1Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
2act to consolidate, editorially revise, and codify the public
3welfare laws of the Commonwealth," in public assistance,
4further providing for medical assistance payments for 
5institutional care; in intermediate care facilities 
6assessments, further providing for time periods and making 
7editorial changes; and, in hospital assessments, further 
8providing for authorization and for time period.

9The General Assembly of the Commonwealth of Pennsylvania
10hereby enacts as follows:

11Section 1. Section 443.1(7)(iv) of the act of June 13, 1967
12(P.L.31, No.21), known as the Public Welfare Code, amended June 
1330, 2011 (P.L.89, No.22), is amended to read:

14Section 443.1. Medical Assistance Payments for Institutional 
15Care.--The following medical assistance payments shall be made 
16on behalf of eligible persons whose institutional care is 
17prescribed by physicians:

18* * *

19(7) After June 30, 2007, payments to county and nonpublic
20nursing facilities enrolled in the medical assistance program as
21providers of nursing facility services shall be determined in

1accordance with the methodologies for establishing payment rates
2for county and nonpublic nursing facilities specified in the
3department's regulations and the Commonwealth's approved Title
4XIX State Plan for nursing facility services in effect after
5June 30, 2007. The following shall apply:

6* * *

7(iv) Subject to Federal approval of such amendments as may
8be necessary to the Commonwealth's approved Title XIX State
9Plan, for each fiscal year beginning on or after July 1, 2011,
10the department shall apply a revenue adjustment neutrality
11factor to county and nonpublic nursing facility payment rates so
12that the estimated Statewide day-weighted average payment rate
13in effect for that fiscal year is limited to the amount
14permitted by the funds appropriated by the General Appropriation
15Act for the fiscal year. The revenue adjustment neutrality
16factor shall remain in effect until the sooner of June 30,
17[2013] 2016, or the date on which a new rate-setting methodology
18for medical assistance nursing facility services which replaces
19the rate-setting methodology codified in 55 Pa. Code Chs. 1187
20(relating to nursing facility services) and 1189 (relating to
21county nursing facility services) takes effect.

22* * *

23Section 2. The heading of Article XVIII-C and sections
24801-C, 802-C, 803-C, 804-C, 805-C, 806-C, 807-C, 808-C, 809-C
25and 810-C of the act, added July 4, 2004 (P.L.528, No.69), are
26amended to read:

27ARTICLE VIII-C

28INTERMEDIATE CARE FACILITIES FOR [MENTALLY RETARDED] PERSONS
29WITH AN INTELLECTUAL DISABILITY

30ASSESSMENTS

1Section 801-C. Definitions.

2The following words and phrases when used in this article
3shall have the meanings given to them in this section unless the
4context clearly indicates otherwise:

5"Assessment." The fee implemented pursuant to this article
6on every intermediate care facility for [mentally retarded]
7persons with an intellectual disability.

8"Department." The Department of Public Welfare of the
9Commonwealth.

10"Intermediate care facility for [mentally retarded] persons
11with an intellectual disability" or "[ICF/MR] ICF/ID." A public
12or private facility defined in section 1905 of the Social
13Security Act (49 Stat. 620, 42 U.S.C. § 1905).

14"Medicaid." The program established under Title XIX of the
15Social Security Act (49 Stat. 620, 42 U.S.C. § 1396 et seq.).

16"Medical assistance program" or "program." The medical
17assistance program as administered by the Department of Public
18Welfare.

19"Secretary." The Secretary of Public Welfare of the
20Commonwealth.

21"Social Security Act." 49 Stat. 620, 42 U.S.C. § 301 et seq.

22Section 802-C. Authorization.

23In order to generate additional revenues for medical
24assistance program recipients to have access to medically
25necessary [mental retardation] intellectual disability services,
26the department shall implement a monetary assessment on each
27[ICF/MR] ICF/ID subject to the conditions and requirements
28specified in this article.

29Section 803-C. Implementation.

30The [ICF/MR] ICF/ID assessments shall be implemented on an

1annual basis as a health care-related tax as defined in section
21903(w)(3)(B) of the Social Security Act, or any amendments
3thereto, and may be imposed and is required to be paid only to
4the extent that the revenues generated from the assessment will
5qualify as the State share of program expenditures eligible for
6Federal financial participation.

