Regular Session 2023-2024 House Bill 1300 P.N. 1943

SENATE AMENDED

PRIOR PRINTER'S NOS. 1378, 1446

PRINTER'S NO. 1943

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No.

1300

Session of

2023

INTRODUCED BY MEHAFFIE, KIM, MADDEN, HILL-EVANS, KHAN,

SCHLOSSBERG, DELLOSO, GUENST, CIRESI, SANCHEZ, GREEN,

KENYATTA, T. DAVIS AND WEBSTER, MAY 30, 2023

SENATOR MARTIN, APPROPRIATIONS, IN SENATE, RE-REPORTED AS

AMENDED, AUGUST 30, 2023

AN ACT

Amending the act of November 24, 2015 (P.L.232, No.64), entitled

"An act establishing the Pennsylvania Long-term Care Council;

providing for its powers and duties; and repealing related

provisions of the Public Welfare Code," further providing for

Pennsylvania Long-term Care Council.

AMENDING THE ACT OF APRIL 9, 1929 (P.L.343, NO.176), ENTITLED

"AN ACT RELATING TO THE FINANCES OF THE STATE GOVERNMENT;

PROVIDING FOR CANCER CONTROL, PREVENTION AND RESEARCH, FOR

AMBULATORY SURGICAL CENTER DATA COLLECTION, FOR THE JOINT

UNDERWRITING ASSOCIATION, FOR ENTERTAINMENT BUSINESS

FINANCIAL MANAGEMENT FIRMS, FOR PRIVATE DAM FINANCIAL

ASSURANCE AND FOR REINSTATEMENT OF ITEM VETOES; PROVIDING FOR

THE SETTLEMENT, ASSESSMENT, COLLECTION, AND LIEN OF TAXES,

BONUS, AND ALL OTHER ACCOUNTS DUE THE COMMONWEALTH, THE

COLLECTION AND RECOVERY OF FEES AND OTHER MONEY OR PROPERTY

DUE OR BELONGING TO THE COMMONWEALTH, OR ANY AGENCY THEREOF,

INCLUDING ESCHEATED PROPERTY AND THE PROCEEDS OF ITS SALE,

THE CUSTODY AND DISBURSEMENT OR OTHER DISPOSITION OF FUNDS

AND SECURITIES BELONGING TO OR IN THE POSSESSION OF THE

COMMONWEALTH, AND THE SETTLEMENT OF CLAIMS AGAINST THE

COMMONWEALTH, THE RESETTLEMENT OF ACCOUNTS AND APPEALS TO THE

COURTS, REFUNDS OF MONEYS ERRONEOUSLY PAID TO THE

COMMONWEALTH, AUDITING THE ACCOUNTS OF THE COMMONWEALTH AND

ALL AGENCIES THEREOF, OF ALL PUBLIC OFFICERS COLLECTING

MONEYS PAYABLE TO THE COMMONWEALTH, OR ANY AGENCY THEREOF,

AND ALL RECEIPTS OF APPROPRIATIONS FROM THE COMMONWEALTH,

AUTHORIZING THE COMMONWEALTH TO ISSUE TAX ANTICIPATION NOTES

TO DEFRAY CURRENT EXPENSES, IMPLEMENTING THE PROVISIONS OF

SECTION 7(A) OF ARTICLE VIII OF THE CONSTITUTION OF

PENNSYLVANIA AUTHORIZING AND RESTRICTING THE INCURRING OF

CERTAIN DEBT AND IMPOSING PENALTIES; AFFECTING EVERY

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DEPARTMENT, BOARD, COMMISSION, AND OFFICER OF THE STATE

GOVERNMENT, EVERY POLITICAL SUBDIVISION OF THE STATE, AND

CERTAIN OFFICERS OF SUCH SUBDIVISIONS, EVERY PERSON,

ASSOCIATION, AND CORPORATION REQUIRED TO PAY, ASSESS, OR

COLLECT TAXES, OR TO MAKE RETURNS OR REPORTS UNDER THE LAWS

IMPOSING TAXES FOR STATE PURPOSES, OR TO PAY LICENSE FEES OR

OTHER MONEYS TO THE COMMONWEALTH, OR ANY AGENCY THEREOF,

EVERY STATE DEPOSITORY AND EVERY DEBTOR OR CREDITOR OF THE

COMMONWEALTH," IN DISPOSITION OF ABANDONED AND UNCLAIMED

PROPERTY, FURTHER PROVIDING FOR CLAIM FOR PROPERTY PAID OR

DELIVERED; IN OIL AND GAS WELLS, FURTHER PROVIDING FOR OIL

AND GAS LEASE FUND; IN HUMAN SERVICES, PROVIDING FOR CHILD

SUPPORT COSTS AND FEES; PROVIDING FOR STATEWIDE QUALITY CARE

ASSESSMENT AND FOR PENNSYLVANIA LONG-TERM CARE COUNCIL; IN

ADDITIONAL SPECIAL FUNDS AND RESTRICTED ACCOUNTS, FURTHER

PROVIDING FOR ESTABLISHMENT OF SPECIAL FUND AND ACCOUNT, FOR

USE OF FUND AND FOR DISTRIBUTIONS FOR PENNSYLVANIA RACE HORSE

DEVELOPMENT FUND, REPEALING PROVISIONS RELATING TO ENHANCED

REVENUE COLLECTION ACCOUNT; IN ADDITIONAL SPECIAL FUNDS AND

RESTRICTED ACCOUNTS, FURTHER PROVIDING FOR CLEAN STREAMS FUND

AND FOR DEFINITIONS, RENAMING THE SPORTS TOURISM AND

MARKETING ACCOUNT TO THE SPORTS, MARKETING AND TOURISM

ACCOUNT, FURTHER PROVIDING FOR TRANSFER OF FUNDS AND

PROVIDING FOR FACILITY TRANSITION ACCOUNT AND FOR GAME FUND;

