2023 New York Laws › PBH - Public Health › Article 28 - Hospitals › 2807-D - Hospital Assessments.

§  2807-d.  Hospital assessments. 1. (a) Hospitals, as defined in this
article,  excluding  hospitals  specified  in  paragraph  (b)  of   this
subdivision,  are  charged  assessments on their gross receipts received
from all patient care services and other operating income, less personal
needs allowances and refunds, on a cash basis in the percentage  amounts
and  for  the periods specified in subdivision two of this section. Such
assessments shall be submitted by or  on  behalf  of  hospitals  to  the
commissioner or his designee.
(b)  Subject  to the provisions of subdivision twelve of this section,
the following categories of hospitals shall not be  charged  assessments
pursuant   to   this   section:  (i)  voluntary  nonprofit  and  private
proprietary general hospitals which qualify for  distributions  made  in
accordance  with  paragraph  (c)  of  subdivision  nineteen  of  section
twenty-eight hundred seven-c of this article, or for assessments  during
the period January first, nineteen hundred ninety-seven through December
thirty-first,  nineteen  hundred  ninety-seven  voluntary  nonprofit and
private proprietary general hospitals which qualified for  distributions
made in accordance with paragraph (c) of subdivision nineteen of section
twenty-eight   hundred   seven-c   of   this   article  as  of  December
thirty-first, nineteen hundred  ninety-five;  (ii)  voluntary  nonprofit
hospitals  totally financed by charitable contributions or by the income
thereon dedicated to free care of low income  patients;  and  (iii)  any
facility   dedicated  solely  to  the  care  of  police,   firefighters,
volunteer firefighters, and emergency service personnel.
(c) On and after December first, nineteen  hundred  ninety-seven,  the
term  "general  hospital",  as  used in this section, includes specialty
hospitals for persons who are developmentally disabled, licensed by  the
office  for  people  with  developmental disabilities and which are also
issued an operating certificate pursuant to section twenty-eight hundred
five of this article.
2. (a) (i) For general  hospitals  the  overall  assessment  shall  be
six-tenths  of  one  percent  and the assessment shall vary from 0.5% to
0.675% of each general  hospital's  gross  receipts  received  from  all
patient  care services and other operating income on a cash basis during
the period January first,  nineteen  hundred  ninety-one  through  March
thirty-first, nineteen hundred ninety-two for hospital or health-related
services,  including  but  not  limited to inpatient service, outpatient
service, emergency service, referred ambulatory service  and  ambulatory
surgical  service. The assessment shall vary according to the percentage
of  nineteen  hundred  eighty-nine  medicaid  inpatient  revenues  as  a
percentage  of total  nineteen hundred eighty-nine inpatient revenues as
reported on the institutional cost report submitted  to  the  department
for   nineteen  hundred  eighty-nine  according  to  the  following: for
hospitals with medicaid revenue up to and including 10%, the  assessment
shall  be .5%,   for hospitals with medicaid revenue greater than 10% up
to and including 15%, the assessment shall be .525%, for hospitals  with
medicaid  revenue  greater  than  15%  up  to  and  including  20%,  the
assessment shall be .65%, and for hospitals with medicaid  revenue  over
20%,  the  assessment  shall  be .675%. In the event that the provisions
relating to the additional supplementary low income  patient  adjustment
established   in  accordance  with  subdivision  fourteen-d  of  section
twenty-eight hundred seven-c of this   article  cannot  be  implemented,
then the general hospital assessment established in accordance with this
paragraph  shall  be  calculated  without  variation  specified  in this
paragraph and the assessment for each general hospital whose  assessment
was  greater  than  six-tenths of one percent shall become six-tenths of
one percent.
(ii) For general hospitals the assessment shall be six-tenths  of  one
percent  of  each  general  hospital's  gross receipts received from all
patient care services  and  other  operating  income  on  a  cash  basis
beginning  April  first,  nineteen  hundred  ninety-two  for hospital or
health-related   services,  including,  but  not  limited  to  inpatient
service, outpatient  service,  emergency  service,  referred  ambulatory
service and ambulatory surgical service; provided, however, that for all
such  gross  receipts  received  on  or  after  December first, nineteen
hundred  ninety-eight,  such  assessment  shall  be  two-tenths  of  one
percent,  and further provided that for all such gross receipts received
on or after April first, nineteen hundred ninety-nine,  such  assessment
shall  be  one-tenth  of  one  percent,  and  further provided that such
assessment shall expire and be of no further effect for all  such  gross
receipts received on or after January first, two thousand.
(iii)   For  general  hospitals  an  additional  assessment  shall  be
one-tenth of one percent  of  each  general  hospital's  gross  receipts
received  from all patient care services and other operating income on a
cash basis  beginning  April  first,  nineteen  hundred  ninety-two  for
hospital  or  health-related  services,  including,  but  not limited to
inpatient  service,  outpatient  service,  emergency  service,  referred
ambulatory  service  and ambulatory surgical service; provided, however,
that such additional assessment shall expire and be of no further effect
for all such  gross  receipts  received  on  or  after  December  first,
nineteen hundred ninety-seven.
(iv)  Subject to the provisions of subdivision twelve of this section,
the assessment and additional assessment pursuant to subparagraphs  (ii)
and  (iii)  of  this paragraph during the period January first, nineteen
hundred ninety-eight through  December  thirty-first,  nineteen  hundred
ninety-eight  for  voluntary  nonprofit  and private proprietary general
hospitals which qualified for  distributions  made  in  accordance  with
paragraph  (c)  of  subdivision nineteen of section twenty-eight hundred
seven-c of this article as of December  thirty-first,  nineteen  hundred
ninety-five  shall  be  abated  by  seventy-five percent, and during the
period January first,  nineteen  hundred  ninety-nine  through  December
thirty-first,   nineteen   hundred   ninety-nine   shall  be  abated  by
twenty-five percent.
