Wis. Stat. § 50.38 — WI Code / Chapter 50 / Section 50.38
Hospital assessment.
Status: in_force

(1) In this section “eligible hospital” means a hospital that is not any of the following:

(b) An institution for mental diseases, as defined in s. 46.011 (1m) .

(c) A general psychiatric hospital for which the department has issued a certificate of approval under s. 50.35 that applies only to the psychiatric hospital, and that is not a satellite of an acute care hospital.

(d) A long-term care hospital that meets the requirements of 42 CFR 412.23 (e) and is reimbursed by the federal Medicare program under the Medicare prospective payment system for long-term care hospitals, for which the department has issued a certificate of approval under s. 50.35 that only applies to the long-term care hospital and that is not a satellite operating under the certificate of approval of an acute care hospital.

(2)

(a) For the privilege of doing business in this state, there is imposed on each eligible hospital that is not a critical access hospital an assessment each state fiscal year that is equal to an outpatient uniform percentage, determined under sub. (3) , of the hospital’s outpatient gross patient revenues, as reported under s. 153.46 (5) and determined by the department, plus an inpatient uniform percentage, determined under sub. (3) , of the hospital’s inpatient gross revenues, as reported under s. 153.46 (5) and determined by the department. The assessments shall be deposited in the hospital assessment fund.

(b) For the privilege of doing business in this state, there is imposed on each critical access hospital an assessment each state fiscal year that is equal to the inpatient uniform percentage, established by the department under sub. (3) , of the critical access hospital’s gross inpatient revenues, as reported under s. 153.46 (5) and determined by the department. The assessments shall be deposited in the hospital assessment fund.

(3) Beginning July 1, 2025, the department shall establish the inpatient and outpatient uniform percentages that are applicable under sub. (2) (a) and (b) so that the total amount of assessments collected under sub. (2) (a) and (b) is equal to $1,507,096,900 in a state fiscal year or is equal to the greatest amount that may be collected in a state fiscal year without resulting in the reduction of the amount paid to this state under 42 USC 1396b (w), whichever amount is lower.

(3m) The secretary shall notify the joint committee on finance of any material change in federal law that results in refunds or recoupments under sub. (6) . Notwithstanding s. 50.38 (2) , following such notice, the department shall be authorized to suspend part of or all assessments under s. 50.38 (2) pursuant to s. 227.24 .

(4) Except as provided in sub. (5) , each eligible hospital shall pay the applicable annual assessment under sub. (2) in 4 equal amounts that are due by September 30, December 31, March 31, and June 30 of each year.

(5) At the discretion of the department, a hospital that is unable timely to make a payment by a date specified under sub. (4) may be allowed to make a delayed payment. A determination by the department that a hospital may not make a delayed payment under this subsection is final and is not subject to review under ch. 227 . At the discretion of the department, a hospital that is unable to timely make a payment by a date specified under sub. (4) and that is not granted a payment extension under this subsection may be referred to the department of revenue for debt collection.

(6)

(a)

1. If the federal government does not provide federal financial participation under the federal Medicaid program for amounts collected under sub. (2) (a) or (b) that are used to make payments required under s. 49.45 (3) (e) 11. or (5r) , that are transferred under sub. (8) and used to make payments from the Medical Assistance trust fund, or that are transferred under sub. (9) and expended under s. 20.435 (4) (jw) , the department shall, from the fund from which the payment or expenditure was made, refund eligible hospitals the amount for which the federal government does not provide federal financial participation.

2. If the department makes a refund under subd. 1. as result of failure to obtain federal financial participation under the federal Medicaid program for a payment required under s. 49.45 (3) (e) 11. or (5r) or a payment from the Medical Assistance trust fund, the department shall recoup the part of the payment for which the federal government does not provide federal financial participation.

3. Moneys recouped under subd. 2. for payments made from the hospital assessment fund shall be deposited in the hospital assessment fund.

4. Moneys recouped under subd. 2. for payments made from the Medical Assistance trust fund shall be deposited in the Medical Assistance trust fund.

(b) On June 30 of each state fiscal year, the department shall, from the appropriation account under s. 20.435 (4) (xc) , refund to eligible hospitals any amounts not expended or encumbered from that appropriation in the fiscal year or transferred under sub. (8) .

(c) The department shall allocate any refund under this subsection to eligible hospitals in proportion to the percentage of the total assessments collected under sub. (2) that each hospital paid.

(7) By June 1 of each year the department shall report to the joint committee on finance all of the following information for the state fiscal year ending the previous June 30:

(a) The amount each eligible hospital paid under sub. (2) .

(b) The amounts the department paid each health maintenance organization under s. 49.45 (59) (a) .

