HB-4840, As Passed House, June 10, 2008

 

 

 

 

 

 

 

 

 

 

 

SUBSTITUTE FOR

 

HOUSE BILL NO. 4840

 

 

 

 

 

 

 

 

 

 

 

 

      A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending section 20161 (MCL 333.20161), as amended by 2007 PA

 

85.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

 1        Sec. 20161. (1) The department shall assess fees and other

 

 2  assessments for health facility and agency licenses and

 

 3  certificates of need on an annual basis as provided in this

 

 4  article. Except as otherwise provided in this article, fees and

 

 5  assessments shall be paid in accordance with the following

 

 6  schedule:

 

 

     (a) Freestanding surgical

outpatient facilities................$238.00 per facility.

     (b) Hospitals...................$8.28 per licensed bed.


     (c) Nursing homes, county

medical care facilities, and

hospital long-term care units........$2.20 per licensed bed.

     (d) Homes for the aged..........$6.27 per licensed bed.

     (e) Clinical laboratories.......$475.00 per laboratory.

     (f) Hospice residences..........$200.00 per license

                                     survey; and $20.00 per

                                     licensed bed.

     (g) Subject to subsection

10 (13), quality assurance assessment

11 for nursing homes and hospital

12 long-term care units.................an amount resulting

13                                      in not more than 6%

14                                      of total industry

15                                      revenues.

16      (h) Subject to subsection

17 (14), quality assurance assessment

18 for hospitals........................at a fixed or variable

19                                      rate that generates

20                                      funds not more than the

21                                      maximum allowable under

22                                      the federal matching

23                                      requirements, after

24                                      consideration for the

25                                      amounts in subsection

26                                      (14)(a) and (i).

 

 

27        (2) If a hospital requests the department to conduct a

 

28  certification survey for purposes of title XVIII or title XIX of

 

29  the social security act, the hospital shall pay a license fee

 

30  surcharge of $23.00 per bed. As used in this subsection, "title


 

 1  XVIII" and "title XIX" mean those terms as defined in section

 

 2  20155.

 

 3        (3) The base fee for a certificate of need is $1,500.00 for

 

 4  each application. For a project requiring a projected capital

 

 5  expenditure of more than $500,000.00 but less than $4,000,000.00,

 

 6  an additional fee of $4,000.00 shall be added to the base fee.

 

 7  For a project requiring a projected capital expenditure of

 

 8  $4,000,000.00 or more, an additional fee of $7,000.00 shall be

 

 9  added to the base fee. The department of community health shall

 

10  use the fees collected under this subsection only to fund the

 

11  certificate of need program. Funds remaining in the certificate

 

12  of need program at the end of the fiscal year shall not lapse to

 

13  the general fund but shall remain available to fund the

 

14  certificate of need program in subsequent years.

 

15        (4) If licensure is for more than 1 year, the fees described

 

16  in subsection (1) are multiplied by the number of years for which

 

17  the license is issued, and the total amount of the fees shall be

 

18  collected in the year in which the license is issued.

 

19        (5) Fees described in this section are payable to the

 

20  department at the time an application for a license, permit, or

 

21  certificate is submitted. If an application for a license,

 

22  permit, or certificate is denied or if a license, permit, or

 

23  certificate is revoked before its expiration date, the department

 

24  shall not refund fees paid to the department.

 

25        (6) The fee for a provisional license or temporary permit is

 

26  the same as for a license. A license may be issued at the

 

27  expiration date of a temporary permit without an additional fee


 

 1  for the balance of the period for which the fee was paid if the

 

 2  requirements for licensure are met.

 

 3        (7) The department may charge a fee to recover the cost of

 

 4  purchase or production and distribution of proficiency evaluation

 

 5  samples that are supplied to clinical laboratories pursuant to

 

 6  section 20521(3).

 

 7        (8) In addition to the fees imposed under subsection (1), a

 

 8  clinical laboratory shall submit a fee of $25.00 to the

 

 9  department for each reissuance during the licensure period of the

 

10  clinical laboratory's license.

 

11        (9) The cost of licensure activities shall be supported by

 

12  license fees.

