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

1providers of nursing facility services shall be determined in
2accordance with the methodologies for establishing payment rates
3for county and nonpublic nursing facilities specified in the
4department's regulations and the Commonwealth's approved Title
5XIX State Plan for nursing facility services in effect after
6June 30, 2007. The following shall apply:

7* * *

8(iv) Subject to Federal approval of such amendments as may
9be necessary to the Commonwealth's approved Title XIX State
10Plan, for each fiscal year beginning on or after July 1, 2011,
11the department shall apply a revenue adjustment neutrality
12factor to county and nonpublic nursing facility payment rates so
13that the estimated Statewide day-weighted average payment rate
14in effect for that fiscal year is limited to the amount
15permitted by the funds appropriated by the General Appropriation
16Act for the fiscal year. The revenue adjustment neutrality
17factor shall remain in effect until the sooner of June 30,
18[2013] 2016, or the date on which a new rate-setting methodology
19for medical assistance nursing facility services which replaces
20the rate-setting methodology codified in 55 Pa. Code Chs. 1187
21(relating to nursing facility services) and 1189 (relating to
22county nursing facility services) takes effect.

23* * *

24Section 2. The heading of Article XVIII-C and sections
25801-C, 802-C, 803-C, 804-C, 805-C, 806-C, 807-C, 808-C, 809-C
26and 810-C of the act, added July 4, 2004 (P.L.528, No.69), are
27amended to read:

28ARTICLE VIII-C

29INTERMEDIATE CARE FACILITIES FOR [MENTALLY RETARDED] PERSONS
30WITH AN INTELLECTUAL DISABILITY

1ASSESSMENTS

2Section 801-C. Definitions.

3The following words and phrases when used in this article
4shall have the meanings given to them in this section unless the
5context clearly indicates otherwise:

6"Assessment." The fee implemented pursuant to this article
7on every intermediate care facility for [mentally retarded]
8persons with an intellectual disability.

9"Department." The Department of Public Welfare of the
10Commonwealth.

11"Intermediate care facility for [mentally retarded] persons
12with an intellectual disability" or "[ICF/MR] ICF/ID." A public
13or private facility defined in section 1905 of the Social
14Security Act (49 Stat. 620, 42 U.S.C. § 1905).

15"Medicaid." The program established under Title XIX of the
16Social Security Act (49 Stat. 620, 42 U.S.C. § 1396 et seq.).

17"Medical assistance program" or "program." The medical
18assistance program as administered by the Department of Public
19Welfare.

20"Secretary." The Secretary of Public Welfare of the
21Commonwealth.

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

23Section 802-C. Authorization.

24In order to generate additional revenues for medical
25assistance program recipients to have access to medically
26necessary [mental retardation] intellectual disability services,
27the department shall implement a monetary assessment on each
28[ICF/MR] ICF/ID subject to the conditions and requirements
29specified in this article.

30Section 803-C. Implementation.

1The [ICF/MR] ICF/ID assessments shall be implemented on an
2annual basis as a health care-related tax as defined in section
31903(w)(3)(B) of the Social Security Act, or any amendments
4thereto, and may be imposed and is required to be paid only to
5the extent that the revenues generated from the assessment will
6qualify as the State share of program expenditures eligible for
7Federal financial participation.

8Section 804-C. Amount.

9The assessment rate shall be determined in accordance with
10this article and implemented on an annual basis by the
11department, as approved by the Governor, upon notification to
12and in consultation with the [ICFs/MR] ICFs/ID. In each year in
13which the assessment is implemented, the assessment rate shall
14equal the amount established by the department subject to the
15maximum aggregate amount that may be assessed pursuant to the 6%
16indirect guarantee threshold set forth in 42 CFR 433.68(f)(3)(i)
17(relating to permissible health care-related taxes [after the
18transition period]) or any other maximum aggregate amount
19established by law.

20Section 805-C. Administration.

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

1Bulletin announcing the rate of the assessment.

2(b) Review of assessment.--Except as permitted under section
3809-C, the secretary's determination of the aggregate amount and
4the rate of the assessment pursuant to subsection (a) shall not
5be subject to administrative or judicial review under 2 Pa.C.S.
6Chs. 5 Subch. A (relating to practice and procedure of
7Commonwealth agencies) and 7 Subch. A (relating to judicial
8review of Commonwealth agency action) or any other provision of
9law. No assessment implemented under this article nor forms or
10reports required to be completed by [ICFs/MR] ICFs/ID pursuant
11to this article shall be subject to the act of July 31, 1968
12(P.L.769, No.240), referred to as the Commonwealth Documents
13Law, the act of October 15, 1980 (P.L.950, No.164), known as the
14Commonwealth Attorneys Act, or the act of June 25, 1982
15(P.L.633, No.181), known as the Regulatory Review Act.

16Section 806-C. Calculation.

