Okla. Stat. tit. 63, § 63-3241.3

of rules.

A. For the purpose of assuring access to quality care for

Oklahoma Medicaid consumers, the Oklahoma Health Care Authority,

after considering input and recommendations from the Hospital

Advisory Committee, shall assess hospitals licensed in Oklahoma,

unless exempt under subsection B of this section, a supplemental

hospital offset payment program fee.

B. The following hospitals shall be exempt from the

supplemental hospital offset payment program fee:

1. A hospital that is owned or operated by the state or a state

agency, the federal government, a federally recognized Indian tribe,

or the Indian Health Service;

2. A hospital that provides more than fifty percent (50%) of

its inpatient days under a contract with a state agency other than

the Authority;

3. A hospital for which the majority of its inpatient days are

for any one of the following services, as determined by the

Authority using the Inpatient Discharge Data File published by the

State Department of Health, or in the case of a hospital not

included in the Inpatient Discharge Data File, using substantially

equivalent data provided by the hospital:

a. treatment of a neurological injury,

b. treatment of cancer,

c. treatment of cardiovascular disease,

d. obstetrical or childbirth services, and

e. surgical care, except that this exemption shall not

apply to any hospital located in a city of less than

five hundred thousand (500,000) population and for

which the majority of inpatient days are for back,

neck, or spine surgery;

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4. A hospital that is certified by the federal Centers for

Medicare and Medicaid Services as a long-term acute care hospital or

as a children's hospital; and

5. A hospital that is certified by the federal Centers for

Medicare and Medicaid Services as a critical access hospital.

C. The supplemental hospital offset payment program fee shall

be an assessment imposed on each eligible hospital, except those

exempted under subsection B of this section, for each calendar year

in an amount calculated as a percentage of each eligible hospital's

net hospital patient revenue.

1. Funds generated by the supplemental hospital offset payment

program fee shall be disbursed for the following purposes in the

following priority order:

a. One Hundred Thirty Million Dollars ($130,000,000.00)

to be transferred annually to the Medical Payments

Cash Management Improvement Act Programs Disbursing

Fund to fund the state Medicaid program,

b. the nonfederal share of:

(1) the upper payment limit gap,

(2) the managed care gap,

(3) the managed care provider incentive pool to

support health care quality assurance and access

improvement initiatives, with the pool amount

determined by the representative sharing ratio of

provider and hospital participation in Medicaid.

Provider eligibility shall be determined by the

Authority. For purposes of this division,

eligible providers shall not include those

employed by or contracted with, or otherwise a

member of, the faculty practice plan of either:

(a) a public, accredited Oklahoma medical

school, or
pool amount

determined by the representative sharing ratio of

provider and hospital participation in Medicaid.

Provider eligibility shall be determined by the

Authority. For purposes of this division,

eligible providers shall not include those

employed by or contracted with, or otherwise a

member of, the faculty practice plan of either:

(a) a public, accredited Oklahoma medical

school, or

(b) a hospital or health care entity directly or

indirectly owned or operated by the entities

created pursuant to Section 3224 or 3290 of

this title,

(4) the annual fee to be paid to the Authority under

subparagraph c of paragraph 1 of subsection G of

Section 3241.4 of this title, and

(5) Thirty Million Dollars ($30,000,000.00) annually

to be transferred by the Authority to the Medical

Payments Cash Management Improvement Act Programs

Disbursing Fund under subsection C of Section

3241.4 of this title.

If the nonfederal share generated by the supplemental

hospital offset payment program fee is not sufficient

to fully fund the disbursements described in divisions

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1 through 5 of this subparagraph, the funds directed

toward such disbursements shall be reduced

proportionally, and

c. any remaining funds shall be deposited into the

Medicaid Health Improvement Revolving Fund created in

Section 23 of Enrolled Senate Bill No. 1337 of the 2nd

Session of the 58th Oklahoma Legislature.

2. The assessment rate until December 31, 2012, shall be fixed

at two and one-half percent (2.5%). For the calendar year ending

December 31, 2022, the assessment rate shall be fixed at three

percent (3%). For the calendar year ending December 31, 2023, the

assessment rate shall be fixed at three and one-half percent (3.5%).

For the calendar year ending December 31, 2024 and for all

subsequent calendar years, the assessment rate shall be fixed at

four percent (4%).

3. Net hospital patient revenue shall be determined using the

data from each eligible hospital's Medicare Cost Report contained in

the federal Centers for Medicare and Medicaid Services' Healthcare

Cost Report Information System file.

a. Through 2013, the base year for assessment shall be

the eligible hospital's fiscal year that ended in

2009, as contained in the Healthcare Cost Report

Information System file dated December 31, 2010.

b. For years after 2013, the base year for assessment

shall be determined by rules established by the

Oklahoma Health Care Authority Board and beginning

January 1, 2022, the base year for assessment shall be

determined annually.