 

13        (10) The application fee for a waiver under section 21564 is

 

14  $200.00 plus $40.00 per hour for the professional services and

 

15  travel expenses directly related to processing the application.

 

16  The travel expenses shall be calculated in accordance with the

 

17  state standardized travel regulations of the department of

 

18  management and budget in effect at the time of the travel.

 

19        (11) An applicant for licensure or renewal of licensure

 

20  under part 209 shall pay the applicable fees set forth in part

 

21  209.

 

22        (12) Except as otherwise provided in this section, the fees

 

23  and assessments collected under this section shall be deposited

 

24  in the state treasury, to the credit of the general fund. The

 

25  department may use the unreserved fund balance in fees and

 

26  assessments for the background check program required under this

 

27  article.


 

 1        (13) The quality assurance assessment collected under

 

 2  subsection (1)(g) and all federal matching funds attributed to

 

 3  that assessment shall be used only for the following purposes and

 

 4  under the following specific circumstances:

 

 5        (a) The quality assurance assessment and all federal

 

 6  matching funds attributed to that assessment shall be used to

 

 7  finance medicaid nursing home reimbursement payments. Only

 

 8  licensed nursing homes and hospital long-term care units that are

 

 9  assessed the quality assurance assessment and participate in the

 

10  medicaid program are eligible for increased per diem medicaid

 

11  reimbursement rates under this subdivision. A nursing home or

 

12  long-term care unit that is assessed the quality assurance

 

13  assessment and that does not pay the assessment required under

 

14  subsection (1)(g) in accordance with subdivision (c)(i) or in

 

15  accordance with a written payment agreement with the state shall

 

16  not receive the increased per diem medicaid reimbursement rates

 

17  under this subdivision until all of its outstanding quality

 

18  assurance assessments and any penalties assessed pursuant to

 

19  subdivision (g) have been paid in full. Nothing in this

 

20  subdivision shall be construed to authorize or require the

 

21  department to overspend tax revenue in violation of the

 

22  management and budget act, 1984 PA 431, MCL 18.1101 to 18.1594.

 

23        (b) Except as otherwise provided under subdivision (c),

 

24  beginning October 1, 2005, the quality assurance assessment is

 

25  based on the total number of patient days of care each nursing

 

26  home and hospital long-term care unit provided to nonmedicare

 

27  patients within the immediately preceding year and shall be


 

 1  assessed at a uniform rate on October 1, 2005 and subsequently on

 

 2  October 1 of each following year, and is payable on a quarterly

 

 3  basis, the first payment due 90 days after the date the

 

 4  assessment is assessed.

 

 5        (c) Within 30 days after September 30, 2005, the department

 

 6  shall submit an application to the federal centers for medicare

 

 7  and medicaid services to request a waiver pursuant to 42 CFR

 

 8  433.68(e) to implement this subdivision as follows:

 

 9        (i) If the waiver is approved, the quality assurance

 

10  assessment rate for a nursing home or hospital long-term care

 

11  unit with less than 40 licensed beds or with the maximum number,

 

12  or more than the maximum number, of licensed beds necessary to

 

13  secure federal approval of the application is $2.00 per

 

14  nonmedicare patient day of care provided within the immediately

 

15  preceding year or a rate as otherwise altered on the application

 

16  for the waiver to obtain federal approval. If the waiver is

 

17  approved, for all other nursing homes and long-term care units

 

18  the quality assurance assessment rate is to be calculated by

 

19  dividing the total statewide maximum allowable assessment

 

20  permitted under subsection (1)(g) less the total amount to be

 

21  paid by the nursing homes and long-term care units with less than

 

22  40 or with the maximum number, or more than the maximum number,

 

23  of licensed beds necessary to secure federal approval of the

 

24  application by the total number of nonmedicare patient days of

 

25  care provided within the immediately preceding year by those

 

26  nursing homes and long-term care units with more than 39, but

 

27  less than the maximum number of licensed beds necessary to secure


 

 1  federal approval. The quality assurance assessment, as provided

 

 2  under this subparagraph, shall be assessed in the first quarter

 

 3  after federal approval of the waiver and shall be subsequently

 

 4  assessed on October 1 of each following year, and is payable on a

 

 5  quarterly basis, the first payment due 90 days after the date the

 

 6  assessment is assessed.