(v) Notwithstanding any contrary provisions of this paragraph  or  any
other  provision  of  law  or  regulation,  for  general  hospitals  the
assessment shall be  thirty-five  hundredths  of  one  percent  of  each
general  hospital's  gross  receipts  received  from  all  patient  care
services and other operating income on a cash basis for the period April
first, two thousand five through March thirty-first two  thousand  seven
for  hospital  or health-related services, including, but not limited to
inpatient  service,  outpatient  service,  emergency  service,  referred
ambulatory  service  and ambulatory surgical services, but not including
residential  health  care  facilities  services  or  home  health   care
services.
(vi)  Notwithstanding any contrary provisions of this paragraph or any
other  provision  of  law  or  regulation,  for  general  hospitals  the
assessment  shall  be  thirty-five  hundredths  of  one  percent of each
general  hospital's  gross  receipts  received  from  all  patient  care
services  and  other operating income on a cash basis for periods on and
after April first, two thousand nine,  for  hospital  or  health-related
services,  including,  but not limited to inpatient services, outpatient
services,  emergency  services,   referred   ambulatory   services   and
ambulatory  surgical services, but not including residential health care
facilities services or home health care services.
(b) (i) For residential health care facilities the assessment shall be
six-tenths of one percent of each  residential  health  care  facility's
gross  receipts  received  from  all  patient  care  services  and other
operating income on a cash basis beginning April first, nineteen hundred
ninety-one  for hospital or health-related services, including adult day
services; provided, however, that for all such gross  receipts  received
on   or  after  September  first,  nineteen  hundred  ninety-seven  such
assessment shall be three-tenths of one percent,  and  further  provided
that  such  assessment  shall expire and be of no further effect for all
such gross receipts  received  on  or  after  December  first,  nineteen
hundred ninety-eight.
(ii)  For  residential health care facilities an additional assessment
shall be one and two-tenths percent  of  each  residential  health  care
facility's  gross  receipts  received from all patient care services and
other operating income on a cash basis beginning April  first,  nineteen
hundred  ninety-two  for  hospital or health-related services, including
adult day services; provided, however, that such  additional  assessment
shall  expire  and  be  of no further effect for all such gross receipts
received on or after April first, nineteen hundred ninety-nine.
(iii) For residential health  care  facilities  a  further  additional
assessment  shall  be three and eight tenths percent of each residential
health care facility's gross receipts received  from  all  patient  care
services  and  other  operating income on a cash basis for the period of
July first, nineteen hundred  ninety-five  through  March  thirty-first,
nineteen  hundred  ninety-six  for  hospital or health-related services,
including adult day services. The residential health care facility shall
file the assessment return with any balance due or any refund claimed by
May first, nineteen hundred ninety-six. Notwithstanding any inconsistent
provision of this section, the residential health  care  facility  shall
make  estimated payments to the commissioner on a monthly basis starting
August fifteenth, nineteen hundred ninety-five  and  continuing  on  the
fifteenth  of  each  month  through  March  fifteenth,  nineteen hundred
ninety-six equal to one-eighth of the total estimated for  this  further
additional  assessment  for the further additional assessment period. If
the total of estimated payments is less than ninety-five percent of  the
actual  payment  due,  the residential health care facility shall pay to
the commissioner a penalty of fifteen percent of the difference due  for
each  month  in  addition to the amount due. The commissioner may recoup
deficiencies and penalties pursuant to paragraph (c) of subdivision  six
of this section.
* (iv)  For  residential  health  care facilities a further additional
assessment shall be one and  nine-tenths  percent  of  each  residential
health  care  facility's  gross  receipts received from all patient care
services and other operating income on a cash basis for  the  period  of
April  first,  nineteen  hundred  ninety-six through March thirty-first,
nineteen hundred ninety-seven for hospital or  health-related  services,
including adult day services. The residential health care facility shall
file the assessment return with any balance due or any refund claimed by
May   first,   nineteen   hundred   ninety-seven.   Notwithstanding  any
inconsistent provision of this  section,  the  residential  health  care
facility  shall make estimated payments to the commissioner on a monthly
basis starting May fifteenth, and continuing on the  fifteenth  of  each
month  through  March  fifteenth  equal  to  one-eleventh  of  the total
estimated for this further additional assessment for  the  period  April
first,  nineteen  hundred ninety-six through March thirty-first nineteen
hundred ninety-seven. If the total of estimated payments  is  less  than
ninety-five  percent  of  the actual payment due, the residential health
care facility shall pay to the commissioner a penalty of fifteen percent

of the difference due each month in addition  to  the  amount  due.  The
commissioner may recoup deficiencies and penalties pursuant to paragraph
(c) of subdivision six of this section.
* NB There are 2 subpar (iv)'s
* (iv)  For  residential  health  care facilities a further additional
assessment shall be one and  nine-tenths  percent  of  each  residential
health  care  facility's  gross  receipts received from all patient care
services and other operating income on a cash basis for  the  period  of
April  first,  nineteen  hundred ninety-six through  March thirty-first,
nineteen hundred ninety-seven for hospital or  health-related  services,
including adult day services. The residential health care facility shall
file the assessment return with any balance due or any refund claimed by
May   first,   nineteen   hundred   ninety-seven.   Notwithstanding  any
inconsistent provision of this  section,  the  residential  health  care
facility  shall make estimated payments to the commissioner on a monthly
basis starting May fifteenth, and continuing on the  fifteenth  of  each
month  through  March  fifteenth,  equal  to  one-eleventh of the  total
estimated  for  this  further  additional  assessment  for  the   period
beginning  April  first  of nineteen hundred ninety-six and ending March
thirty-first, nineteen hundred ninety-seven. If the total of the  eleven
required  estimated  payments  is  less  than ninety-five percent of the
actual payment due, the residential health care facility  shall  pay  to
the commissioner a penalty of fifteen  percent of the difference due for
each  month  in  addition to the amount due. The commissioner may recoup
deficiencies and penalties pursuant  to paragraph (c) of subdivision six
of this section.
