003 c.736 §20]
Sec. 21. (1) Each long term care facility subject to assessment under section 16 of this 2003 Act shall maintain records sufficient to determine the amount of the assessment under section 16 of this 2003 Act.
(2) Unless otherwise exempt, a long term care facility shall report the payment of the assessment as an allowable cost for Medicaid reimbursement purposes.
(3) The Department of Human Services may audit the records of any long term care facility in this state to determine compliance with sections 15 to 22 of this 2003 Act. The department may audit records at any time for a period of three years following the date an assessment is due to be reported and paid under section 16 of this 2003 Act. [2003 c.736 §21]
Sec. 22. Amounts collected by the Department of Human Services from the assessment under section 16, chapter 736, Oregon Laws 2003 shall be deposited in the Long Term Care Facility Quality Assurance Fund established under section 24, chapter 736, Oregon Laws 2003. [2003 c.736 §22; 2005 c.757 §10]
Sec. 23. Sections 15 to 22, chapter 736, Oregon Laws 2003, apply to long term care facility assessments imposed in calendar quarters beginning on or after November 26, 2003, and before July 1, 2014. [2003 c.736 §23; 2005 c.757 §8; 2007 c.780 §11]
Sec. 24. (1) The Long Term Care Facility Quality Assurance Fund is established in the State Treasury, separate and distinct from the General Fund. Interest earned by the Long Term Care Facility Quality Assurance Fund shall be credited to the fund.
(2) Amounts in the Long Term Care Facility Quality Assurance Fund are continuously appropriated to the Department of Human Services for the purposes of paying refunds due under section 20, chapter 736, Oregon Laws 2003, and funding long term care facilities, as defined in section 15, chapter 736, Oregon Laws 2003, that are a part of the Oregon Medicaid reimbursement system.
(3) Funds in the Long Term Care Facility Quality Assurance Fund and the matching federal financial participation under Title XIX of the Social Security Act may be used to fund Medicaid-certified long term care facilities using only the reimbursement methodology described in subsection (4) of this section to achieve a rate of reimbursement greater than the rate in effect on June 30, 2003.
(4) The reimbursement methodology used to make additional payments to Medicaid-certified long term care facilities includes but is not limited to:
(a) Rebasing biennially, beginning on July 1 of each odd-numbered year;
(b) Adjusting for inflation in the nonrebasing year;
(c) Continuing the use of the pediatric rate;
(d) Continuing the use of the complex medical needs additional payment;
(e) Discontinuing the use of the relationship percentage, except when calculating the pediatric rate in paragraph (c) of this subsection; and
(f) Requiring the Department of Human Services to reimburse costs at a rate not lower than the 63rd percentile ceiling of allowable costs for the biennium for which the reimbursement is made. [2003 c.736 §24; 2005 c.757 §11; 2007 c.780 §12]
Sec. 29. Notwithstanding any other provision of law, an assessment under sections 15 to 22, chapter 736, Oregon Laws 2003, may be imposed only in a calendar quarter for which the long term care facility reimbursement rate that is part of the Oregon Medicaid reimbursement system was calculated according to the methodology described in section 24 (4), chapter 736, Oregon Laws 2003. The Department of Human Services may make retroactive increases in payments for the first six months the assessment is imposed. [2003 c.736 §29; 2007 c.780 §13]
Sec. 31. Sections 15 to 22 and 24, chapter 736, Oregon Laws 2003, are repealed on January 2, 2015. [2003 c.736 §31; 2005 c.757 §9; 2007 c.780 §14]
Note: Sections 21 and 23 to 26, chapter 780, Oregon Laws 2007, provide:
Sec. 21. Sections 22 and 23 of this 2007 Act and sections 24 and 29, chapter 736, Oregon Laws 2003, are added to and made a part of sections 15 to 22, chapter 736, Oregon Laws 2003. [2007 c.780 §21]
Sec. 23. Notwithstanding section 17 (1), chapter 736, Oregon Laws 2003, for the period from January 1, 2008, to June 30, 2008, the Director of Human Services, on or before November 15, 2007, shall establish the assessment rate under section 17, chapter 736, Oregon Laws 2003, at a rate estimated to collect an amount for that period not to exceed 5.5 percent of the gross revenue of all long term care facilities in this state during that period, excluding the gross revenue of long term care facilities that are exempt from the assessment imposed under section 16, chapter 736, Oregon Laws 2003. [2007 c.780 §23]
Sec. 24. Section 23 of this 2007 Act is repealed on July 1, 2008. [2007 c.780 §24]
Sec. 25. The repeal of section 23 of this 2007 Act by section 24 of this 2007 Act does not affect any long term care facility assessment imposed at the rate and for the period established pursuant to section 23 of this 2007 Act. [2007 c.780 §25]
Sec. 26. Section 23 of this 2007 Act and the amendments to sections 15, 16, 17, 18, 23, 24 and 29, chapter 736, Oregon Laws 2003, by sections 7 to 13 of this 2007 Act apply to long term care facility assessment in assessment years beginning on or after July 1, 2007. [2007 c.780 §26]
MEDICAID MANAGED CARE TAXES
Note: Sections 37 to 45 and 49 to 51, chapter 736, Oregon Laws 2003, provide:
Sec. 37. As used in sections 37 to 44 of this 2003 Act:
(1) “Managed care premiums” means premium payments paid to a prepaid managed care health services organization, but does not include Medicare premiums.