 

 7        (ii) If the waiver is approved, continuing care retirement

 

 8  centers are exempt from the quality assurance assessment if the

 

 9  continuing care retirement center requires each center resident

 

10  to provide an initial life interest payment of $150,000.00, on

 

11  average, per resident to ensure payment for that resident's

 

12  residency and services and the continuing care retirement center

 

13  utilizes all of the initial life interest payment before the

 

14  resident becomes eligible for medical assistance under the

 

15  state's medicaid plan. As used in this subparagraph, "continuing

 

16  care retirement center" means a nursing care facility that

 

17  provides independent living services, assisted living services,

 

18  and nursing care and medical treatment services, in a campus-like

 

19  setting that has shared facilities or common areas, or both.

 

20        (d) Beginning October 1, 2011, the department shall no

 

21  longer assess or collect the quality assurance assessment or

 

22  apply for federal matching funds.

 

23        (e) Beginning May 10, 2002, the department of community

 

24  health shall increase the per diem nursing home medicaid

 

25  reimbursement rates for the balance of that year. For each

 

26  subsequent year in which the quality assurance assessment is

 

27  assessed and collected, the department of community health shall


 

 1  maintain the medicaid nursing home reimbursement payment increase

 

 2  financed by the quality assurance assessment.

 

 3        (f) The department of community health shall implement this

 

 4  section in a manner that complies with federal requirements

 

 5  necessary to assure that the quality assurance assessment

 

 6  qualifies for federal matching funds.

 

 7        (g) If a nursing home or a hospital long-term care unit

 

 8  fails to pay the assessment required by subsection (1)(g), the

 

 9  department of community health may assess the nursing home or

 

10  hospital long-term care unit a penalty of 5% of the assessment

 

11  for each month that the assessment and penalty are not paid up to

 

12  a maximum of 50% of the assessment. The department of community

 

13  health may also refer for collection to the department of

 

14  treasury past due amounts consistent with section 13 of 1941 PA

 

15  122, MCL 205.13.

 

16        (h) The medicaid nursing home quality assurance assessment

 

17  fund is established in the state treasury. The department of

 

18  community health shall deposit the revenue raised through the

 

19  quality assurance assessment with the state treasurer for deposit

 

20  in the medicaid nursing home quality assurance assessment fund.

 

21        (i) The department of community health shall not implement

 

22  this subsection in a manner that conflicts with 42 USC 1396b(w).

 

23        (j) The quality assurance assessment collected under

 

24  subsection (1)(g) shall be prorated on a quarterly basis for any

 

25  licensed beds added to or subtracted from a nursing home or

 

26  hospital long-term care unit since the immediately preceding July

 

27  1. Any adjustments in payments are due on the next quarterly


 

 1  installment due date.

 

 2        (k) In each fiscal year governed by this subsection,

 

 3  medicaid reimbursement rates shall not be reduced below the

 

 4  medicaid reimbursement rates in effect on April 1, 2002 as a

 

 5  direct result of the quality assurance assessment collected under

 

 6  subsection (1)(g).

 

 7        (l) In each fiscal year, $39,900,000.00 of the quality

 

 8  assurance assessment collected pursuant to subsection (1)(g)

 

 9  shall be appropriated to the department of community health to

 

10  support medicaid expenditures for long-term care services. These

 

11  funds shall offset an identical amount of general fund/general

 

12  purpose revenue originally appropriated for that purpose.

 

13        (14) The quality assurance dedication is an earmarked

 

14  assessment collected under subsection (1)(h). That assessment and

 

15  all federal matching funds attributed to that assessment shall be

 

16  used only for the following purpose and under the following

 

17  specific circumstances:

 

18        (a) To maintain the increased medicaid reimbursement rate

 

19  increases as provided for in subdivision (c).

