HB322 Alabama 2018 Session

Summary

Primary Sponsor

Steve ClouseRepresentative

Republican

Session

Regular Session 2018

Title

Hospitals, private hospital assessment and Medicaid funding program extended for fiscal year 2019, Secs. 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-88 am'd.

Summary

HB 322 extends the private hospital assessment and Medicaid funding program for fiscal year 2019 to continue funding hospital payments through a dedicated Hospital Assessment Account.

What This Bill Does

Keeps a private hospital assessment of about 5.50% to 5.75% of net patient revenue (based on 2014–2016 data) in effect for FY 2019, with net revenue determined from Medicare Cost Reports; funds are deposited into the Hospital Assessment Account to pay inpatient and outpatient hospital payments and to support Medicaid funding. It establishes intergovernmental transfers from publicly/state-owned hospitals and sets how those transfers and the overall funding level are calculated and capped, aligned with federal rules. It specifies how Medicaid payments to hospitals are calculated (APR-DRG inpatient and OPPS-based outpatient payments), requires quarterly hospital access payments, and prevents offsetting these payments against other Medicaid payments. It also includes refund provisions if expenditures fall or federal funds change, and sets an automatic termination date unless extended, with an effective date of October 1, 2018.

Who It Affects

• Privately operated hospitals, which are subject to the private hospital assessment and must contribute to the Hospital Assessment Account to fund hospital payments.
• Publicly owned and state-owned hospitals, which participate in intergovernmental transfers and receive hospital access payments funded through the Hospital Assessment Account.

Key Provisions

• Imposes a privately operated hospital assessment of 5.50% to 5.75% of net patient revenue for state fiscal year 2018-2019, calculated using data from 2014-2016 Medicare Cost Reports; if adverse federal reimbursement impacts are found, the issue is reported to the House committee for possible amendments.
• Creates the Hospital Assessment Account within the Health Care Trust Fund; requires that funds from assessments (and related interest/penalties) be used to pay hospital payments and reimburse errors, with balances carried over and potential refunds to hospitals if no new assessments are needed or if federal matching is reduced.
• Requires publicly/state-owned hospitals to make intergovernmental transfers to the Medicaid Agency, with a total cap (not to exceed $333,434,048) and a pro rata calculation based on FY 2017-2018 IGTs; funds must comply with federal rules and CMS waivers.
• Sets inpatient (APR-DRG) and outpatient (OPPS) base payments for FY 2018-2019 if Medicaid begins paying under Title 22, with no retroactive adjustments if timing changes; outpatient base payments use the existing OPPS schedule or fee schedule if necessary.
• Establishes hospital access payments (inpatient and outpatient) for all eligible hospitals, equal to the relevant upper payment limits, paid quarterly and not used to offset other Medicaid payments.
• Includes refund and termination provisions: the assessment can be halted and funds refunded if expenditures fall or if federal participation changes; the act remains in effect only if federal funding is available, and it will automatically terminate on September 30, 2019 unless extended.
• Effective date is October 1, 2018, with the automatic termination unless another extension is enacted.

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

Subjects

Hospitals