IN GENERAL BUDGET IMPLEMENTATION, FURTHER PROVIDING FOR

DEPARTMENT OF AGRICULTURE, FOR DEPARTMENT OF CONSERVATION AND

NATURAL RESOURCES, FOR DEPARTMENT OF EDUCATION, FOR

PENNSYLVANIA STATE POLICE, FOR SURCHARGES, FOR FEDERAL AND

COMMONWEALTH USE OF FOREST LAND AND FOR MULTIMODAL

TRANSPORTATION FUND AND REPEALING PROVISIONS RELATING TO

SALES BY DISTILLERIES; PROVIDING FOR 2023-2024 BUDGET

IMPLEMENTATION, FOR 2023-2024 RESTRICTIONS ON APPROPRIATIONS

FOR FUNDS AND ACCOUNTS AND FOR PRIOR YEAR APPROPRIATIONS;

IMPOSING PENALTIES; MAKING REPEALS; AND MAKING AN EDITORIAL

CHANGE.

THE GENERAL ASSEMBLY FINDS AND DECLARES AS FOLLOWS:

(1) THE INTENT OF THIS ACT IS TO PROVIDE FOR THE

IMPLEMENTATION OF THE 2023-2024 COMMONWEALTH BUDGET.

(2) THE CONSTITUTION OF PENNSYLVANIA CONFERS NUMEROUS

EXPRESS DUTIES UPON THE GENERAL ASSEMBLY, INCLUDING THE

PASSAGE OF A BALANCED BUDGET FOR THE COMMONWEALTH.

(3) SECTION 24 OF ARTICLE III OF THE CONSTITUTION OF

PENNSYLVANIA REQUIRES THE GENERAL ASSEMBLY TO ADOPT ALL

APPROPRIATIONS FOR THE OPERATION OF GOVERNMENT IN THIS

COMMONWEALTH, REGARDLESS OF THEIR SOURCE. THE SUPREME COURT

HAS REPEATEDLY AFFIRMED THAT "IT IS FUNDAMENTAL WITHIN

PENNSYLVANIA'S TRIPARTITE SYSTEM THAT THE GENERAL ASSEMBLY

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ENACTS THE LEGISLATION ESTABLISHING THOSE PROGRAMS WHICH THE

STATE PROVIDES FOR ITS CITIZENS AND APPROPRIATES THE FUNDS

NECESSARY FOR THEIR OPERATION."

(4) PURSUANT TO SECTION 13 OF ARTICLE VIII OF THE

CONSTITUTION OF PENNSYLVANIA, THE GENERAL ASSEMBLY IS

EXPLICITLY REQUIRED TO ADOPT A BALANCED COMMONWEALTH BUDGET.

GIVEN THE UNPREDICTABILITY AND POTENTIAL INSUFFICIENCY OF

REVENUE COLLECTIONS, VARIOUS CHANGES IN STATE LAW RELATING TO

SOURCES OF REVENUE, THE COLLECTION OF REVENUE AND THE

IMPLEMENTATION OF STATUTES WHICH IMPACT REVENUE MAY BE

REQUIRED TO DISCHARGE THIS CONSTITUTIONAL OBLIGATION.

(5) SECTION 11 OF ARTICLE III OF THE CONSTITUTION OF

PENNSYLVANIA REQUIRES THE ADOPTION OF A GENERAL APPROPRIATION

ACT THAT EMBRACES "NOTHING BUT APPROPRIATIONS." WHILE ACTUAL

ITEMS OF APPROPRIATION CAN BE CONTAINED IN A GENERAL

APPROPRIATION ACT, THE ACHIEVEMENT AND IMPLEMENTATION OF A

COMPREHENSIVE BUDGET INVOLVES MORE THAN SUBJECTS OF

APPROPRIATIONS AND DOLLAR AMOUNTS. ULTIMATELY, THE BUDGET HAS

TO BE BALANCED UNDER SECTION 13 OF ARTICLE VIII OF THE

CONSTITUTION OF PENNSYLVANIA. THIS MAY NECESSITATE CHANGES TO

SOURCES OF FUNDING AND ENACTMENT OF STATUTES TO ACHIEVE FULL

COMPLIANCE WITH THESE CONSTITUTIONAL PROVISIONS.

(6) FOR THE REASONS UNDER PARAGRAPHS (1), (2), (3), (4)

AND (5), IT IS THE INTENT OF THE GENERAL ASSEMBLY THROUGH

THIS ACT TO PROVIDE FOR THE IMPLEMENTATION OF THE 2023-2024

COMMONWEALTH BUDGET.

