PRINTER'S NO. 187
No. 170 Session of 1993
INTRODUCED BY WOZNIAK AND TRELLO, FEBRUARY 3, 1993
REFERRED TO COMMITTEE ON RULES, FEBRUARY 3, 1993
AN ACT
1 Establishing a hospital financial pool to finance charity care
2 provided by licensed acute care hospitals; providing for a
3 nonprofit corporation to make certain recommendations, and
4 for limited hospital reimbursements.
5 The General Assembly of the Commonwealth of Pennsylvania
6 hereby enacts as follows:
7 Section 1. Short title.
8 This act shall be known and may be cited as the Hospital
9 Charity Care Financing Act.
10 Section 2. Legislative findings and intent.
11 (a) Findings.--The General Assembly finds that some
12 hospitals are providing a disproportionate share of charity care
13 to low-income, uninsured Pennsylvanians.
14 (b) Intent.--The intent of this act is to provide for a
15 pooling of funds to finance charity care provided by hospitals
16 which will insure continued access to needed inpatient care by
17 low-income, uninsured Pennsylvanians and permit hospitals
18 providing charity care to compete fairly in the health care
1 marketplace.
2 Section 3. Definitions.
3 The following words and phrases when used in this act shall
4 have the meanings given to them in this section unless the
5 context clearly indicates otherwise:
6 "Charity care." The provision of uncompensated inpatient
7 care, provided in a licensed acute care hospital, which will
8 comply with the definition for "charity care" set forth in
9 regulations of the Health Care Cost Containment Council.
10 "Council." The Charity Care Council established under this
11 act.
12 "Department." The Department of Revenue of the Commonwealth.
13 "Medically indigent." The status of a person who has limited
14 or no health insurance benefits, who is ineligible for medical
15 assistance under the act of June 13, 1967 (P.L.31, No.21), known
16 as the Public Welfare Code, who receives charity care in a
17 licensed acute care hospital as defined under the regulations of
18 the Health Care Cost Containment Council.
19 Section 4. Council.
20 (a) Establishment.--There is hereby established a nonprofit
21 Pennsylvania corporation, named the Charity Care Council, whose
22 function is:
23 (1) To establish geographic regions throughout this
24 Commonwealth for the financing and distribution of funds for
25 charity care to hospitals.
26 (2) To provide guidelines for the collection and
27 investment of funds from all hospitals in each geographic
28 region.
29 (3) To provide guidelines for the distribution of funds
30 to finance a portion of the costs of charity care provided by
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1 acute care hospitals in each geographic region.
2 (4) To provide guidelines for determining criteria for
3 establishing medical indigency.
4 (5) To make annual recommendations to the General
5 Assembly on the level of funding required for charity care.
6 (b) Board of directors.--The board of directors of the
7 council shall be composed of:
8 (1) One medical school representative appointed by the
9 Hospital Association of Pennsylvania.
10 (2) Two teaching acute care hospital representatives
11 appointed by the Hospital Association of Pennsylvania.
12 (3) One urban nonteaching acute care hospital
13 representative appointed by the Hospital Association of
14 Pennsylvania.
15 (4) Two suburban acute care hospital representatives
16 appointed by the Hospital Association of Pennsylvania.
17 (5) Two rural hospital representatives appointed by the
18 Hospital Association of Pennsylvania.
19 (6) One specialty acute care hospital representative
20 appointed by the Hospital Association of Pennsylvania.
21 (7) Two appointees of the Governor, one to be a consumer
22 and one to be a member of the Medical Assistance Advisory
23 Committee.
24 (8) Two members of the Senate, one appointed by the
25 Majority Leader and one appointed by the Minority Leader.
26 (9) Two members of the House of Representatives, one
27 appointed by the Majority Leader and one appointed by the
28 Minority Leader.
29 (c) Organization deadline.--Within 90 days of the effective
30 date of this act, the Hospital Association of Pennsylvania, the
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1 Governor, the Majority and Minority Leaders of the Senate and
2 the Majority and Minority Leaders of the House of
3 Representatives shall make their appointments to the board of
4 directors of the council, and the Governor shall call a meeting
5 of the board of directors of the council for organizational
6 purposes.
7 (d) Creation of regional councils.--The council may
8 establish regional councils composed of hospital and consumer
9 representatives in each charity care region.
10 (e) Funding recommendations.--On or before March 1 of each
11 year, the council shall submit recommendations to the Governor
12 and the General Assembly for the level of funding required for
13 charity care provided by acute care hospitals in each region.
14 Section 5. Charity care pool.
15 (a) Annual hearings of General Assembly.--The Public Health
16 and Welfare Committee of the Senate and the Health and Welfare
17 Committee of the House of Representatives shall hold annual
18 joint public hearings in each region to review the council's
19 recommendations for the level of funding required for charity
20 care.
21 (b) Imposition of surcharge.--A charity care surcharge is
22 hereby imposed on acute care hospitals in a region to finance
23 the charity care in accordance with all of the following
24 provisions:
25 (1) The surcharge shall be based on the number of
26 dollars per licensed bed necessary to fund the amount of
27 charity care approved by the General Assembly.
28 (2) The charity care financed shall be reimbursement for
29 care provided in the preceding calendar year by the licensed
30 acute care hospital.
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1 (3) The surcharge imposed shall be collected by the
2 department from the effected hospitals on or before July 1 of
3 any year in which the surcharge shall be imposed.
4 (4) Payment for charity care shall be made on or before
5 December 1 of that year.
6 (5) Charity care financed by the Charity Care Pool shall
7 not be reported as charity care.
8 (6) No surcharge shall be imposed on a hospital that
9 establishes that it has provided a level of charity care in
10 excess of the regional average during the most recent fiscal
11 year.
12 (7) No nonprofit acute care hospital shall receive
13 reimbursement for charity care from the Charity Care Pool in
14 an amount that exceeds the actual cost of providing care.
15 (c) Departmental responsibilities.--The department shall be
16 responsible for the following:
17 (1) Collection and distribution of the hospital
18 surcharge for the Charity Care Pool.
19 (2) Development of an application form based on the
20 guidelines recommended by the council for hospitals to use to
21 determine eligibility of patients to be considered as charity
22 care for the purposes of financing under this act.
23 (3) Development of forms for hospitals to apply for
24 charity care financing.
25 Section 6. Expiration.
26 This act shall expire July 1, 1997, unless reenacted by the
27 General Assembly.
28 Section 7. Effective date.
29 This act shall take effect January 1, 1994.
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