(2) “Prepaid managed care health services organization” or “organization” means a managed health, dental, mental health or chemical dependency organization that contracts with the Department of Human Services on a prepaid capitated basis under ORS 414.725. A prepaid managed care health services organization may be a dental care organization, fully capitated health plan, physician care organization, mental health organization or chemical dependency organization. [2003 c.736 §37]
Sec. 38. (1) An assessment is imposed on each prepaid managed care health services organization in this state. The assessment shall be imposed at a rate set by the Director of Human Services. The rate may not exceed six percent of managed care premiums paid to an organization.
(2) The assessment shall be reported on a form prescribed by the Department of Human Services and shall contain the information required to be reported by the department. The assessment form shall be filed with the department on or before the 75th day following the end of the calendar quarter for which the assessment is being reported. The organization shall pay the assessment at the time the organization files the assessment report. The payment shall accompany the report unless the department permits a later payment under criteria prescribed by the department by rule.
(3) A prepaid managed care health services organization is not guaranteed that any additional moneys paid to the organization shall equal or exceed the amount of the assessment paid by the organization. [2003 c.736 §38; 2007 c.780 §15]
Sec. 39. Notwithstanding section 38 of this 2003 Act, the Director of Human Services may reduce the rate of assessment imposed under section 38 of this 2003 Act to the maximum rate allowed under federal law if the reduction is required to comply with federal law. [2003 c.736 §39]
Sec. 40. (1) A prepaid managed care health services organization that fails to file a report or pay an assessment under section 38 of this 2003 Act by the date the report or payment is due shall be subject to a penalty of $500 per day of delinquency. The total amount of penalties imposed under this section for each reporting period may not exceed five percent of the assessment for the reporting period for which penalties are being imposed.
(2) Penalties imposed under this section shall be collected by the Department of Human Services and deposited in the Department of Human Services Account established under ORS 409.060.
(3) Penalties paid under this section are in addition to and not in lieu of the assessment imposed under section 38 of this 2003 Act. [2003 c.736 §40]
Sec. 41. (1) A prepaid managed care health services organization that has paid an amount that is not required under sections 37 to 44 of this 2003 Act may file a claim for refund with the Department of Human Services.
(2) Any organization that is aggrieved by an action of the Department of Human Services or by an action of the Director of Human Services taken pursuant to subsection (1) of this section shall be entitled to notice and an opportunity for a contested case hearing under ORS chapter 183. [2003 c.736 §41]
Sec. 42. The Department of Human Services may audit the records of any organization in this state to determine compliance with sections 37 to 44 of this 2003 Act. The department may audit the records at any time for a period of five years following the date an assessment is due to be reported and paid under section 38 of this 2003 Act. [2003 c.736 §42]
Sec. 43. Amounts collected by the Department of Human Services from the assessments under section 38, chapter 736, Oregon Laws 2003, shall be deposited in the Medical Care Quality Assurance Fund established under section 44, chapter 736, Oregon Laws 2003. [2003 c.736 §43; 2005 c.757 §12]
Sec. 44. (1) The Medical Care Quality Assurance Fund is established in the State Treasury, separate and distinct from the General Fund. Interest earned by the Medical Care Quality Assurance Fund shall be credited to the Medical Care Quality Assurance Fund.
(2) Amounts in the Medical Care Quality Assurance Fund are continuously appropriated to the Department of Human Services for the purpose of paying refunds due under section 41, chapter 736, Oregon Laws 2003, and funding the state medical assistance program, including but not limited to health services provided by prepaid managed care health services organizations.
(3) The department may not use moneys from the Medical Care Quality Assurance Fund to supplant, directly or indirectly, other moneys made available to fund the program and services described in subsection (2) of this section. [2003 c.736 §44; 2005 c.757 §13; 2007 c.780 §16]
Sec. 45. Sections 37 to 44, chapter 736, Oregon Laws 2003, apply to managed care premiums received by prepaid managed care health services organizations on or after January 1, 2004, and before October 1, 2009. [2003 c.736 §45; 2007 c.780 §17]
Sec. 49. Sections 37 to 44, chapter 736, Oregon Laws 2003, are repealed on January 2, 2012. [2003 c.736 §49; 2007 c.780 §18]
Sec. 50. Nothing in the repeal of sections 37 to 44, chapter 736, Oregon Laws 2003, by section 49, chapter 736, Oregon Laws 2003, affects the imposition and collection of a prepaid managed care health services organization assessment under sections 37 to 44, chapter 736, Oregon Laws 2003, for a calendar quarter beginning before September 30, 2009. [2003 c.736 §50; 2007 c.780 §19]
Sec. 51. Any moneys remaining in the Medical Care Quality Assurance Fund on December 31, 2011, are transferred to the General Fund. [2003 c.736 §51; 2007 c.780 §20]
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Section: Previous 409.615 409.617 409.619 409.620 409.621 409.623 409.625 409.630 409.710 409.720 409.740 409.742 409.745 409.747 409.750Last modified: August 7, 2008