(7) EVERY PROVISION OF THIS ACT RELATES TO THE

IMPLEMENTATION OF THE OPERATING BUDGET OF THE COMMONWEALTH

FOR THIS FISCAL YEAR, ADDRESSING IN VARIOUS WAYS THE FISCAL

OPERATIONS, REVENUES AND POTENTIAL LIABILITIES OF THE

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COMMONWEALTH. TO THAT END, THIS ACT IS INTENDED TO IMPLEMENT

THE 2023-2024 COMMONWEALTH BUDGET WITHOUT SPECIFICALLY

APPROPRIATING PUBLIC MONEY FROM THE GENERAL FUND. THIS ACT

PROVIDES ACCOUNTABILITY FOR SPENDING AND MAKES TRANSFERS OR

OTHER CHANGES NECESSARY TO IMPACT THE AVAILABILITY OF REVENUE

IN ORDER TO MEET THE REQUIREMENTS OF SECTION 13 OF ARTICLE

VIII OF THE CONSTITUTION OF PENNSYLVANIA AND TO IMPLEMENT THE

ACT OF AUGUST 3, 2023 (P.L. , NO.1A), KNOWN AS THE GENERAL

APPROPRIATION ACT OF 2023.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. Section 3(b)(10) of the act of November 24, 2015

(P.L.232, No.64), known as the Pennsylvania Long-term Care

Council Act, is amended by adding a subparagraph to read:

Section 3. Pennsylvania Long-term Care Council.

* * *

(b) Membership.--The council shall be composed of and

appointed in accordance with the following:

* * *

(10) The following members to be appointed by the

Governor, in consultation with the Secretary of Aging:

* * *

(xii) One member who represents the Office of the

State Long-Term Care Ombudsman within the department.

* * *

Section 2. This act shall take effect immediately.

SECTION 1. SECTION 1301.19 OF THE ACT OF APRIL 9, 1929

(P.L.343, NO.176), KNOWN AS THE FISCAL CODE, IS AMENDED TO READ:

SECTION 1301.19. CLAIM FOR PROPERTY PAID OR DELIVERED.--(A)

ANY PERSON CLAIMING AN INTEREST IN ANY PROPERTY PAID OR

20230HB1300PN1943 - 4 -

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DELIVERED TO THE COMMONWEALTH UNDER THIS ARTICLE MAY FILE A

CLAIM THERETO OR TO THE PROCEEDS FROM THE SALE THEREOF ON THE

FORM PRESCRIBED BY THE STATE TREASURER.

(B) REGARDLESS OF WHETHER A CLAIM IS FILED UNDER SUBSECTION

(A), THE STATE TREASURER MAY PAY OR DELIVER ANY PROPERTY PAID OR

DELIVERED TO THE COMMONWEALTH UNDER THIS ARTICLE, OR THE

PROCEEDS FROM THE SALE OF THE PROPERTY, TO A PERSON IF THE STATE

TREASURER FINDS THAT A REPORT FILED UNDER SECTION 1301.11

IDENTIFIES THE PERSON AS THE SOLE OWNER OF THE PROPERTY AND THE

VALUE OF THE PROPERTY OR PROCEEDS IS LESS THAN FIVE THOUSAND

DOLLARS ($5,000).

SECTION 2. SECTION 1601.2-E(E)(1)(II) OF THE ACT, AMENDED

JULY 11, 2022 (P.L.540, NO.54), IS AMENDED TO READ:

SECTION 1601.2-E. OIL AND GAS LEASE FUND.

* * *

(E) ANNUAL TRANSFERS.--THE FOLLOWING APPLY:

(1) * * *

(II) NO AMOUNT SHALL BE TRANSFERRED FROM THE FUND TO

THE MARCELLUS LEGACY FUND FOR DISTRIBUTION TO THE

ENVIRONMENTAL STEWARDSHIP FUND FOR THE 2019-2020, 2020-

2021, 2021-2022 [AND], 2022-2023 AND 2023-2024 FISCAL

YEAR.

* * *

SECTION 3. THE ACT IS AMENDED BY ADDING A SECTION TO READ:

SECTION 1607-T. CHILD SUPPORT COSTS AND FEES.

(A) COSTS AND FEES .-- IF AN OBLIGEE PREVAILS IN A PROCEEDING

TO ESTABLISH PATERNITY OR TO OBTAIN A SUPPORT ORDER, A COURT MAY

ASSESS AGAINST THE OBLIGOR FILING FEES, REASONABLE ATTORNEY FEES

AND NECESSARY TRAVEL AND OTHER REASONABLE COSTS AND EXPENSES

INCURRED BY THE OBLIGEE AND THE OBLIGEE'S WITNESSES. ATTORNEY

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FEES MAY BE TAXED AS COSTS AND SHALL BE ORDERED TO BE PAID

DIRECTLY TO THE ATTORNEY, WHO MAY ENFORCE THE ORDER IN THE

ATTORNEY'S OWN NAME. PAYMENT OF SUPPORT OWED TO THE OBLIGEE

SHALL HAVE PRIORITY OVER FEES, COSTS AND EXPENSES.