* NB There are 2 subpar (iv)'s
* (v) For residential health care facilities  in  addition  a  further
additional  assessment shall be (a) two and three-tenths percent of each
residential care facility's gross receipts  received  from  all  patient
care  services  and other operating income on a cash basis beginning May
first,  nineteen  hundred  ninety-six  through   December  thirty-first,
nineteen  hundred  ninety-six  for  hospital or health-related services,
including adult day services and (b) one and nine-tenths percent of each
residential care facility's gross receipts  received  from  all  patient
care  services  and  other  operating  income on a cash basis  beginning
January  first,  nineteen  hundred  ninety-seven  and  ending  February
twenty-eighth,   nineteen   hundred   ninety-seven   for   hospital   or
health-related services, including adult day services.
* NB There are 2 subpar (v)'s
* (v) For residential health care facilities  in  addition  a  further
additional  assessment shall be (a) two and three-tenths percent of each
residential care facility's gross receipts  received  from  all  patient
care  services  and other operating income on a cash basis beginning May
first, nineteen hundred ninety-six  and  ending  December  thirty-first,
nineteen  hundred  ninety-six  for  hospital or health-related services,
including adult day services and (b) one and nine-tenths percent of each
residential care facility's gross receipts  received  from  all  patient
care  services  and  other  operating  income  on a cash basis beginning
January  first,  nineteen  hundred  ninety-seven  and  ending   February
twenty-eighth,   nineteen   hundred   ninety-seven   for   hospital   or
health-related  services,  including  adult  day   services;   provided,
however,  that  for  all  such gross receipts received on or after April
first, nineteen hundred ninety-seven, such further additional assessment
shall be three and six-tenths percent, and further provided that for all
such gross receipts received on or after April first,  nineteen  hundred
ninety-nine,  such  further  additional  assessment  shall  be  two  and
four-tenths percent, and further provided that such  further  additional

assessment  shall  expire and be of no further effect for all such gross
receipts received on or after January first, two thousand.
* NB There are 2 subpar (v)'s
(vi)  Notwithstanding  any contrary provision of this paragraph or any
other provision of law or regulation to the  contrary,  for  residential
health  care  facilities  the  assessment  shall  be six percent of each
residential health care facility's  gross  receipts  received  from  all
patient care services and other operating income on a cash basis for the
period  April  first,  two  thousand two through March thirty-first, two
thousand three for hospital or health-related services, including  adult
day   services;   provided,   however,   that  residential  health  care
facilities' gross receipts attributable to payments received pursuant to
title XVIII of the federal  social  security  act  (medicare)  shall  be
excluded from the assessment; provided, however, that for all such gross
receipts  received  on  or after April first, two thousand three through
March thirty-first, two thousand five, such  assessment  shall  be  five
percent,  and further provided that for all such gross receipts received
on or after April first, two thousand five through  March  thirty-first,
two  thousand  nine,  and  on  or  after  April first, two thousand nine
through March thirty-first, two thousand eleven such assessment shall be
six percent, and further provided  that  for  all  such  gross  receipts
received  on  or  after  April  first, two thousand eleven through March
thirty-first,  two  thousand  thirteen  such  assessment  shall  be  six
percent,  and further provided that for all such gross receipts received
on  or  after  April  first,  two  thousand   thirteen   through   March
thirty-first, two thousand fifteen such assessment shall be six percent,
and  further  provided  that  for all such gross receipts received on or
after April first, two thousand fifteen through March thirty-first,  two
thousand  seventeen  such  assessment  shall be six percent, and further
provided that for all such gross receipts received  on  or  after  April
first,  two  thousand seventeen through March thirty-first, two thousand
nineteen such assessment shall be six percent, and further provided that
for all such gross receipts  received  on  or  after  April  first,  two
thousand  nineteen  through  March thirty-first, two thousand twenty-one
such assessment shall be six percent, and further provided that for  all
such  gross  receipts  received  on  or  after April first, two thousand
twenty-one through March thirty-first, two  thousand  twenty-three  such
assessment  shall be six percent, and further provided that for all such
gross  receipts  received  on  or  after  April  first,   two   thousand
twenty-three  through  March thirty-first, two thousand twenty-five such
assessment shall be six percent.
(c) For all other facilities issued an operating certificate  pursuant
to   section  twenty-eight  hundred  five  of  this  article,  including
diagnostic and treatment centers, the assessment shall be six-tenths  of
one  percent of each facility's gross receipts received from all patient
care services and other operating  income  on  a  cash  basis  beginning
January   first,   nineteen   hundred   ninety-one   for   hospital   or
health-related  services,  including  diagnostic  and  treatment  center
services;  provided,  however, that for all such gross receipts received
on or after April first, nineteen hundred ninety-nine,  such  assessment
shall  be  two-tenths  of  one  percent,  and further provided that such
assessment shall expire and be of no further effect for all  such  gross
receipts received on or after January first, two thousand.
