AN ACT
Relating to medical care; amending RCW 74.09.700 and 74.09.730; adding a new
chapter to Title 82 RCW; creating new sections; making appropriations;
providing effective dates; and declaring an emergency.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1.
DEFINITIONS. Unless the context clearly requires otherwise, the
definitions in this section apply throughout this chapter.
(1)
"State medicaid receipts" means that portion of the gross income of
the business that consists of Washington state general fund payments
attributable to the medicaid program, other than from federal sources, for
inpatient and outpatient hospital services under the medical assistance program
provided in RCW 74.09.520 or under the limited casualty program provided in RCW
74.09.700 for persons who are medically needy under the social security Title
XIX state plan.
(2)
"Hospital" means a hospital required to be licensed under chapter
70.41 RCW, or a private hospital required to be licensed under chapter 71.12
RCW, but not including federal hospitals or state hospitals established under
chapter 72.23 RCW.
(3)
The meaning given to words and phrases in chapter 82.04 RCW apply throughout
this chapter, to the extent applicable.
NEW
SECTION. Sec. 2. In
addition to any other tax, a tax is imposed on every hospital for the act or
privilege of engaging in business within this state. The tax is equal to state
medicaid receipts multiplied by the rate of twenty percent.
NEW
SECTION. Sec. 3. Chapter
82.32 RCW applies to the tax imposed in this chapter. The tax due dates,
reporting periods, and return requirements applicable to chapter 82.04 RCW
apply equally to the tax imposed in this chapter.
NEW
SECTION. Sec. 4. This
chapter is temporary and shall expire on the earliest of:
(1)
The date that federal medicaid matching funds for the purposes specified in
section 10(1) of this act become unavailable or are substantially reduced, as
such date is certified by the secretary of social and health services;
(2)
The date that federal medicaid matching funds for the purposes specified in
section 10(1) of this act become unavailable or are substantially reduced, as
determined by a permanent injunction, court order, or final court decision; or
(3)
July 1, 1993.
NEW
SECTION. Sec. 5. (1) The
expiration of sections 1 through 4 of this act shall not be construed as
affecting any existing right acquired or liability or obligation incurred under
those sections or under any rule or order adopted under those sections, nor as
affecting any proceeding instituted under those sections.
(2)
Taxes that have been paid under sections 1 through 4 of this act, but are
properly attributable to taxable events occurring after the expiration of those
sections, shall be credited or refunded as provided in RCW 82.32.060.
NEW
SECTION. Sec. 6. Sections
1 through 4 of this act shall constitute a new chapter in Title 82 RCW.
Sec.
7. RCW
74.09.700 and 1991 c 233 s 2 are each amended to read as follows:
(1) To
the extent of available funds and subject to any conditions placed on
appropriations made for this purpose, medical care may be provided under
the limited casualty program to persons not otherwise eligible for medical
assistance or medical care services who are medically needy as defined in the
social security Title XIX state plan and medical indigents in accordance with
((medical)) eligibility requirements established by the department. The
eligibility requirements may include minimum levels of incurred medical
expenses. This includes residents of skilled nursing homes, intermediate
care facilities, and intermediate care facilities for the mentally retarded who
are aged, blind, or disabled as defined in Title XVI of the federal social
security act and whose income exceeds three hundred percent of the federal
supplement security income benefit level.
(2)
Determination of the amount, scope, and duration of medical coverage under the
limited casualty program shall be the responsibility of the department, subject
to the following:
(a)
Only ((inpatient hospital services; outpatient hospital and)) the
following services may be covered:
(i)
For persons who are medically needy as defined in the social security Title XIX
state plan: Inpatient and outpatient hospital services;
(ii)
For persons who are medically needy as defined in the social security Title XIX
state plan, and for persons who are medical indigents under the eligibility
requirements established by the department: Rural health clinic services;
physicians' and clinic services; prescribed drugs, dentures, prosthetic
devices, and eyeglasses; skilled nursing home services, intermediate care
facility services, and intermediate care facility services for the mentally
retarded; home health services; other laboratory and x‑ray services; rehabilitative
services, including occupational therapy; medically necessary transportation;
and other services for which funds are specifically provided in the omnibus
appropriations act ((shall be covered));
(b) ((Persons
who are medically indigent and are not eligible for a federal aid program shall
satisfy a deductible of not less than one hundred dollars nor more than five
hundred dollars in any twelve-month period;
(c))) Medical
care services provided to the medically indigent and received no more than
seven days prior to the date of application shall be retroactively certified
and approved for payment on behalf of a person who was otherwise eligible at
the time the medical services were furnished: PROVIDED, That eligible persons
who fail to apply within the seven‑day time period for medical reasons or
other good cause may be retroactively certified and approved for payment.
