HB191 Alabama 2016 Session

Summary

Primary Sponsor

Steve ClouseRepresentative

Republican

Session

Regular Session 2016

Title

Hospitals, Medicaid Program, private hospital assessment and Medicaid funding extended for fiscal year 2017 using 2014 as a base year, use of certified public expenditures, by publicly and state owned hospitals clarified, Sec. 40-26B-77 repealed; Secs. 40-26B-70, 40-26B-71, 40-26B-73, 40-26B-77.1, 40-26B-79, 40-26B-80, 40-26B-81, 40-26B-82, 40-26B-84, 40-26B-86, 40-26B-88 am'd.

Summary

HB191 extends Alabama's private hospital assessment and Medicaid funding program through 2019, uses 2014 as the base year for calculations, clarifies certified public expenditures, and repeals an older provision.

What This Bill Does

The bill extends the private hospital assessment and Medicaid funding program for fiscal years 2017–2019 and changes the calculation base year to 2014. It clarifies how certified public expenditures by publicly and state-owned hospitals may be used and creates a Hospital Assessment Account to hold funds from assessments and intergovernmental transfers. It sets up hospital payment structures (including inpatient/outpatient access payments and potential DRG/OPPS payments) funded to obtain federal matching funds, requires quarterly intergovernmental transfers from public/state hospitals, and provides for refunds or cessation of the program if federal rules or funding conditions change; it also terminates in 2019 unless extended by future legislation.

Who It Affects

• Privately operated hospitals: subject to a 5.50% assessment of net patient revenue (based on 2011–2014 data) to fund Medicaid payments and related access payments; the assessment may be adjusted or refunded if certain conditions occur.
• Publicly owned and state-owned hospitals: must make intergovernmental transfers to Medicaid; eligible to receive hospital access payments and base payments; their intergovernmental transfers and use of certified public expenditures are clarified and regulated.

Key Provisions

• Extend the private hospital assessment and Medicaid funding program for fiscal years 2017, 2018, and 2019 and change the base year for calculating the assessment to fiscal year 2014.
• Repeal Section 40-26B-77 and clarify the use of Certified Public Expenditures by publicly owned and state-owned hospitals.
• Create the Hospital Assessment Account in the Health Care Trust Fund to receive hospital assessments, intergovernmental transfers, and related funds, and specify that funds be used for inpatient and outpatient private hospital payments and to obtain federal matching funds.
• Publicly owned and state-owned hospitals must make quarterly intergovernmental transfers to the Medicaid Agency, with a total annual cap (about $324.9 million) and pro‑rata calculation based on FY 2016 IGT and CPE contributions.
• Medicaid pays hospitals base amounts for inpatient and outpatient services (and may utilize DRG/OPPS mechanisms) and provides hospital access payments equal to the upper payment limit, subject to CMS approvals and not offsetting other Medicaid payments.
• Program funds and payments are contingent on federal participation; the Act automatically terminates on September 30, 2019 unless extended, and refunds may occur if conditions reduce federal matching or required payments.
• An uncompensated care survey is required annually for hospitals affected by the article, and the Medicaid Plan must comply with federal rules for disproportionate share payments.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Medicaid