3.  Gross  receipts  received from all patient care services and other
operating income for purposes of the assessment pursuant to this section
shall include, but not be limited to:
(a) for general hospitals, all monies received for or  on  account  of
inpatient  hospital  service,  outpatient  service,  emergency  service,

referred ambulatory service and ambulatory surgical  service,  or  other
hospital   or   health-related   services,  excluding,  subject  to  the
provisions of subdivision twelve of this section: distributions from bad
debt  and  charity  care  regional  pools,  primary health care services
regional pools, bad debt and charity  care  for  financially  distressed
hospitals  statewide  pools  and  bad  debt and charity care and capital
statewide pools created in accordance with section twenty-eight  hundred
seven-c  of  this  article  and  the  components  of rates of payment or
charges  related  to  the  allowances  provided   in   accordance   with
subdivisions   fourteen,   fourteen-b  and  fourteen-c,  the  adjustment
provided in  accordance  with  subdivision  fourteen-a,  the  adjustment
provided  in  accordance with subdivision fourteen-d, the adjustment for
health  maintenance  organization  reimbursement   rates   provided   in
accordance  with  section  twenty-eight hundred seven-f of this article,
the adjustment for commercial insurer reimbursement  rates  provided  in
accordance   with   paragraph  (i)  of  subdivision  eleven  of  section
twenty-eight hundred seven-c of  this  article  or,  if  effective,  the
adjustment  provided  in  accordance with subdivision fifteen of section
twenty-eight hundred seven-c of this article or the adjustment  provided
in  accordance with section eighteen of chapter two hundred sixty-six of
the laws  of  nineteen  hundred  eighty-six  as  amended  and  physician
practice or faculty practice plan revenue received by a general hospital
based  on  discrete  billings for private practicing physician services,
revenue received by a general hospital from a public  hospital  pursuant
to  an  affiliation  agreement  contract for the delivery of health care
services to such public hospital, revenue received pursuant to paragraph
(i) of subdivision thirty-five of section twenty-eight  hundred  seven-c
of  this  article,  revenue  received  pursuant  to section twenty-eight
hundred   seven-w   of   this   article,   all   revenue   received   as
disproportionate  share  hospital  payments,  in  accordance  with title
nineteen of the federal Social Security Act, revenue  received  pursuant
to  sections  eleven, twelve, thirteen and fourteen of part A of chapter
one of the laws of  two  thousand  two,  revenue  received  pursuant  to
sections  thirteen  and fourteen of part B of chapter one of the laws of
two thousand two, revenue from patient personal fund allowances, revenue
from income earned on patient funds, investment income  from  externally
restricted  funds,  revenue  from investment sinking funds, revenue from
investment operating escrow  accounts,  investment  income  from  funded
depreciation, investment income from mortgage repayment escrow accounts,
revenue  derived from the operation of schools leading to licensure, and
revenue from the collection of sales and excise taxes;
(b) for residential health care facilities, all monies received for or
on account of hospital or health-related service,  including  adult  day
services,  excluding  subject to the provisions of subdivision twelve of
this section the component of rates of payment related to the adjustment
provided in accordance with subdivision twelve of  section  twenty-eight
hundred eight of this article;
(c)  for all other facilities issued an operating certificate pursuant
to  section  twenty-eight  hundred  five  of  this  article,   including
diagnostic  and treatment centers, all monies received for or on account
of  hospital  or  health-related  services,  however,  subject  to   the
provisions   of  subdivision  twelve  of  this  section,  excluding  the
component of rates of payment  related  to  the  allowance  provided  in
accordance with paragraph (f) of subdivision two of section twenty-eight
hundred  seven of this article, excluding for a diagnostic and treatment
center operated  by  a  health  maintenance  organization  operating  in
accordance  with the provisions of article forty-four of this chapter or
article forty-three of the insurance  law  monies  received  for  or  on

account  of  services provided to subscribers of such health maintenance
organization and excluding patient care services which  if  provided  to
persons  eligible  for  medical  assistance  pursuant to title eleven of
article  five  of  the  social services law would be eligible for ninety
percent federal funds as set forth in section nineteen hundred three  of
the federal social security act; and
(d)  for  all  hospitals,  excluding  diagnostic and treatment centers
operated by a health maintenance organization  operating  in  accordance
with  the  provisions  of  article forty-four of this chapter or article
forty-three of the insurance law, shall include monies received  for  or
on  account  of such revenue sources as investment income, parking lots,
cafeterias, gift  shops  and  rental  income,  provided,  however,  that
subject  to  the provisions of subdivision twelve of this section income
received from grants, charitable contributions, donations  and  bequests
and governmental deficit financing and the component of rates of payment
reflecting   any   cost  of  the  assessment  reimbursable  pursuant  to
subdivision  ten of this section shall not be included.
4. For  periods  prior  to  January  first,  two  thousand  five,  the
commissioner  is  authorized  to  contract  with the article forty-three
insurance law plans, or if not available such  other  administrators  as
the  commissioner  shall  designate,  to receive and distribute hospital
assessment funds. In the event contracts with the  article   forty-three
insurance  law  plans or other commissioner's designees are effectuated,
the  commissioner  shall  conduct  annual  audits  of  the  receipt  and
distribution  of the assessment funds. The reasonable costs and expenses
of an administrator as approved by the commissioner, not to  exceed  for
personnel  services on an annual basis four hundred thousand dollars for
all assessments established pursuant to this section, shall be paid from
the assessment funds.
5. Estimated payments by or on behalf of hospitals to the commissioner
or  his  designee  of  funds  due  from  the  assessments  pursuant   to
subdivision  two  of  this  section  shall  be  made on a monthly basis.
Estimated payments shall be due on or before the fifteenth day following
the end of a calendar month to which an assessment applies.
6. (a) If an estimated payment made for a month to which an assessment
applies is less than seventy  percent  of  an  amount  the  commissioner
determines  is due, based on evidence of prior period moneys received by
a hospital or evidence of moneys received  by  such  hospital  for  that
month,  the  commissioner may estimate the amount due from such hospital
and may collect  the  deficiency  pursuant  to  paragraph  (c)  of  this
subdivision.
