Sec. HH-1. 22 MRSA §1812-I is enacted to read:
§1812-I. Critical access hospital defined
For purposes of this chapter, "critical access hospital" has the same meaning as set out in section 7932, subsection 10.
Sec. HH-2. 22 MRSA §7932, sub-§10, as enacted by PL 1999, c. 384, §13, is amended to read:
10. Critical access hospital. "Critical access hospital" means a hospital that must first be designated and approved by the State, as long as the State also has established an approved rural hospital flexibility program, and that meets the conditions in effect on March 1, 2004 for critical access hospital status under the federal Medicare program. In addition, it must also:
A. Be a rural public or nonprofit hospital located in a state that has established a rural hospital flexibility program;
B. Have a Medicare participation agreement as a hospital and be in compliance with the Medicare hospital conditions of participation when applying to become a critical access hospital;
C. Be certified by the State prior to January 1, 2006 as being a necessary provider of health care services to residents in the area or be located more than a 35-mile drive from any other hospital or critical access hospital. In mountainous terrain or in areas with only secondary roads, the mileage criterion is 15 miles;
D. Provide not more than 15 25 beds for acute hospital-level inpatient care:
(1) Except that a swing-bed facility is allowed to have up to 25 inpatient beds that can be used interchangeably for acute or skilled nursing facility care, as long as not more than 15 beds are used at any one time for acute care; and
(2) In addition to the 25-bed limit for acute inpatient care, a hospital may have distinct parts with 10 or fewer psychiatric inpatient beds or 10 or fewer inpatient rehabilitation beds, or both; and
E. Agree to keep each provide inpatient for no longer than care for a period that does not exceed, as determined on an annual average basis, 96 hours, unless a longer period is required because of inclement weather or other emergency conditions or a Peer Reviser Organization, "PRO" or other equivalent entity, on request, waives the 96-hour restriction; and per patient.
F. Meet the requirements of the Conditions of Participation for Critical Access Hospitals found in 42 Code of Federal Regulations, Part 485, Subpart F.
Sec. HH-3. 36 MRSA §2892, as enacted by PL 2003, c. 513, Pt. H, §1, is amended to read:
For the state fiscal years year beginning on or after July 1, 2003, a tax is imposed annually against each hospital in the State. The tax is equal to .74% of net operating revenue for the tax year as identified on the hospital's most recent audited annual financial statement for that tax year. Delinquent tax payments are subject to Title 22, section 3175-C.
For state fiscal years beginning on or after July 1, 2004, a tax is imposed annually against each hospital in the State. The tax is equal to 2.23% of net operating revenue used in the determination of the tax due for the state fiscal year beginning on July 1, 2003.
Sec. HH-4. 36 MRSA §2893, sub-§2, as enacted by PL 2003, c. 513, Pt. H, §1, is amended to read:
2. Return required in state fiscal years beginning on or after July 1, 2004. For tax due for state fiscal years beginning on or after July 1, 2004, a person subject to the tax imposed by this chapter shall submit to the assessor a return on a form prescribed and furnished by the assessor and pay the tax by July 15th one half of the total tax due by November 15th of the state fiscal year for which the tax is being imposed and one half of the total tax due by May 15th of the state fiscal year for which the tax is being imposed.
Sec. HH-5. Rules. The Department of Human Services shall adopt rules to implement that section of this Part that amends the Maine Revised Statutes, Title 22, section 7932, subsection 10. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.
Sec. HH-6. Contingency for continued federal approval of hospitals tax. Notwithstanding any other provision of law, the tax imposed under the Maine Revised Statues, Title 36, section 2892 must be terminated within 30 days of notification by the United States Department of Health and Human Services that the tax is not a permissible health care related tax. All liability for the tax incurred prior to the effective date of this notification continues to be payable to the State. In the event of such a notification, the modifications to hospital payments funded under section 8 of this Part must also be terminated. The Department of Human Services shall adopt emergency rules to modify hospital payments accordingly. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.