4. If an eligible hospital's applicable Medicare Cost Report is

not contained in the federal Centers for Medicare and Medicaid

Services' Healthcare Cost Report Information System file, the

eligible hospital shall submit a copy of its applicable Medicare

Cost Report to the Authority in order to allow the Authority to

determine the eligible hospital's net hospital patient revenue for

the base year.

5. If an eligible hospital commenced operations after the due

date for a Medicare Cost Report, the eligible hospital shall submit

its initial Medicare Cost Report to the Authority in order to allow

the Authority to determine the hospital's net patient revenue for

the base year.

6. Partial year reports may be prorated for an annual basis.

7. In the event that an eligible hospital does not file a

uniform cost report under 42 U.S.C., Section 1396a(a)(40), the

Authority shall establish a uniform cost report for such facility

subject to the Supplemental Hospital Offset Payment Program provided

for in this section.

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8. The Authority shall review which hospitals are eligible to

participate in the Supplemental Hospital Offset Payment Program

provided for in this subsection and which hospitals are exempted

pursuant to subsection B of this section. Such review shall occur
pplemental Hospital Offset Payment Program provided

for in this section.

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8. The Authority shall review which hospitals are eligible to

participate in the Supplemental Hospital Offset Payment Program

provided for in this subsection and which hospitals are exempted

pursuant to subsection B of this section. Such review shall occur

at a fixed period of time. This review and decision shall occur

within twenty (20) days of the time of federal approval and annually

thereafter in November of each year.

9. The Authority shall review and determine the amount of the

annual assessment. Such review and determination shall occur within

the twenty (20) days of federal approval and annually thereafter in

November of each year.

D. An eligible hospital may not charge any patient for any

portion of the supplemental hospital offset payment program fee.

E. Closure, merger and new hospitals.

1. If an eligible hospital ceases to be an eligible hospital

for any reason, the assessment for the year in which the cessation

occurs shall be adjusted by multiplying the annual assessment by a

fraction, the numerator of which is the number of days in the year

during which the hospital is subject to the assessment and the

denominator of which is 365. Immediately upon ceasing to be an

eligible hospital, the hospital shall pay the assessment for the

year as adjusted, to the extent not previously paid.

2. In the case of an eligible hospital that did not operate as

a hospital throughout the base year, its assessment and any

potential receipt of a hospital access payment will commence in

accordance with rules for implementation and enforcement promulgated

by the Oklahoma Health Care Authority Board, after consideration of

the input and recommendations of the Hospital Advisory Committee.

F. 1. In the event that federal financial participation

pursuant to Title XIX of the Social Security Act is not available to

the Oklahoma Medicaid program for purposes of matching expenditures

from the Supplemental Hospital Offset Payment Program Fund at the

approved federal medical assistance percentage for the applicable

year for one or more of the purposes identified in division 1, 2, or

3 of subparagraph b of paragraph 1 of subsection C of this section,

the portion of the supplemental hospital offset payment program fee

attributable to any such purpose for which matching expenditures are

unavailable shall be null and void as of the date of the

nonavailability of such federal funding through and during any

period of nonavailability.

2. In the event of an invalidation of the Supplemental Hospital

Offset Payment Program Act by any court of last resort, the

supplemental hospital offset payment program fee shall be null and

void as of the effective date of that invalidation.

3. In the event that the supplemental hospital offset payment

program fee is determined to be null and void for any of the reasons

enumerated in this subsection, any supplemental hospital offset

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payment program fee assessed and collected for any period after such

invalidation shall be returned in full within twenty (20) days by

the Authority to the eligible hospital from which it was collected.

G. The Oklahoma Health Care Authority Board, after considering

the input and recommendations of the Hospital Advisory Committee,

shall promulgate rules for the implementation and enforcement of the

supplemental hospital offset payment program fee. Unless otherwise

provided, the rules adopted under this subsection shall not grant

any exceptions to or exemptions from the hospital assessment imposed

under this section.

H. The Authority shall provide for administrative penalties in

the event a hospital fails to:

1. Submit the supplemental hospital offset payment program fee

in a timely manner; or
ntal hospital offset payment program fee. Unless otherwise

provided, the rules adopted under this subsection shall not grant

any exceptions to or exemptions from the hospital assessment imposed

under this section.

H. The Authority shall provide for administrative penalties in

the event a hospital fails to:

1. Submit the supplemental hospital offset payment program fee

in a timely manner; or

2. Submit reports as required by this section in a timely

manner.

I. The Oklahoma Health Care Authority Board shall have the

power to promulgate emergency rules to implement the provisions of

the Supplemental Hospital Offset Payment Program Act.