(B) ANNUAL FEE.--THE COMMONWEALTH SHALL IMPOSE A FEE OF $35

IN EACH CASE IN WHICH AN INDIVIDUAL HAS NEVER RECEIVED

ASSISTANCE UNDER 42 U.S.C. CH. 7 SUBCH. I (RELATING TO GRANTS TO

STATES FOR OLD-AGE ASSISTANCE) AND FOR WHOM THE COMMONWEALTH HAS

COLLECTED AT LEAST $550 OF SUPPORT IN A FEDERAL FISCAL YEAR. THE

COMMONWEALTH SHALL PAY THE $35 FEE FOR THOSE CASES IN WHICH THE

ANNUAL COLLECTION IS BETWEEN $550 AND $1,999.99. THE $35 FEE

SHALL BE COLLECTED FROM THE CUSTODIAL PARENT IN CASES WHERE

ANNUAL COLLECTIONS EQUAL $2,000 OR MORE.

INDIVIDUAL SUBJECT TO A CHILD SUPPORT ORDER DID NOT HAVE GOOD

CAUSE FOR FAILING TO MAKE CHILD SUPPORT PAYMENTS ON TIME, THE

COURT MAY FURTHER ASSESS COSTS AND REASONABLE ATTORNEY FEES

INCURRED BY THE PARTY SEEKING TO ENFORCE THE ORDER.

SECTION 4. THE ACT IS AMENDED BY ADDING ARTICLES TO READ:

ARTICLE XVI-U

STATEWIDE QUALITY CARE ASSESSMENT

SECTION 1601-U. DEFINITIONS.

THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS ARTICLE

SHALL HAVE THE MEANINGS GIVEN TO THEM IN THIS SECTION UNLESS THE

CONTEXT CLEARLY INDICATES OTHERWISE:

"ASSESSMENT." THE FEE, KNOWN AS THE QUALITY CARE ASSESSMENT,

AUTHORIZED TO BE IMPLEMENTED UNDER THIS ARTICLE ON EVERY COVERED

HOSPITAL.

"BAD DEBT EXPENSE." THE COST OF CARE FOR WHICH A HOSPITAL

EXPECTED PAYMENT FROM THE PATIENT OR A THIRD-PARTY PAYER, BUT

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WHICH THE HOSPITAL SUBSEQUENTLY DETERMINES TO BE UNCOLLECTIBLE,

AS FURTHER DESCRIBED IN THE MEDICARE PROVIDER REIMBURSEMENT

MANUAL PUBLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND

HUMAN SERVICES.

"CHARITY CARE EXPENSE." THE COST OF CARE FOR WHICH A

HOSPITAL ORDINARILY CHARGES A FEE BUT WHICH IS PROVIDED FREE OR

AT A REDUCED RATE TO PATIENTS WHO CANNOT AFFORD TO PAY BUT WHO

ARE NOT ELIGIBLE FOR PUBLIC PROGRAMS, AND FROM WHOM THE HOSPITAL

DID NOT EXPECT PAYMENT IN ACCORDANCE WITH THE HOSPITAL'S CHARITY

CARE POLICY, AS FURTHER DESCRIBED IN THE MEDICARE PROVIDER

REIMBURSEMENT MANUAL PUBLISHED BY THE UNITED STATES DEPARTMENT

OF HEALTH AND HUMAN SERVICES.

"CONTRACTUAL ALLOWANCE." THE DIFFERENCE BETWEEN WHAT A

HOSPITAL CHARGES FOR SERVICES AND THE AMOUNTS THAT CERTAIN

PAYERS HAVE AGREED TO PAY FOR THE SERVICES AS FURTHER DESCRIBED

IN THE MEDICARE PROVIDER REIMBURSEMENT MANUAL PUBLISHED BY THE

UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES.

"COVERED HOSPITAL." A HOSPITAL OTHER THAN AN EXEMPT

HOSPITAL.

"CRITICAL ACCESS HOSPITAL." ANY HOSPITAL THAT HAS QUALIFIED

UNDER 42 U.S.C. § 1395X(MM)(1) (RELATING TO DEFINITIONS) AS A

CRITICAL ACCESS HOSPITAL UNDER MEDICARE.

"DEPARTMENT." THE DEPARTMENT OF HUMAN SERVICES OF THE

COMMONWEALTH.

"EXEMPT HOSPITAL." ANY OF THE FOLLOWING:

(1) A FEDERAL VETERANS' AFFAIRS HOSPITAL.

(2) A HOSPITAL THAT PROVIDES CARE, INCLUDING INPATIENT

HOSPITAL SERVICES, TO ALL PATIENTS FREE OF CHARGE.

(3) A PRIVATE PSYCHIATRIC HOSPITAL.

(4) A STATE-OWNED PSYCHIATRIC HOSPITAL.

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(5) A CRITICAL ACCESS HOSPITAL.

(6) A LONG-TERM ACUTE CARE HOSPITAL.

(7) A FREE-STANDING ACUTE CARE HOSPITAL ORGANIZED

PRIMARILY FOR THE TREATMENT OF AND RESEARCH ON CANCER IN

WHICH AT LEAST 30% OF THE INPATIENT ADMISSIONS HAD CANCER AS

THE PRINCIPAL DIAGNOSIS BASED ON PENNSYLVANIA HEALTH CARE

COST CONTAINMENT COUNCIL CY 2014 INPATIENT DISCHARGE DATA.

FOR THE PURPOSES OF MEETING THIS DEFINITION, ONLY DISCHARGES

WITH ICD-9-CM PRINCIPAL DIAGNOSES CODES OF 140 THROUGH 239,

V58.0, V58.1, V66.1, V66.2 OR 990 ARE CONSIDERED.