(3)
The department shall establish standards of assistance and resource and income
exemptions. All nonexempt income and resources of limited casualty program
recipients shall be applied against the cost of their medical care services.
Sec.
8. RCW
74.09.730 and 1989 c 260 s 1 are each amended to read as follows:
In
establishing Title XIX payments ((rates)) for inpatient hospital
services:
(1)
The department of social and health services shall ((take into account the
situation of hospitals which serve a disproportionate number of low-income
patients with special needs;
(2)
The department shall define eligible disproportionate share hospitals by
regulation, and shall consider)) provide a disproportionate
share hospital adjustment considering the following components:
(a)
A low‑income care component based on a hospital's medicaid
utilization rate, its low-income utilization rate, ((and)) its provision
of obstetric services, and other factors authorized by federal law;
(b)
A medical indigency care component based on a hospital's services to persons
who are medically indigent; and
(c)
A state‑only component, to be paid from available state funds to
hospitals that do not qualify for federal payments under (b) of this
subsection, based on a hospital's services to persons who are medically
indigent;
(((3)))
(2) The payment methodology for disproportionate share hospitals shall
be specified by the department in regulation.
NEW
SECTION. Sec. 9. (1) In
addition to the components in RCW 74.09.730, the department of social and
health services shall consider the following components in providing
disproportionate share hospital adjustments:
(a) A
medicaid care component proportionately based on a hospital's services to
persons who are eligible for medicaid; and
(b) A
state‑only component, to be paid from available state funds to hospitals
that do not qualify for federal payments under (a) of this subsection, based on
a hospital's services to persons who are eligible for medicaid.
(2)
Each in-state hospital that provides care to medicaid beneficiaries shall be
eligible for payments under either subsection (1) (a) or (b) of this section.
(3)
This section shall expire on the expiration date of sections 1 through 4 of
this act.
NEW
SECTION. Sec. 10. (1) The sum of
one hundred twenty-eight million four hundred ten thousand dollars from the
state general fund, of which sixty-nine million nine hundred thousand dollars
is from the general fund‑-federal, is hereby appropriated for the fiscal
period beginning September 1, 1991, and ending June 30, 1993, to the medical
assistance program of the department of social and health services for the
purpose of the payment of the components of the disproportionate share
adjustment under section 9 of this act. The appropriation in this subsection
shall lapse on the date that sections 1 through 4 of this act expire. Amounts
that have been paid under this subsection, but are properly attributable to a
period after the expiration of sections 1 through 4 of this act, shall be
repaid or credited to the state as provided in rules of the department.
(2)
The sum of thirty-eight million one hundred eighty-seven thousand dollars from
the state general fund, of which twenty million nine hundred ninety-five
thousand dollars is from the general fund‑-federal, is hereby
appropriated for the biennium ending June 30, 1993, to the medical assistance
program of the department of social and health services for the purpose of the
payment of the medical indigency care components of the disproportionate share
adjustment under RCW 74.09.730(1) (b) and (c).
(3)
The allotments from the appropriations in this section shall be made so as to
enable expenditure of the appropriations through the end of the 1991‑93
biennium.
(4)
The appropriations is this section are supplemental to other appropriations to
the medical assistance program. The department of social and health services
shall not use the moneys appropriated in this section in lieu of any other
appropriations for the medical assistance program.
NEW
SECTION. Sec. 11. This act
is necessary for the immediate preservation of the public peace, health, or
safety, or support of the state government and its existing public
institutions, and shall take effect on July 1, 1991, except sections 1 through
6 and 9 of this act which shall take effect on September 1, 1991.
