                                 CODE OF VIRGINIA

HEALTH CARE PROVIDER PAYMENT RATE ASSESSMENT FUND (§ 32.1-331.02)

A. As used in this section:
			&#8220;Covered hospital&#8221; means any in-state private acute care hospital
other than a hospital classified as a public hospital, freestanding psychiatric
and rehabilitation hospital, children&#8217;s hospital, long stay hospital,
long-term care hospital, or critical access hospital.
			&#8220;Managed care organization hospital payment gap&#8221; means the
difference between the amount included in rates for inpatient and outpatient
services provided by covered hospitals, based on historical paid claims, and the
amount that would be included when hospital services are priced according to the
existing State Plan methodology but using 100 percent of the adjustment factors,
including the capital reimbursement percentage, and full inflation subject to
approval by the Centers for Medicare and Medicaid Services pursuant to 42 C.F.R.
&#xA7; 438.6(c).
			&#8220;State Plan&#8221; means the state plan for medical assistance under
Title XIX (42 U.S.C. &#xA7; 1396 et seq.) of the Social Security Act.
			&#8220;Upper payment limit&#8221; means the amount equal to the maximum
amount of payment for inpatient services for recipients of medical assistance
services established in accordance with 42 C.F.R &#xA7; 447.272 and outpatient
services for recipients of medical assistance services pursuant to 42 CFR &#xA7;
447.321.

B. There is hereby created in the state treasury a special nonreverting fund to
be known as the Health Care Payment Rate Assessment Fund, referred to in this
section as &#8220;the Fund.&#8221; The Fund shall be established on the books of
the Comptroller. All revenues collected or received as a result of imposition of
a health care payment rate assessment on covered hospitals and any other such
moneys, public or private, received for the administration of the health care
payment assessment shall be paid into the state treasury and credited to the
Fund. Interest earned on moneys in the Fund shall remain in the Fund and be
credited to it. Any moneys remaining in the Fund, including interest thereon, at
the end of each fiscal year shall not revert to the general fund but shall
remain in the Fund. Moneys deposited to the Fund shall be used solely for the
nonfederal share of the cost of payment rate actions associated with the payment
rate assessment as provided in the general appropriation act and the
administrative costs of collecting the assessment and of implementing and
operating the associated payment rate actions. Such moneys shall be appropriated
as provided in the general appropriation act. Expenditures and disbursements
from the Fund shall be made by the State Treasurer on warrants issued by the
Comptroller upon written request signed by the Director of the Department of
Medical Assistance Services.

HISTORY: 2018, Sp. Sess. I, c. 2.