"HOSPITAL." A FACILITY LICENSED AS A HOSPITAL UNDER 28 PA.

CODE PT. IV SUBPT. B (RELATING TO GENERAL AND SPECIAL

HOSPITALS).

"LONG-TERM ACUTE CARE HOSPITAL." A HOSPITAL OR UNIT OF A

HOSPITAL WHOSE PATIENTS HAVE A LENGTH OF STAY OF GREATER THAN 25

DAYS AND THAT PROVIDES SPECIALIZED ACUTE CARE OF MEDICALLY

COMPLEX PATIENTS WHO ARE CRITICALLY ILL.

"MEDICAL ASSISTANCE MANAGED CARE ORGANIZATION." A MEDICAID

MANAGED CARE ORGANIZATION AS DEFINED IN 42 U.S.C. §

1396B(M)(1)(A) (RELATING TO PAYMENTS TO STATES) THAT IS A PARTY

TO A MEDICAID MANAGED CARE CONTRACT WITH THE DEPARTMENT. THE

TERM SHALL NOT INCLUDE A BEHAVIORAL HEALTH MANAGED CARE

ORGANIZATION THAT IS A PARTY TO A MEDICAID MANAGED CARE CONTRACT

WITH THE DEPARTMENT.

"NET INPATIENT REVENUE." GROSS REVENUES RECEIVED OR EARNED

BY A HOSPITAL FOR INPATIENT SERVICES, INCLUDING MEDICAL

ASSISTANCE SUPPLEMENTAL REVENUES RECEIVED BY THE HOSPITAL FOR

INPATIENT HOSPITAL SERVICES, LESS ANY DEDUCTED AMOUNTS FOR BAD

DEBT EXPENSE, CHARITY CARE EXPENSE AND CONTRACTUAL ALLOWANCES AS

IDENTIFIED IN THE HOSPITAL'S RECORDS AND REPORTED ON FORMS

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SPECIFIED BY THE DEPARTMENT.

"NET OUTPATIENT REVENUE." GROSS REVENUES RECEIVED OR EARNED

BY A HOSPITAL FOR OUTPATIENT SERVICES, INCLUDING MEDICAL

ASSISTANCE SUPPLEMENTAL REVENUES RECEIVED BY THE HOSPITAL FOR

OUTPATIENT HOSPITAL SERVICES, LESS ANY DEDUCTED AMOUNTS FOR BAD

DEBT EXPENSE, CHARITY CARE EXPENSE AND CONTRACTUAL ALLOWANCES AS

IDENTIFIED IN THE HOSPITAL'S RECORDS AND REPORTED ON FORMS

SPECIFIED BY THE DEPARTMENT.

"PROGRAM." THE COMMONWEALTH'S MEDICAL ASSISTANCE PROGRAM AS

AUTHORIZED UNDER ARTICLE IV OF THE ACT OF JUNE 13, 1967 (P.L.31,

NO.21), KNOWN AS THE HUMAN SERVICES CODE.

"SECRETARY." THE SECRETARY OF HUMAN SERVICES OF THE

COMMONWEALTH.

SECTION 1602-U. MEDICAL ASSISTANCE PAYMENTS FOR INSTITUTIONAL

CARE.

NOTWITHSTANDING SECTION 443.1(1.1)(I) OF THE ACT OF JUNE 13,

1967 (P.L.31, NO.21), KNOWN AS THE HUMAN SERVICES CODE, AND

SUBJECT TO SECTION 1614-U, FOR INPATIENT HOSPITAL SERVICES

PROVIDED DURING A FISCAL YEAR IN WHICH AN ASSESSMENT IS IMPOSED

UNDER THIS ARTICLE, PAYMENTS UNDER THE MEDICAL ASSISTANCE FEE-

FOR-SERVICE PROGRAM SHALL BE DETERMINED IN ACCORDANCE WITH THE

DEPARTMENT'S REGULATIONS, EXCEPT IF THE COMMONWEALTH'S APPROVED

TITLE XIX STATE PLAN FOR INPATIENT HOSPITAL SERVICES IN EFFECT

FOR THE PERIOD OF JULY 1, 2010, THROUGH JUNE 30, 2028, SPECIFIES

A METHODOLOGY FOR CALCULATING PAYMENTS THAT IS DIFFERENT FROM

THE DEPARTMENT'S REGULATIONS OR AUTHORIZES ADDITIONAL PAYMENTS

NOT SPECIFIED IN THE DEPARTMENT'S REGULATIONS, INCLUDING

INPATIENT DISPROPORTIONATE SHARE PAYMENTS AND DIRECT MEDICAL

EDUCATION PAYMENTS, THE DEPARTMENT SHALL FOLLOW THE METHODOLOGY

OR MAKE THE ADDITIONAL PAYMENTS AS SPECIFIED IN THE APPROVED

20230HB1300PN1943 - 9 -

TITLE XIX STATE PLAN.

SECTION 1603-U. AUTHORIZATION.

IN ORDER TO GENERATE ADDITIONAL REVENUES FOR THE PURPOSE OF

ASSURING THAT MEDICAL ASSISTANCE RECIPIENTS HAVE ACCESS TO

HOSPITAL SERVICES, THE DEPARTMENT SHALL IMPLEMENT A MONETARY

ASSESSMENT, KNOWN AS THE QUALITY CARE ASSESSMENT, ON EACH

COVERED HOSPITAL SUBJECT TO THE CONDITIONS AND REQUIREMENTS

SPECIFIED IN THIS ARTICLE, INCLUDING SECTION 1614-U.