Sec. HH-7. Contingency for continued federal approval of hospital payment. Notwithstanding any other provision of law, the tax imposed under the Maine Revised Statutes, Title 36, section 2892 must be terminated within 30 days of notification by the United States Department of Health and Human Services that all or a part of the hospital payment modifications funded under section 8 of this Part are disapproved hospital reimbursements under the State's Medicaid program.
Sec. HH-8. Appropriations and allocations. The following appropriations and allocations are made.
HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers 0147
Initiative: Allocates funds to increase MaineCare payments to hospitals in accordance with rules duly adopted by the Department of Human Services.
Federal Expenditures Fund 2003-04 2004-05
All Other $0 $28,900,000
__________ __________
Federal Expenditures Fund Total $0 $28,900,000
Other Special Revenue Funds 2003-04 2004-05
All Other $0 $15,445,558
__________ __________
Other Special Revenue
Funds Total $0 $15,445,558
Medical Care - Payments to Providers 0147
Initiative: Allocates funds to meet the costs to the MaineCare program resulting from the program's adoption of the new critical-access hospital standards specified in the federal Medicare Prescription Drug Improvement and Modernization Act of 2003.
Federal Expenditures Fund 2003-04 2004-05
All Other $0 $3,742,176
__________ __________
Federal Expenditures Fund Total $0 $3,742,176
Other Special Revenue Funds 2003-04 2004-05
All Other $0 $2,000,000
__________ __________
Other Special Revenue
Funds Total $0 $2,000,000
Medical Care - Payments to Providers 0147
Initiative: Allocates dedicated revenue from the hospital tax for MaineCare program expenses as already assumed in the base assumptions underlying the Medical Care - Payments to Providers account appropriations in Part A of this Act.
Other Special Revenue Funds 2003-04 2004-05
All Other $0 $12,200,000
__________ __________
Other Special Revenue
Funds Total $0 $12,200,000
Medical Care - Payments to Providers 0147
Initiative: Allocates dedicated revenue from the hospital tax for MaineCare program expenses that will now be charged to Other Special Revenue funds instead of the General Fund.
Other Special Revenue Funds 2003-04 2004-05
All Other $0 $20,250,416
__________ __________
Other Special Revenue
Funds Total $0 $20,250,416
HUMAN SERVICES, DEPARTMENT OF
DEPARTMENT TOTALS 2003-04 2004-05
FEDERAL EXPENDITURES FUND $0 $32,642,176
OTHER SPECIAL REVENUE
FUNDS 0 49,895,974
__________ __________
DEPARTMENT TOTAL -
ALL FUNDS $0 $82,538,150
Sec. HH-9. Appropriations and allocations. The following appropriations and allocations are made.
HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers 0147
Initiative: Deappropriates funds to be replaced by dedicated revenue from the hospital tax.
General Fund 2003-04 2004-05
All Other $0 ($20,250,416)
__________ __________
General Fund Total $0 ($20,250,416)
Medical Care - Payments to Providers 0147
Initiative: Deappropriates funds originally appropriated to hospitals under the hospital payment equity project, to reflect elimination of the payment equity project for state fiscal year 2004-05.
General Fund 2003-04 2004-05
All Other $0 ($9,433,125)
__________ __________
General Fund Total $0 ($9,433,125)
Federal Expenditures Fund 2003-04 2004-05
All Other $0 ($17,650,208)
__________ __________
Federal Expenditures Fund Total $0 ($17,650,208)
HUMAN SERVICES, DEPARTMENT OF
DEPARTMENT TOTALS 2003-04 2004-05
GENERAL FUND $0 ($29,683,541)
FEDERAL EXPENDITURES FUND $0 (17,650,208)
__________ __________
DEPARTMENT TOTAL -
ALL FUNDS $0 ($47,333,749)
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