(b)  If  an  estimated payment made for a month to which an assessment
applies is less than  ninety  percent  of  an  amount  the  commissioner
determines  is due, based on evidence of prior period moneys received by
a hospital or evidence of moneys received  by  such  hospital  for  that
month, and at least two previous estimated payments within the preceding
six  months  were  less  than ninety percent of the amount due, based on
similar evidence, the commissioner may estimate the amount due from such
hospital and may collect the deficiency pursuant  to  paragraph  (c)  of
this subdivision.
(c) Upon receipt of notification from the commissioner of a hospital's
deficiency  under this section, the comptroller or a fiscal intermediary
designated by the director of the budget, or the commissioner of  social
services,  or  a  corporation organized and operating in accordance with
article forty-three of the insurance law, or an  organization  operating
in  accordance  with  article  forty-four of this chapter shall withhold
from the amount of any payment to be  made  by  the  state  or  by  such
article  forty-three  corporation  or article forty-four organization to

the hospital the amount of the deficiency determined under paragraph (a)
or (b) of this subdivision or paragraph (e) of subdivision seven of this
section. Upon withholding such amount, the comptroller or  a  designated
fiscal   intermediary,  or  the  commissioner  of  social  services,  or
corporation  organized  and  operating  in   accordance   with   article
forty-three of the insurance law or organization operating in accordance
with  article  forty-four of this chapter shall pay the commissioner, or
his designee, such amount withheld on behalf of the hospital.
(d) The commissioner shall provide  a  hospital  with  notice  of  any
estimate of an amount due for an assessment pursuant to paragraph (a) or
(b)  of  this  subdivision or paragraph (e) of subdivision seven of this
section at least three days prior to collection of such  amount  by  the
commissioner.  Such  notice  shall  contain  the financial basis for the
commissioner's estimate.
(e) In the event a hospital objects to an estimate by the commissioner
pursuant to paragraph (a) or (b) of this subdivision or paragraph (e) of
subdivision seven of this section of the amount due for  an  assessment,
the  hospital, within sixty days of notice of an amount due, may request
a public hearing. If a hearing  is  requested,  the  commissioner  shall
provide  the hospital an opportunity to be heard and to present evidence
bearing on the amount due for an assessment  within  thirty  days  after
collection  of  an  amount  due  or  receipt of a request for a hearing,
whichever is later. An administrative hearing is not a  prerequisite  to
seeking judicial relief.
(f)  The  commissioner  may  direct that a hearing be held without any
request by a hospital.
7. (a) Every hospital shall submit reports on a cash basis  of  actual
gross  receipts  received  from  all patient care services and operating
income for each month as follows:
(i) for the period January first, nineteen hundred ninety-one  through
January  thirty-first,  nineteen hundred ninety-one, the report shall be
filed on or before March fifteenth, nineteen hundred ninety-one; and
(ii) for the quarter year ending March thirty-first, nineteen  hundred
ninety-one and for each quarter thereafter, the report shall be filed on
or before the forty-fifth day after the end of such quarter.
(b)  Every  hospital  shall submit a certified annual report on a cash
basis of gross receipts received in such calendar year from all  patient
care services and operating income.
(c)  The  reports  shall  be  in such form as may be prescribed by the
commissioner to accurately disclose information  required  to  implement
this  section,  provided,  however,  that  for periods on and after July
first,  two  thousand  twelve,   such   reports   and   any   associated
certifications  shall  be  submitted  electronically in a form as may be
required by the commissioner.
(d) Final payments shall be due for all hospitals for the  assessments
pursuant  to  subdivision  two  of  this  section  upon the due date for
submission of the applicable quarterly report.
(e)  The  commissioner  may  recoup  deficiencies  in  final  payments
pursuant to paragraph (c) of subdivision six of this section. Delinquent
amounts  which  have  been referred for recoupment or offset pursuant to
paragraph (c) of subdivision six of this section,  or  which  have  been
referred  to the office of the attorney general for collection, shall be
deemed final and not subject to further revision  or  reconciliation  by
the  commissioner  based  on any additional reports or other information
submitted by the hospital, provided, however,  that  such  delinquencies
shall  not  be referred for such recoupment or for such collection based
on  estimated  amounts  unless  the  hospital   has   received   written

notification  of  such  delinquencies  and  has  been given no less than
thirty days in which to submit delinquent reports.
(f)  Payments and reports submitted or required to be submitted to the
commissioner or to the commissioner's designee pursuant to this  section
shall  be subject to audit by the commissioner for a period of six years
following the close of the calendar year  in  which  such  payments  and
reports are due, after which such payments shall be deemed final and not
subject  to  further  adjustment  or  reconciliation,  including through
offset adjustments or reconciliations made to subsequent  payments  made
pursuant  to  this section, provided, however, that nothing herein shall
be construed as precluding the commissioner from pursuing collection  of
any  such  payments  which  are identified as delinquent within such six
year period, or which are identified as delinquent as  a  result  of  an
audit commenced within such six year period, or from conducting an audit
of any adjustment or reconciliation made by a hospital.
8. (a) If an estimated payment made for a month to which an assessment
applies  is  less  than ninety percent of the actual amount due for such
month, interest shall be due and payable  to  the  commissioner  on  the
difference  between  the  amount paid and the amount due from the day of
the month the estimated payment was due until the date of  payment.  The
rate  of  interest  shall  be twelve percent per annum or at the rate of
interest set by the commissioner of taxation and finance with respect to
underpayments of tax pursuant to subsection (e) of section one  thousand
ninety-six  of  the tax law minus four percentage points. Interest under
this paragraph shall not be paid if the amount thereof is less than  one
dollar.  Interest,  if not paid by the due date of the following month's
estimated payment, may be collected  by  the  commissioner  pursuant  to
paragraph  (c)  of subdivision six of this section in the same manner as
an assessment pursuant to subdivision two of this section.