SECTION 1604-U. IMPLEMENTATION.

(A) HEALTH CARE-RELATED FEE.--THE ASSESSMENT AUTHORIZED

UNDER THIS ARTICLE, ONCE IMPOSED, SHALL BE IMPLEMENTED AS A

HEALTH CARE-RELATED FEE UNDER 42 U.S.C. § 1396B(W)(3)(B)

(RELATING TO PAYMENT TO STATES) OR ANY AMENDMENTS THERETO AND

MAY BE COLLECTED ONLY TO THE EXTENT AND FOR THE PERIODS THAT THE

SECRETARY DETERMINES THAT REVENUES GENERATED BY THE ASSESSMENT

WILL QUALIFY AS THE STATE SHARE OF PROGRAM EXPENDITURES ELIGIBLE

FOR FEDERAL FINANCIAL PARTICIPATION.

(B) ASSESSMENT PERCENTAGE.--SUBJECT TO SUBSECTION (C), EACH

COVERED HOSPITAL SHALL BE ASSESSED AS FOLLOWS:

(1) FOR FISCAL YEAR 2010-2011, EACH COVERED HOSPITAL

SHALL BE ASSESSED AN AMOUNT EQUAL TO 2.69% OF THE NET

INPATIENT REVENUE OF THE COVERED HOSPITAL,

(2) FOR FISCAL YEARS 2011-2012, 2012-2013, 2013-2014 AND

2014-2015, AN AMOUNT EQUAL TO 3.22% OF THE NET INPATIENT

REVENUE OF THE COVERED HOSPITAL.

(3) FOR FISCAL YEARS 2015-2016, 2016-2017 AND 2017-2018,

AN AMOUNT EQUAL TO 3.71% OF THE NET INPATIENT REVENUE OF THE

COVERED HOSPITAL.

(4) FOR FISCAL YEAR 2018-2019, AN AMOUNT EQUAL TO 2.98%

OF THE NET INPATIENT REVENUE OF THE COVERED HOSPITAL AND

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1.55% OF THE NET OUTPATIENT REVENUE OF THE COVERED HOSPITAL.

(5) FOR FISCAL YEARS 2019-2020, 2020-2021, 2021-2022 AND

2022-2023, AN AMOUNT EQUAL TO 3.32% OF THE NET INPATIENT

REVENUE OF THE COVERED HOSPITAL AND 1.73% OF THE NET

OUTPATIENT REVENUE OF THE COVERED HOSPITAL.

(6) FOR FISCAL YEAR 2023-2024, AN AMOUNT EQUAL TO 3.54%

OF THE NET INPATIENT REVENUE OF THE COVERED HOSPITAL AND

1.78% OF THE NET OUTPATIENT REVENUE OF THE COVERED HOSPITAL;

(7) FOR FISCAL YEARS 2024-2025, 2025-2026, 2026-2027 AND

2027-2028, AN AMOUNT EQUAL TO 4.36% OF THE NET INPATIENT

REVENUE OF THE COVERED HOSPITAL AND 2.20% OF THE NET

OUTPATIENT REVENUE OF THE COVERED HOSPITAL.

ADJUST THE ASSESSMENT PERCENTAGE SPECIFIED IN SUBSECTION (B) FOR

ALL OR PART OF THE FISCAL YEAR FOR INPATIENT SERVICES,

OUTPATIENT SERVICES OR BOTH, PROVIDED THAT, BEFORE IMPLEMENTING

AN ADJUSTMENT, THE SECRETARY SUBMITS A NOTICE TO THE LEGISLATIVE

REFERENCE BUREAU FOR PUBLICATION IN THE NEXT AVAILABLE ISSUE OF

THE PENNSYLVANIA BULLETIN THAT SPECIFIES THE PROPOSED ASSESSMENT

PERCENTAGE AND IDENTIFIES THE AGGREGATE IMPACT ON COVERED

HOSPITALS SUBJECT TO THE ASSESSMENT. INTERESTED PARTIES SHALL

HAVE 30 DAYS IN WHICH TO SUBMIT COMMENTS TO THE SECRETARY. UPON

EXPIRATION OF THE 30-DAY COMMENT PERIOD, THE SECRETARY, AFTER

CONSIDERATION OF THE COMMENTS, SHALL SUBMIT A SECOND NOTICE TO

THE LEGISLATIVE REFERENCE BUREAU FOR PUBLICATION IN THE NEXT

AVAILABLE ISSUE OF THE PENNSYLVANIA BULLETIN ANNOUNCING THE

ASSESSMENT PERCENTAGE.

