Development of a Provider Assessment

Item 278 #1s

Language
Page 238, line 3, strike "$673,257" and insert "$723,257".
Page 238, after line 45, insert:
"C.1. The Secretary of Health and Human Resources shall develop a hospital provider assessment program that: (i) complies with applicable federal law and regulations; (ii) is designed to operate in a fashion that is mutually beneficial to the Commonwealth and affected health care organizations; (iii) addresses health system challenges in meeting the needs of the uninsured and preserving access to essential health care services (e.g. trauma programs, obstetrical care) throughout the Commonwealth; (iv) supports the indigent care and graduate medical education costs at private teaching hospitals in the Commonwealth; and (iv) advances reforms that are consistent with the goals of improved health care access, lower overall costs and better health for Virginians. In development of this program, the Secretary’s office shall be assisted by the Department of Medical Assistance Services, the Virginia Center for Healthcare Innovation, the Virginia Hospital and Healthcare Association and other affected stakeholders. The resulting hospital provider assessment program developed by the Secretary shall not be implemented until after June 30, 2016.  
2.  As part of the development of a hospital provider assessment program, the Secretary of Health and Human Resources shall also develop as an option a more limited program that is focused on supporting the indigent care and graduate medical education costs at private teaching hospitals in the Commonwealth.  This limited hospital provider assessment program developed by the Secretary shall not be implemented until after June 30, 2016.
3.  The Secretary of Health and Human Resources shall also undertake a review of a program that would provide supplemental payments for qualifying private hospitals as provided for in the State Plan for Medical Assistance Services amendments 11-018 and 11-019 submitted to the Centers for Medicare and Medicaid Services on or about December 20, 2011.  If the Secretary deems that such a program would be consistent with the goals of an assessment program as stated in subparagraph 1, then implementation of this program may be implemented after June 30, 2016.
4. The hospital provider assessment program developed by the Secretary of Health and Human Resources shall require that no less than 20 percent of any assessment revenue collected be deposited to the Virginia Health Reform and Innovation Fund.  
5. The Secretary shall report to the Chairmen of the House Appropriations and Senate Finance Committees by November 2, 2015 on the appropriate details regarding the hospital provider assessment program, which shall include: (i) the structure, collection process, and amount of the assessment; (ii) the process for supplemental payments; (iii) an estimate by hospital of the net financial impact of the program; and (iv) an implementation timeline.  In addition, the Secretary shall include in his report details on the requirements of subparagraphs 2, 3, and 4.
6.  The Secretary is authorized to direct the appropriate agency to submit requests for federal preapproval of a program or programs developed pursuant to subparagraphs 1, 2 and 3.
7.  Out of this appropriation, $50,000 the second year from the general fund is provided for consulting and legal services related to the development of a provider assessment program.  If this funding can be matched with federal funds, then the Department of Planning and Budget may transfer this appropriation to the Department of Medical Assistance Services."

Explanation
(This amendment provides $50,000 from the general fund the second year for consulting and legal costs as part of the requirement for the Secretary of Health and Human Resources to develop various health care provider assessments and report on the details of such programs to the General Assembly by November 2, 2015. Any provider assessment program developed shall be implemented after June 30, 2016. A companion amendment in Item 301 eliminates language requiring a pilot program to implement a hospital provider assessment to adjust Medicaid hospital rates.)