(b) If an estimated payment made for a month to  which  an  assessment
applies  is  less than seventy percent of the actual amount due for such
month, a penalty shall be due and payable  to the commissioner  of  five
percent   of  the  difference between the amount paid and the amount due
for such month when the failure to pay is for a  duration  of  not  more
than  one  month  after  the due date of the payment with  an additional
five percent for each additional month or  fraction thereof during which
such  failure  continues,  not  exceeding  twenty-five  percent  in  the
aggregate.  A  penalty may be collected by  the commissioner pursuant to
paragraph (c) of subdivision six of this section in the same  manner  as
an assessment pursuant to subdivision two of this section.
(c) Overpayment by a hospital of an estimated payment shall be applied
to any other payment due from the hospital pursuant to this section, or,
if  no  payment is due, at the election of the hospital shall be applied
to future estimated payments or refunded to the hospital. Interest shall
be paid on overpayments from the date of  overpayment  to  the  date  of
crediting  or refund at the rate determined in accordance with paragraph
(a) of this subdivision if the overpayment was made at the direction  of
the commissioner. Interest under this paragraph shall not be paid if the
amount thereof is less than one dollar.
9.  Funds  accumulated, including income from invested funds, from the
assessments specified in this section, including interest and penalties,
shall be deposited by the commissioner and:
(a) credited to the general fund;
(b) provided, however, that funds accumulated, including  income  from
invested  funds,  from  the  assessments  provided  in  accordance  with
subparagraph (v) of paragraph (a) and subparagraphs (iii), (iv), (v) and
(vi) of paragraph (b) of subdivision  two  of  this  section,  including
interest  and  penalties,  shall  be  deposited  by the commissioner and

credited  to  the  special  revenue  fund-other,  miscellaneous  special
revenue  fund  (339), medical assistance account. To the extent of funds
appropriated therefor, funds shall be made available for payments  under
the  medical  assistance  program  provided  pursuant to title eleven of
article five of the social services law;
(c) and provided further, however, that funds  accumulated,  including
income  from  invested  funds,  for  a  period  from  the assessment and
additional assessment provided in accordance with subparagraphs (ii) and
(iii) of paragraph (a) of subdivision two  of  this  section,  including
interest  and  penalties, on voluntary nonprofit and private proprietary
general hospitals which qualified for distributions made  in  accordance
with  paragraph  (c)  of  subdivision  nineteen  of section twenty-eight
hundred seven-c of this article as of  December  thirty-first,  nineteen
hundred  ninety-five  shall  be  transferred  by  the  commissioner  and
consolidated with funds  accumulated  from  the  allowance  pursuant  to
subdivision  two of section twenty-eight hundred seven-j of this article
for such period and allocated in accordance  with  subdivision  nine  of
section twenty-eight hundred seven-j of this article.
10. Notwithstanding any inconsistent provision of law or regulation to
the contrary:
(a) the assessments pursuant to this section shall not be an allowable
cost  in  the  determination  of  reimbursement  rates  pursuant to this
article;
(b) provided, however, that  for  purposes  of  determining  rates  of
payment pursuant to this article for residential health care facilities,
for  the period January first, nineteen hundred ninety-two through March
thirty-first, nineteen hundred ninety-nine, the additional assessment of
one and two-tenths percent, and for  the  period  July  first,  nineteen
hundred   ninety-five   through  March  thirty-first,  nineteen  hundred
ninety-six the further additional assessment of three  and  eight-tenths
percent,  and  for  the  period April first, nineteen hundred ninety-six
through March thirty-first, nineteen hundred  ninety-seven  the  further
additional assessment of one and nine-tenths percent, and for the period
May  first,  nineteen  hundred ninety-six through December thirty-first,
nineteen hundred ninety-six the further additional assessment of two and
three-tenths percent and for the period January first, nineteen  hundred
ninety-seven    through   February   twenty-eighth,   nineteen   hundred
ninety-seven the further additional assessment of  one  and  nine-tenths
percent,  and  for the period April first, nineteen hundred ninety-seven
through March thirty-first, nineteen  hundred  ninety-nine  the  further
additional  assessment  of  three  and  six-tenths  percent, and for the
period  April  first,  nineteen  hundred  ninety-nine  through  December
thirty-first,   nineteen  hundred  ninety-nine  the  further  additional
assessment of two and four-tenths  percent,  imposed  pursuant  to  this
section  shall  be  a  reimbursable  cost  to  be reflected as timely as
practicable in rates of payment applicable within the assessment period,
contingent, for  payments  by  governmental  agencies,  on  all  federal
approvals necessary by federal law and regulations for federal financial
participation  in  payments  made for beneficiaries eligible for medical
assistance under title XIX of the federal social security act.
(c) provided, however, that for the purposes of determining  rates  of
payment pursuant to this article for residential health care facilities,
the assessment imposed pursuant to subparagraph (vi) of paragraph (b) of
subdivision  two  of  this  section  shall  be a reimbursable cost to be
reflected as timely  as  practicable,  and  subsequently  reconciled  to
actual  cost,  in  rates  of  payment  applicable  within the assessment
period, provided further, however, that insofar as such assessment is in

excess of six percent it shall not be deemed  a  reimbursable  cost  and
shall not be reflected in such rates of payment.