7Section 804-C. Amount.

8The assessment rate shall be determined in accordance with
9this article and implemented on an annual basis by the
10department, as approved by the Governor, upon notification to
11and in consultation with the [ICFs/MR] ICFs/ID. In each year in
12which the assessment is implemented, the assessment rate shall
13equal the amount established by the department subject to the
14maximum aggregate amount that may be assessed pursuant to the 6%
15indirect guarantee threshold set forth in 42 CFR 433.68(f)(3)(i)
16(relating to permissible health care-related taxes [after the
17transition period]) or any other maximum aggregate amount
18established by law.

19Section 805-C. Administration.

20(a) Notice of assessment.--The secretary, before
21implementing an assessment in any fiscal year, shall publish a
22notice in the Pennsylvania Bulletin that specifies the amount of
23the assessment being proposed and an explanation of the
24assessment methodology and amount determination that identifies
25the aggregate impact on [ICFs/MR] ICFs/ID subject to the
26assessment. Interested parties shall have 30 days in which to
27submit comments to the secretary. Upon expiration of the 30-day
28comment period, the secretary, after consideration of the
29comments, shall publish a second notice in the Pennsylvania
30Bulletin announcing the rate of the assessment.

1(b) Review of assessment.--Except as permitted under section
2809-C, the secretary's determination of the aggregate amount and
3the rate of the assessment pursuant to subsection (a) shall not
4be subject to administrative or judicial review under 2 Pa.C.S.
5Chs. 5 Subch. A (relating to practice and procedure of
6Commonwealth agencies) and 7 Subch. A (relating to judicial
7review of Commonwealth agency action) or any other provision of
8law. No assessment implemented under this article nor forms or
9reports required to be completed by [ICFs/MR] ICFs/ID pursuant
10to this article shall be subject to the act of July 31, 1968
11(P.L.769, No.240), referred to as the Commonwealth Documents
12Law, the act of October 15, 1980 (P.L.950, No.164), known as the
13Commonwealth Attorneys Act, or the act of June 25, 1982
14(P.L.633, No.181), known as the Regulatory Review Act.

15Section 806-C. Calculation.

16Using the assessment rate implemented by the secretary
17pursuant to section 804-C, each [ICF/MR] ICF/ID shall calculate
18the assessment amounts it owes for a calendar quarter on a form
19specified by the department and shall submit the form and the
20amount owed to the department no later than the last day of that
21calendar quarter or 30 days from the date of the department's
22second notice published pursuant to section 805-C(a), whichever
23is later.

24Section 807-C. Purposes and uses.

25No [ICF/MR] ICF/ID shall be directly guaranteed a repayment
26of its assessment in derogation of 42 CFR 433.68 (relating to
27permissible health care-related taxes [after the transition
28period]), provided, however, in each fiscal year in which an
29assessment is implemented, the department shall use the State
30revenue collected from the assessment and any Federal funds

1received by the Commonwealth as a direct result of the
2assessment to fund services for persons with [mental
3retardation] an intellectual disability.

4Section 808-C. Records.

5Upon request by the department, an [ICF/MR] ICF/ID shall
6furnish to the department such records as the department may
7specify in order to determine the assessment rate for a fiscal
8year or the amount of the assessment due from the [ICF/MR]
9ICF/ID or to verify that the [ICF/MR] ICF/ID has paid the
10correct amount due. In the event that the department determines
11that an [ICF/MR] ICF/ID has failed to pay an assessment or that
12it has underpaid an assessment, the department shall notify the
13[ICF/MR] ICF/ID in writing of the amount due, including
14interest, and the date on which the amount due must be paid,
15which shall not be less than 30 days from the date of the
16notice. In the event that the department determines that an
17[ICF/MR] ICF/ID has overpaid an assessment, the department shall
18notify the [ICF/MR] ICF/ID in writing of the overpayment and,
19within 30 days of the date of the notice of the overpayment,
20shall either authorize a refund of the amount of the overpayment
21or offset the amount of the overpayment against any amount that
22may be owed to the department by the [ICF/MR] ICF/ID.

23Section 809-C. Appeal rights.