(D) REBASING NET INPATIENT REVENUE AND NET OUTPATIENT

REVENUE AMOUNTS ON AMOUNTS OWED FOR FISCAL YEARS PRIOR TO 2023-

2024.--FOR PURPOSES OF CALCULATING THE ANNUAL ASSESSMENT AMOUNT

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OWED FOR FISCAL YEARS 2018-2019, 2019-2020, 2020-2021, 2021-2022

AND 2022-2023, THE SECRETARY MAY REQUIRE THE USE OF NET

INPATIENT REVENUE AND NET OUTPATIENT REVENUE AMOUNTS AS

IDENTIFIED IN THE RECORDS OF COVERED HOSPITALS FOR A STATE

FISCAL YEAR COMMENCING ON OR AFTER JULY 1, 2015. IF THE

SECRETARY DECIDES THAT THE NET INPATIENT REVENUE AND NET

OUTPATIENT REVENUE AMOUNTS SHOULD BE BASED ON A STATE FISCAL

YEAR COMMENCING ON OR AFTER JULY 1, 2015, THE SECRETARY SHALL

SUBMIT A NOTICE TO THE LEGISLATIVE REFERENCE BUREAU FOR

PUBLICATION IN THE NEXT AVAILABLE ISSUE OF THE PENNSYLVANIA

BULLETIN SPECIFYING THE STATE FISCAL YEAR FOR WHICH THE NET

INPATIENT REVENUE AND NET OUTPATIENT REVENUE AMOUNTS WILL BE

USED AT LEAST 30 DAYS PRIOR TO THE DATE ON WHICH AN ASSESSMENT

AMOUNT CALCULATED WITH THE REBASED AMOUNTS IS DUE TO BE PAID TO

THE DEPARTMENT.

(E) REBASING NET INPATIENT REVENUE AND NET OUTPATIENT

REVENUE AMOUNTS ON AMOUNTS OWED FOR FISCAL YEAR 2023-2024 AND

THEREAFTER.--FOR PURPOSES OF CALCULATING THE ANNUAL ASSESSMENT

AMOUNT OWED ON OR AFTER JULY 1, 2023, THE SECRETARY MAY REQUIRE

THE USE OF NET INPATIENT REVENUE AND NET OUTPATIENT REVENUE

AMOUNTS AS IDENTIFIED IN THE RECORDS OF COVERED HOSPITALS FOR A

STATE FISCAL YEAR COMMENCING ON OR AFTER JULY 1, 2018. IF THE

SECRETARY DECIDES THAT THE NET INPATIENT REVENUE AND NET

OUTPATIENT REVENUE AMOUNTS SHOULD BE BASED ON A STATE FISCAL

YEAR COMMENCING ON OR AFTER JULY 1, 2018, THE SECRETARY SHALL

SUBMIT A NOTICE TO THE LEGISLATIVE REFERENCE BUREAU FOR

PUBLICATION IN THE NEXT AVAILABLE ISSUE OF THE PENNSYLVANIA

BULLETIN SPECIFYING THE STATE FISCAL YEAR FOR WHICH THE NET

INPATIENT REVENUE AND NET OUTPATIENT REVENUE AMOUNTS WILL BE

USED AT LEAST 30 DAYS PRIOR TO THE DATE ON WHICH AN ASSESSMENT

20230HB1300PN1943 - 12 -

AMOUNT CALCULATED WITH THE REBASED AMOUNTS IS DUE TO BE PAID TO

THE DEPARTMENT.

(F) MAXIMUM AMOUNT.--IN EACH YEAR IN WHICH THE ASSESSMENT IS

IMPLEMENTED, THE ASSESSMENT SHALL BE SUBJECT TO THE MAXIMUM

AGGREGATE AMOUNT THAT MAY BE ASSESSED UNDER 42 CFR 433.68(F)(3)

(I) (RELATING TO PERMISSIBLE HEALTH CARE-RELATED TAXES) OR ANY

OTHER MAXIMUM ESTABLISHED UNDER FEDERAL LAW.

(G) LIMITED REVIEW.--EXCEPT AS PERMITTED UNDER SECTION 1611-

U, THE SECRETARY'S DETERMINATION OF THE ASSESSMENT PERCENTAGE

UNDER SUBSECTION (B) SHALL NOT BE SUBJECT TO ADMINISTRATIVE OR

JUDICIAL REVIEW UNDER 2 PA.C.S. CHS. 5 SUBCH. A (RELATING TO

PRACTICE AND PROCEDURE OF COMMONWEALTH AGENCIES) AND 7 SUBCH. A

(RELATING TO JUDICIAL REVIEW OF COMMONWEALTH AGENCY ACTION) OR

ANY OTHER PROVISION OF LAW. ASSESSMENTS IMPLEMENTED UNDER THIS

ARTICLE OR FORMS OR REPORTS REQUIRED TO BE COMPLETED BY COVERED

HOSPITALS IN ACCORDANCE WITH THIS ARTICLE SHALL NOT BE SUBJECT

TO THE ACT OF JULY 31, 1968 (P.L.769, NO.240), REFERRED TO AS

THE COMMONWEALTH DOCUMENTS LAW, THE ACT OF OCTOBER 15, 1980

(P.L.950, NO.164), KNOWN AS THE COMMONWEALTH ATTORNEYS ACT, AND

THE ACT OF JUNE 25, 1982 (P.L.633, NO.181), KNOWN AS THE

REGULATORY REVIEW ACT.

SECTION 1605-U. ADMINISTRATION.

(A) CALCULATION AND NOTICE OF ASSESSMENT AMOUNT.--USING THE

ASSESSMENT PERCENTAGE ESTABLISHED UNDER SECTION 1604-U AND

COVERED HOSPITALS' NET INPATIENT REVENUE AND NET OUTPATIENT

REVENUE, THE DEPARTMENT SHALL CALCULATE AND NOTIFY EACH COVERED

HOSPITAL OF THE ASSESSMENT AMOUNT OWED FOR THE FISCAL YEAR.