(d)  provided,  however,  that the adjustment to rates of payment made
pursuant to paragraph (c) of this subdivision shall be calculated  on  a
per  diem  basis  and based on total reported patient days of care minus
reported days attributable to title XVIII of the federal social security
act (medicare) units of service.
(e) the provisions of paragraphs (c) and (d) of this subdivision shall
each be contingent upon receipt of all  federal  approvals  required  by
federal  law  and  regulations  for  federal  financial participation in
payments made  in  accordance  with  paragraphs  (c)  and  (d)  of  this
subdivision.
11.  (a)  (ii)  The assessment shall not be collected in excess of one
hundred thirty-four million three hundred thousand dollars from  general
hospitals  for  the period of April first, nineteen hundred ninety-seven
through March thirty-first, nineteen hundred ninety-eight. The amount of
the assessment collected pursuant to paragraph (a) of subdivision two of
this section in excess of one hundred thirty-four million three  hundred
thousand  dollars  for  the  period  of  April  first,  nineteen hundred
ninety-seven through March thirty-first, nineteen  hundred  ninety-eight
shall  be refunded to general hospitals by the commissioner based on the
ratio which a general hospital's assessment for such period bears to the
total of the assessments for such period paid by general hospitals.
(iii) The additional assessment shall not be collected  in  excess  of
fourteen  million  nine  hundred thousand dollars from general hospitals
for the period of April first,  nineteen  hundred  ninety-seven  through
November  thirtieth,  nineteen  hundred  ninety-seven. The amount of the
additional assessment collected pursuant to paragraph (a) of subdivision
two of this section in excess of fourteen million nine hundred  thousand
dollars  for  the  period  of April first, nineteen hundred ninety-seven
through November  thirtieth,  nineteen  hundred  ninety-seven  shall  be
refunded  to  general  hospitals  by the commissioner based on the ratio
which a general hospital's additional assessment for such  period  bears
to  the  total  of  the  additional  assessments for such period paid by
general hospitals.
(b) (ii) The assessment shall not be collected in  excess  of  fifteen
million  dollars  from residential health care facilities for the period
of  April   first,   nineteen   hundred   ninety-eight   through   March
thirty-first, nineteen hundred ninety-nine. The amount of the assessment
collected  pursuant  to paragraph (b) of subdivision two of this section
in excess of fifteen million dollars for  the  period  of  April  first,
nineteen  hundred  ninety-eight  through  March  thirty-first,  nineteen
hundred  ninety-nine  shall  be  refunded  to  residential  health  care
facilities  by  the  commissioner based on the ratio which a residential
health care facility's assessment for such period bears to the total  of
the  assessments  for  such  period  paid  by  residential  health  care
facilities.
(iii) The additional assessment shall not be collected  in  excess  of
eighty-nine  million  nine  hundred  thousand  dollars  from residential
health care facilities for the period of April first,  nineteen  hundred
ninety-eight  through  March thirty-first, nineteen hundred ninety-nine.
The amount of the additional assessment collected pursuant to  paragraph
(b)  of subdivision two of this section in excess of eighty-nine million
nine hundred thousand dollars for the period of  April  first,  nineteen
hundred   ninety-eight  through  March  thirty-first,  nineteen  hundred
ninety-nine shall be refunded to residential health care  facilities  by
the  commissioner  based  on  the  ratio which a residential health care
facility's additional assessment for such period bears to the  total  of

the  additional  assessments  for such period paid by residential health
care facilities.
(iv)  The  further  additional  assessment  shall  not be collected in
excess of one hundred sixty-four million seven hundred thousand  dollars
from  residential  health  care  facilities  for  the period July first,
nineteen  hundred  ninety-five  through  March  thirty-first,   nineteen
hundred  ninety-six.  The  amount  of  the further additional assessment
collected pursuant to paragraph (b) of subdivision two of  this  section
in  excess  of  one  hundred  sixty-four  million seven hundred thousand
dollars for the period  of  July  first,  nineteen  hundred  ninety-five
through March thirtyfirst, nineteen hundred ninety-six shall be refunded
to  residential  health care facilities by the commissioner based on the
ratio which a residential  health  care  facility's  further  additional
assessment  for such period bears to the total of the further additional
assessments for such period paid by residential health care facilities.
(v) The further additional assessment imposed pursuant to subparagraph
(iv) of paragraph (b) of subdivision two of this section  shall  not  be
collected   in  excess  of  one  hundred  twelve  million  dollars  from
residential health care facilities for the period April first,  nineteen
hundred   ninety-six   through   March  thirty-first,  nineteen  hundred
ninety-seven. The amount of the further additional assessment  collected
pursuant  to  subparagraph  (iv)  of paragraph (b) of subdivision two of
this section in excess of one hundred twelve  million  dollars  for  the
period  of  April  first,  nineteen  hundred  ninety-six  through  March
thirty-first,  nineteen  hundred  ninety-seven  shall  be  refunded   to
residential  health  care  facilities  by  the commissioner based on the
ratio which a residential  health  care  facility's  further  additional
assessment  for such period bears to the total of the further additional
assessments for such period paid by residential health care facilities.
(vi) The further additional  assessment  shall  not  be  collected  in
excess  of  one hundred ten million dollars from residential health care
facilities for  the  period  May  first,   nineteen  hundred  ninety-six
through  February  twenty-eighth,  nineteen  hundred  ninety-seven.  The
amount of  the  further  additional  assessment  collected  pursuant  to
subparagraph  (v) of paragraph (b) of subdivision two of this section in
excess  of  one  hundred  ten  million dollars for the period May first,
nineteen hundred ninety-six  through  February  twenty-eighth,  nineteen
hundred  ninety-seven  shall  be  refunded  to  residential  health care
facilities by the commissioner based on the ratio  which  a  residential
health  care  facility's  further  additional assessment for such period
bears to the total of  the  further  additional   assessments  for  such
period paid by residential health care facilities.