24An [ICF/MR] ICF/ID that is aggrieved by a determination of
25the department as to the amount of the assessment due from the
26[ICF/MR] ICF/ID or a remedy imposed pursuant to section 810-C
27may file a request for review of the decision of the department
28by the Bureau of Hearings and Appeals within the department,
29which shall have exclusive jurisdiction in such matters. The
30procedures and requirements of 67 Pa.C.S. Ch. 11 (relating to

1medical assistance hearings and appeals) shall apply to requests
2for review filed pursuant to this section except that, in any
3such request for review, an [ICF/MR] ICF/ID may not challenge
4the assessment rate determined by the secretary, but only
5whether the department correctly determined the assessment
6amount due from the [ICF/MR] ICF/ID using the assessment rate in
7effect for the fiscal year.

8Section 810-C. Enforcement.

9In addition to any other remedy provided by law, the
10department may enforce this article by imposing one or more of
11the following remedies:

12(1) When an [ICF/MR] ICF/ID fails to pay an assessment
13or penalty in the amount or on the date required by this
14article, the department may add interest at the rate provided
15in section 806 of the act of April 9, 1929 (P.L.343, No.176),
16known as The Fiscal Code, to the unpaid amount of the
17assessment or penalty from the date prescribed for its
18payment until the date it is paid.

19(2) When an [ICF/MR] ICF/ID fails to file a report or to
20furnish records to the department as required by this
21article, the department may impose a penalty against the
22[ICF/MR] ICF/ID in the amount of $1,000 per day for each day
23the report or required records are not filed or furnished to
24the department.

25(3) When an [ICF/MR] ICF/ID fails to pay all or part of
26an assessment or penalty within 60 days of the date that
27payment is due, the department may terminate the [ICF/MR]
28ICF/ID from participation in the medical assistance program
29and/or deduct the unpaid assessment or penalty and any
30interest owed thereon from any payments due to the [ICF/MR]

1ICF/ID until the full amount is recovered. Any such
2termination or payment deduction shall be made only after
3written notice to the [ICF/MR] ICF/ID.

4(4) The secretary may waive all or part of the interest
5or penalties assessed against an [ICF/MR] ICF/ID pursuant to
6this article for good cause as shown by the [ICF/MR] ICF/ID.

7Section 3. Section 811-C of the act, amended July 4, 2008
8(P.L.557, No.44), is amended to read;

9Section 811-C. Time periods.

10(a) Imposition.--The assessment authorized under this
11article shall not be imposed as follows:

12(1) Prior to July 1, 2003, for private [ICFs/MR]
13ICFs/ID.

14(2) Prior to July 1, 2004, for public [ICFs/MR] ICFs/ID.

15(3) In the absence of Federal financial participation as
16described under section 803-C.

17(b) Cessation.--The assessment authorized under this article
18shall cease June 30, [2013] 2016, or earlier, if required by
19law.

20Section 4. Section 802-E of the act is amended by adding a
21subsection to read:

22Section 802-E. Authorization.

23* * *

24(a.1) Adjustments to assessment percentage.--

25(1) For State fiscal years beginning after June 30, 2013,
26and subject to the advance written approval of the secretary,
27the municipality may make a proportionately uniform adjustment
28to the assessment percentage established by ordinance under
29subsection (a).

30(2) After receiving written approval under paragraph (1) and

1before implementing the adjustment, the municipality shall
2provide advance public notice. The notice shall specify the
3proposed adjusted assessment percentage and identify the
4aggregate impact on general acute care hospitals located in the
5municipality subject to the assessment. An interested party
6shall have 30 days in which to submit comments to the
7municipality. Upon expiration of the 30-day comment period, the
8municipality, after consideration of the comments, shall publish
9a subsequent notice announcing the adjusted assessment
10percentage.

11* * *

12Section 5. Section 808-E of the act, reenacted October 22,
132010 (P.L.829, No.84), is amended to read:

14Section 808-E. Time period.

15(a) Cessation.--The assessment authorized under this article
16shall cease June 30, 2013.

17(b) Assessment.--

18(1) A municipality shall have the power to enact the
19assessment authorized in section 802-E(a)(2) either prior to
20or during its fiscal year ending June 30, 2010.

21(2) A municipality may adjust the assessment percentage
22as specified under section 802-E(a.1) either prior to or
23during the fiscal year in which the adjusted assessment
24percentage takes effect.

25Section 6. This act shall take effect in 60 days.