 

20        (b) The quality assurance assessment shall be assessed on

 

21  all net patient revenue, before deduction of expenses, less

 

22  medicare net revenue, as reported in the most recently available

 

23  medicare cost report and is payable on a quarterly basis, the

 

24  first payment due 90 days after the date the assessment is

 

25  assessed. As used in this subdivision, "medicare net revenue"

 

26  includes medicare payments and amounts collected for coinsurance

 

27  and deductibles.


 

 1        (c) Beginning October 1, 2002, the department of community

 

 2  health shall increase the hospital medicaid reimbursement rates

 

 3  for the balance of that year. For each subsequent year in which

 

 4  the quality assurance assessment is assessed and collected, the

 

 5  department of community health shall maintain the hospital

 

 6  medicaid reimbursement rate increase financed by the quality

 

 7  assurance assessments.

 

 8        (d) The department of community health shall implement this

 

 9  section in a manner that complies with federal requirements

 

10  necessary to assure that the quality assurance assessment

 

11  qualifies for federal matching funds.

 

12        (e) If a hospital fails to pay the assessment required by

 

13  subsection (1)(h), the department of community health may assess

 

14  the hospital a penalty of 5% of the assessment for each month

 

15  that the assessment and penalty are not paid up to a maximum of

 

16  50% of the assessment. The department of community health may

 

17  also refer for collection to the department of treasury past due

 

18  amounts consistent with section 13 of 1941 PA 122, MCL 205.13.

 

19        (f) The hospital quality assurance assessment fund is

 

20  established in the state treasury. The department of community

 

21  health shall deposit the revenue raised through the quality

 

22  assurance assessment with the state treasurer for deposit in the

 

23  hospital quality assurance assessment fund.

 

24        (g) In each fiscal year governed by this subsection, the

 

25  quality assurance assessment shall only be collected and expended

 

26  if medicaid hospital inpatient DRG and outpatient reimbursement

 

27  rates and disproportionate share hospital and graduate medical


 

 1  education payments are not below the level of rates and payments

 

 2  in effect on April 1, 2002 as a direct result of the quality

 

 3  assurance assessment collected under subsection (1)(h), except as

 

 4  provided in subdivision (h).

 

 5        (h) The quality assurance assessment collected under

 

 6  subsection (1)(h) shall no longer be assessed or collected after

 

 7  September 30, 2008, or in the event that the quality assurance

 

 8  assessment is not eligible for federal matching funds. Any

 

 9  portion of the quality assurance assessment collected from a

 

10  hospital that is not eligible for federal matching funds shall be

 

11  returned to the hospital.

 

12        (i) In fiscal year 2005-2006, $46,400,000.00 of the quality

 

13  assurance assessment collected pursuant to subsection (1)(h)

 

14  shall be appropriated to the department of community health to

 

15  support medicaid expenditures for hospital services and therapy.

 

16  In fiscal year 2006-2007, $66,400,000.00 of the quality assurance

 

17  assessment collected pursuant to subsection (1)(h) shall be

 

18  appropriated to the department of community health to support

 

19  medicaid expenditures for hospital services and therapy. Except

 

20  as otherwise provided in this subdivision, in fiscal year 2007-

 

21  2008, $66,400,000.00 of the quality assurance assessment

 

22  collected pursuant to subsection (1)(h) shall be appropriated to

 

23  the department of community health to support medicaid

 

24  expenditures for hospital services and therapy. However, if the

 

25  state receives approval from the centers for medicare and

 

26  medicaid services to increase medicaid health maintenance

 

27  organization hospital payment rates that increase medicaid


 

 1  payments to hospitals by $120,000,000.00 or more in fiscal year

 

 2  2007-2008, then in fiscal year 2007-2008, $81,400,000.00, instead

 

 3  of $66,400,000.00, of the quality assurance assessment collected

 

 4  pursuant to subsection (1)(h) shall be appropriated to the

 

 5  department of community health to support medicaid expenditures

 

 6  for hospital services and therapy. These funds shall offset an

 

 7  identical amount of general fund/general purpose revenue

 

 8  originally appropriated for that purpose.

 

 9        (15) The quality assurance assessment provided for under

 

10  this section is a tax that is levied on a health facility or

 

11  agency.

 

12        (16) As used in this section, "medicaid" means that term as

 

13  defined in section 22207.