(c) The total amounts that each eligible hospital received from health maintenance organizations under s. 49.45 (59) (b) .

(d) The total amount of payment increases the department made, in connection with implementation of the hospital assessments under sub. (2) , for inpatient and outpatient hospital services that are reimbursed on a fee-for-service basis.

(e) The total amount of payments that the department made to each hospital under the Medical Assistance Program under subch. IV of ch. 49 .

(f) The portion of capitated payments that the department made to each health maintenance organization under the Medical Assistance Program under subch. IV of ch. 49 from appropriation accounts of general purpose revenues that is for inpatient and outpatient hospital services.

(g) The results of any audits conducted by the department under s. 49.45 (59) (e) 3. and any actions taken by the department as a result of the audits.

(7m)

(a)

1. The department shall submit to the legislative reference bureau for publication in the Wisconsin Administrative Register a notice specifying the information in subd. 2. if any of the following apply:

a. The statewide total of assessment payments in sub. (2) that the department expects to be paid in the current state fiscal year does not equal or exceed $1,356,000,000.

b. The statewide total of Medical Assistance payments required in s. 49.45 (3) (e) 11. that the department expects to be paid in the current state fiscal year does not equal the statewide total of assessment payments in sub. (2) that the department expects to be paid in the current state fiscal year divided by 56.1 percent.

c. The statewide total of assessment payments in sub. (2) that the department expects to be paid in the next state fiscal year does not equal or exceed $1,356,000,000.

d. The statewide total of Medical Assistance payments required in s. 49.45 (3) (e) 11. that the department expects to be paid in the next state fiscal year does not equal the statewide total of assessment payments in sub. (2) that the department expects to be paid in the next state fiscal year divided by 56.1 percent.

2. The department shall include in any notice submitted under subd. 1. all of the following information:

a. The statewide total of assessment payments in sub. (2) that the department expects to be paid in the current state fiscal year.

b. The statewide total of Medical Assistance payments required in s. 49.45 (3) (e) 11. that the department expects to be paid in the current state fiscal year.

c. The statewide total of assessment payments in sub. (2) that the department expects to be paid in the next state fiscal year.

d. The statewide total of Medical Assistance payments required in s. 49.45 (3) (e) 11. that the department expects to be paid in the next state fiscal year.

(b)

1. The department shall submit to the legislative reference bureau for publication in the Wisconsin Administrative Register a notice specifying the information in subd. 2. if, after the department has submitted a notice to the legislative reference bureau for publication in the Wisconsin Administrative Register under par. (a) , any of the following apply:

a. The statewide total of assessment payments in sub. (2) that the department expects to be paid in the current state fiscal year equals or exceeds $1,356,000,000.

b. The statewide total of Medical Assistance payments required in s. 49.45 (3) (e) 11. that the department expects to be paid in the current state fiscal year equals the statewide total of assessment payments in sub. (2) that the department expects to be paid in the current state fiscal year divided by 56.1 percent.

c. The statewide total of assessment payments in sub. (2) that the department expects to be paid in the next state fiscal year equals or exceeds $1,356,000,000.

d. The statewide total of Medical Assistance payments required under s. 49.45 (3) (e) 11. that the department expects to be paid in the next state fiscal year equals the statewide total of assessment payments in sub. (2) that the department expects to be paid in the next state fiscal year divided by 56.1 percent.

2. The department shall include in any notice submitted under subd. 1. all of the following information:

a. The statewide total of assessment payments in sub. (2) that the department expects to be paid in the current state fiscal year.

b. The statewide total of Medical Assistance payments required in s. 49.45 (3) (e) 11. that the department expects to be paid in the current state fiscal year.

c. The statewide total of assessment payments in sub. (2) that the department expects to be paid in the next state fiscal year.

d. The statewide total of Medical Assistance payments required in s. 49.45 (3) (e) 11. that the department expects to be paid in the next state fiscal year.

(8) In each state fiscal year, the secretary of administration shall transfer from the hospital assessment fund to the Medical Assistance trust fund an amount equal to the amount collected under sub. (2) (a) and (b) for that fiscal year minus the state share of payments to hospitals required under s. 49.45 (3) (e) 11. , minus any amounts appropriated under s. 20.285 (1) (qe) and (qj) , and minus any refunds paid to hospitals from the hospital assessment fund under sub. (6) (a) in that fiscal year.

(9) On June 30 of each state fiscal year, the secretary of administration shall transfer from the Medical Assistance trust fund to the appropriation account under s. 20.435 (4) (jw) , an amount equal to 0.5 percent of the amount transferred under sub. (8) .

History: 2009 a. 2 , 190 ; 2011 a. 260 s. 81 ; 2017 a. 59 ; 2025 a. 15 .