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  • PART I ADMINISTRATION OF THE GOVERNMENT
  • TITLE XVII PUBLIC WELFARE
  • CHAPTER 118E DIVISION OF MEDICAL ASSISTANCE
  • Section 67 Liability of acute hospital to fund

[ Subsection (a) effective until July 1, 2013. For text effective July 1, 2013, see below.]

  Section 67. (a) An acute hospital's liability to the fund shall equal the product of: (i) the ratio of its private sector charges to all acute hospitals' private sector charges; and (ii) $160,000,000. Annually, before October 1, the office shall establish each acute hospital's liability to the fund using the best data available, as determined by the health safety net office and shall update each acute hospital's liability to the fund as updated information becomes available. The office shall specify by regulation an appropriate mechanism for interim determination and payment of an acute hospital's liability to the fund. An acute hospital's liability to the fund shall in the case of a transfer of ownership be assumed by the successor in interest to the acute hospital.

[ Subsection (a) as amended by 2013, 38, Sec. 99 effective July 1, 2013. See 2013, 38, Sec. 219. For text effective until July 1, 2013, see above.]

  (a) An acute hospital's liability to the fund shall equal the product of: (i) the ratio of its private sector charges to all acute hospitals' private sector charges; and (ii) the total acute hospital assessment amount. Annually, before October 1, the office shall establish each acute hospital's liability to the fund using the best data available, as determined by the health safety net office and shall update each acute hospital's liability to the fund as updated information becomes available. The office shall specify by regulation an appropriate mechanism for interim determination and payment of an acute hospital's liability to the fund. An acute hospital's liability to the fund shall in the case of a transfer of ownership be assumed by the successor in interest to the acute hospital.

  (b) The office shall establish by regulation an appropriate mechanism for enforcing an acute hospital's liability to the fund in the event that an acute hospital does not make a scheduled payment to the fund. These enforcement mechanisms may include: (i) an offset by the office of Medicaid of payments on the Title XIX claims of any such acute hospital or any health care provider under common ownership with the acute care hospital or any successor in interest to the acute hospital; and (ii) the withholding by the office of Medicaid of the amount of payment owed to the fund, including any interest and late fees and the transfer of the withheld funds into the fund. If the office of Medicaid offsets claims payments as ordered by the office, it shall not be considered to be in breach of contract or any other obligation for the payment of non-contracted services and providers whose payment is offset under an order of the division shall serve all Title XIX recipients under the contract then in effect with the office of Medicaid, or, in the case of a non-contracting or disproportionate share hospital, under its obligation for providing services to Title XIX recipients under this chapter. In no event shall the office direct the office of Medicaid to offset claims unless an acute hospital has maintained an outstanding obligation to the fund for a period longer than 45 days and has received proper notice that the office of Medicaid intends to initiate enforcement actions under regulations promulgated by the office.