17Using the assessment rate implemented by the secretary
18pursuant to section 804-C, each [ICF/MR] ICF/ID shall calculate
19the assessment amounts it owes for a calendar quarter on a form
20specified by the department and shall submit the form and the
21amount owed to the department no later than the last day of that
22calendar quarter or 30 days from the date of the department's
23second notice published pursuant to section 805-C(a), whichever
24is later.

25Section 807-C. Purposes and uses.

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

1revenue collected from the assessment and any Federal funds
2received by the Commonwealth as a direct result of the
3assessment to fund services for persons with [mental
4retardation] an intellectual disability.

5Section 808-C. Records.

6Upon request by the department, an [ICF/MR] ICF/ID shall
7furnish to the department such records as the department may
8specify in order to determine the assessment rate for a fiscal
9year or the amount of the assessment due from the [ICF/MR]
10ICF/ID or to verify that the [ICF/MR] ICF/ID has paid the
11correct amount due. In the event that the department determines
12that an [ICF/MR] ICF/ID has failed to pay an assessment or that
13it has underpaid an assessment, the department shall notify the
14[ICF/MR] ICF/ID in writing of the amount due, including
15interest, and the date on which the amount due must be paid,
16which shall not be less than 30 days from the date of the
17notice. In the event that the department determines that an
18[ICF/MR] ICF/ID has overpaid an assessment, the department shall
19notify the [ICF/MR] ICF/ID in writing of the overpayment and,
20within 30 days of the date of the notice of the overpayment,
21shall either authorize a refund of the amount of the overpayment
22or offset the amount of the overpayment against any amount that
23may be owed to the department by the [ICF/MR] ICF/ID.

24Section 809-C. Appeal rights.

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

1procedures and requirements of 67 Pa.C.S. Ch. 11 (relating to
2medical assistance hearings and appeals) shall apply to requests
3for review filed pursuant to this section except that, in any
4such request for review, an [ICF/MR] ICF/ID may not challenge
5the assessment rate determined by the secretary, but only
6whether the department correctly determined the assessment
7amount due from the [ICF/MR] ICF/ID using the assessment rate in
8effect for the fiscal year.

9Section 810-C. Enforcement.

10In addition to any other remedy provided by law, the
11department may enforce this article by imposing one or more of
12the following remedies:

13(1) When an [ICF/MR] ICF/ID fails to pay an assessment
14or penalty in the amount or on the date required by this
15article, the department may add interest at the rate provided
16in section 806 of the act of April 9, 1929 (P.L.343, No.176),
17known as The Fiscal Code, to the unpaid amount of the
18assessment or penalty from the date prescribed for its
19payment until the date it is paid.

20(2) When an [ICF/MR] ICF/ID fails to file a report or to
21furnish records to the department as required by this
22article, the department may impose a penalty against the
23[ICF/MR] ICF/ID in the amount of $1,000 per day for each day
24the report or required records are not filed or furnished to
25the department.

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

1interest owed thereon from any payments due to the [ICF/MR]
2ICF/ID until the full amount is recovered. Any such
3termination or payment deduction shall be made only after
4written notice to the [ICF/MR] ICF/ID.

5(4) The secretary may waive all or part of the interest
6or penalties assessed against an [ICF/MR] ICF/ID pursuant to
7this article for good cause as shown by the [ICF/MR] ICF/ID.

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

10Section 811-C. Time periods.

11(a) Imposition.--The assessment authorized under this
12article shall not be imposed as follows:

13(1) Prior to July 1, 2003, for private [ICFs/MR]
14ICFs/ID.

15(2) Prior to July 1, 2004, for public [ICFs/MR] ICFs/ID.

16(3) In the absence of Federal financial participation as
17described under section 803-C.

18(b) Cessation.--The assessment authorized under this article
19shall cease June 30, [2013] 2016, or earlier, if required by
20law.

21Section 4. Section 802-E of the act is amended by adding a
22subsection to read:

23Section 802-E. Authorization.

24* * *

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

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

1(2) After receiving written approval under paragraph (1) and
2before implementing the adjustment, the municipality shall
3provide advance public notice. The notice shall specify the
4proposed adjusted assessment percentage and identify the
5aggregate impact on general acute care hospitals located in the
6municipality subject to the assessment. An interested party
7shall have 30 days in which to submit comments to the
8municipality. Upon expiration of the 30-day comment period, the
9municipality, after consideration of the comments, shall publish
10a subsequent notice announcing the adjusted assessment
11percentage.

12* * *

13Section 5. Section 808-E of the act, reenacted October 22,
142010 (P.L.829, No.84), is amended to read:

15Section 808-E. Time period.

16(a) Cessation.--The assessment authorized under this article
17shall cease June 30, [2013<-] 2016.

18(b) Assessment.--

19(1) A municipality shall have the power to enact the
20assessment authorized in section 802-E(a)(2) either prior to
21or during its fiscal year ending June 30, 2010.

22(2) A municipality may adjust the assessment percentage
23as specified under section 802-E(a.1) either prior to or
24during the fiscal year in which the adjusted assessment
25percentage takes effect.

26Section 6. This act shall take effect <-in 60 days 
<-27immediately.