(vii)  The  further  additional  assessment  shall not be collected in
excess of two hundred forty million dollars from residential health care
facilities for the period April  first,  nineteen  hundred  ninety-seven
through March thirty-first, nineteen hundred ninety-eight. The amount of
the further additional assessment collected pursuant to subparagraph (v)
of  paragraph  (b)  of  subdivision two of this section in excess of two
hundred forty million dollars for the period of  April  first,  nineteen
hundred   ninety-seven  through  March  thirty-first,  nineteen  hundred
ninety-eight shall be refunded to residential health care facilities  by
the  commissioner  based  on  the  ratio which a residential health care
facility's further additional assessments for such a period bears to the
total of the further additional assessments  for  such  period  paid  by
residential health care facilities.
(viii)  The  further  additional  assessment shall not be collected in
excess of two hundred fifty-six million eight hundred  thousand  dollars
from  residential  health  care  facilities  for the period April first,

nineteen  hundred  ninety-eight  through  March  thirty-first,  nineteen
hundred  ninety-nine.  The  amount  of the further additional assessment
collected pursuant to subparagraph (v) of paragraph (b)  of  subdivision
two  of  this  section  in excess of two hundred fifty-six million eight
hundred thousand dollars for the period April  first,  nineteen  hundred
ninety-eight  through  March  thirty-first, nineteen hundred ninety-nine
shall  be  refunded  to  residential  health  care  facilities  by   the
commissioner  based  on  the  ratio  which  a  residential  health  care
facility's further additional assessments for such period bears  to  the
total  of  the  further  additional  assessments for such period paid by
residential health care facilities.
(c) (ii) The assessment shall not be  collected  in  excess  of  seven
million  four  hundred thousand dollars from all other facilities issued
an operating certificate pursuant to section twenty-eight  hundred  five
of  this  article  for  the  period  of  April  first,  nineteen hundred
ninety-seven through March thirty-first, nineteen hundred  ninety-eight.
The  amount  of  the  assessment  collected pursuant to paragraph (c) of
subdivision two of this section in excess of seven million four  hundred
thousand  dollars  for  the  period  of  April  first,  nineteen hundred
ninety-seven through March thirty-first, nineteen  hundred  ninety-eight
shall  be  refunded  by  the  commissioner  based  on  the ratio which a
facility's assessment  for  such  period  bears  to  the  total  of  the
assessments for such period paid by such facilities.
12.  (a)  Each  exclusion  of  hospitals  or sources of gross receipts
received from  the  assessments  effective  on  or  after  April  first,
nineteen hundred ninety-two, and prior to April first, two thousand two,
established  pursuant  to  this section shall be contingent upon either:
(i) qualification of the assessments for waiver pursuant to federal  law
and  regulation; or (ii) consistent with federal law and regulation, not
requiring a waiver by the secretary of  the  department  of  health  and
human  services  related to such exclusion; in order for the assessments
under this section to be qualified as a broad-based health care  related
tax  for  purposes of the revenues received by the state pursuant to the
assessments not reducing the amount expended by  the  state  as  medical
assistance   for   purposes  of  federal  financial  participation.  The
commissioner shall collect the assessments relying on  such  exclusions,
pending any contrary action by the secretary of the department of health
and  human  services.  In  the  event the secretary of the department of
health and human services determines that  the  assessments  do  not  so
qualify  based on any such exclusion, then the exclusion shall be deemed
to have  been  null  and  void  as  of  April  first,  nineteen  hundred
ninety-two,  and  the  commissioner shall collect any retroactive amount
due as a result, without interest or penalty provided the hospital  pays
the  retroactive   amount  due  within  ninety  days  of notice from the
commissioner  to the hospital  that  an  exclusion  is  null  and  void.
Interest  and  penalties  shall  be measured from the due date of ninety
days following notice from the commissioner to the hospital.
(b) The exclusion of the  hospitals  described  in  paragraph  (b)  of
subdivision  one  of this section and the exclusion of revenue described
in subdivision two of this section from the  assessments  set  forth  in
subdivision  two  of  this section for periods on and after April first,
two thousand two shall be contingent upon either: (i)  qualification  of
the  assessments  for  waiver pursuant to federal law and regulation; or
(ii) consistent with federal law and regulation, not requiring a  waiver
by  the secretary of the department of health and human services related
to such exclusion; in order for the assessments under this section to be
qualified as a broad-based health care related tax for purposes  of  the
revenues  received by the state pursuant to the assessments not reducing

the amount expended by the state as medical assistance for  purposes  of
federal  financial  participation.  The  commissioner shall collect such
assessments relying on such exclusion, pending any  contrary  action  by
the  secretary  of  the  department of health and human services. In the
event the secretary of the  department  of  health  and  human  services
determines  that  such  assessments  do  not  so  qualify  based on such
exclusion, then the commissioner  shall,  to  the  extent  necessary  to
achieve  such  qualification  for  federal financial participation, deem
such exclusions null and void as of the first  day  of  the  period  for
which  such  assessments  apply,  and the commissioner shall collect any
retroactive amount due as a result, without interest or penalty provided
the hospital pays the retroactive  amount  due  within  ninety  days  of
notice from the commissioner to the hospital that such exclusion is null
and void.
(c)  No  hospital  shall  be  obligated to pay assessments pursuant to
subparagraph (v) of paragraph (a) of subdivision  two  of  this  section
prior  to  December  first,  two  thousand  five. The commissioner shall
collect payment  obligations  incurred  prior  to  December  first,  two
thousand  five  proportionally  over  the  remaining months in the state
fiscal year.