NOTIFICATION UNDER THIS SUBSECTION MAY BE MADE IN WRITING OR

ELECTRONICALLY, AT THE DISCRETION OF THE DEPARTMENT.

(B) CALCULATION OF ASSESSMENT WITH CHANGES OF OWNERSHIP.--

20230HB1300PN1943 - 13 -

(1) IF A SINGLE COVERED HOSPITAL CHANGES OWNERSHIP OR

CONTROL, THE DEPARTMENT SHALL CALCULATE THE ASSESSMENT AS

FOLLOWS:

(I) IF THE CHANGE OF OWNERSHIP OCCURS BEFORE JULY 1,

2018, THE DEPARTMENT SHALL CALCULATE THE ASSESSMENT USING

THE HOSPITAL'S NET INPATIENT REVENUE AND NET OUTPATIENT

REVENUE AMOUNTS FOR STATE FISCAL YEAR 2018-2019, OR A

LATER FISCAL YEAR THAT HAS BEEN SPECIFIED BY THE

SECRETARY IN ACCORDANCE WITH SECTION 1604-U(E).

(II) IF THE CHANGE OF OWNERSHIP OCCURS ON OR AFTER

JULY 1, 2018, THE DEPARTMENT SHALL CALCULATE THE

ASSESSMENT USING THE HOSPITAL'S NET INPATIENT REVENUE AND

NET OUTPATIENT REVENUE AMOUNTS FOR STATE FISCAL YEAR

2018-2019, OR A LATER FISCAL YEAR THAT HAS BEEN SPECIFIED

BY THE SECRETARY IN ACCORDANCE WITH SECTION 1604-U(E); OR

(III) IF THE NET INPATIENT REVENUE AND NET

OUTPATIENT REVENUE AMOUNTS FOR THE STATE FISCAL YEAR

2018-2019, OR A LATER FISCAL YEAR THAT HAS BEEN SPECIFIED

BY THE SECRETARY IN ACCORDANCE WITH SECTION 1604-U(E),

ARE UNAVAILABLE DUE TO A COVERED HOSPITAL'S ESTABLISHMENT

AS A NEW HOSPITAL UNDER SUBSECTION (D), THE DEPARTMENT

SHALL CALCULATE THE ASSESSMENT USING THE HOSPITAL'S NET

INPATIENT REVENUE AND NET OUTPATIENT REVENUE AMOUNTS

UNDER SUBSECTION (D).

(2) THE COVERED HOSPITAL SHALL BE LIABLE FOR ANY

OUTSTANDING ASSESSMENT AMOUNTS, INCLUDING OUTSTANDING AMOUNTS

RELATED TO PERIODS PRIOR TO THE CHANGE OF OWNERSHIP OR

CONTROL.

(3) IF TWO OR MORE HOSPITALS MERGE OR CONSOLIDATE INTO A

SINGLE COVERED HOSPITAL AS A RESULT OF A CHANGE IN OWNERSHIP

20230HB1300PN1943 - 14 -

OR CONTROL, THE DEPARTMENT SHALL CALCULATE THE ASSESSMENT

AMOUNT OWED BY THE SINGLE COVERED HOSPITAL RESULTING FROM THE

MERGER OR CONSOLIDATION AS FOLLOWS:

(I) IF THE MERGER OR CONSOLIDATION OCCURS BEFORE

JULY 1, 2018, THE DEPARTMENT SHALL CALCULATE THE

ASSESSMENT USING THE MERGED OR CONSOLIDATED HOSPITALS'

COMBINED NET INPATIENT REVENUE AND NET OUTPATIENT REVENUE

AMOUNTS FOR STATE FISCAL YEAR 2018-2019, OR A LATER

FISCAL YEAR THAT HAS BEEN SPECIFIED BY THE SECRETARY IN

ACCORDANCE WITH SECTION 1604-U(E);

(II) IF THE MERGER OR CONSOLIDATION OCCURS ON OR

AFTER JULY 1, 2018, THE DEPARTMENT SHALL CALCULATE THE

ASSESSMENT USING THE MERGED OR CONSOLIDATED HOSPITALS'

COMBINED NET INPATIENT REVENUE AND NET OUTPATIENT REVENUE

AMOUNTS FOR STATE FISCAL YEAR 2018-2019, OR A LATER

FISCAL YEAR THAT HAS BEEN SPECIFIED BY THE SECRETARY IN

ACCORDANCE WITH SECTION 1604-U(E); OR

(III) IF ONE OR MORE HOSPITALS' NET INPATIENT

REVENUE AND NET OUTPATIENT REVENUE AMOUNTS FOR THE STATE

FISCAL YEAR 2018-2019, OR A LATER FISCAL YEAR THAT HAS

BEEN SPECIFIED BY THE SECRETARY IN ACCORDANCE WITH

SECTION 1604-U(E), IS UNAVAILABLE DUE TO THE HOSPITAL'S

ESTABLISHMENT AS A NEW HOSPITAL UNDER SUBSECTION (D), THE

FOLLOWING SHALL APPLY:

(A) THE DEPARTMENT SHALL CALCULATE A NEW

HOSPITAL'S NET INPATIENT REVENUE AND NET OUTPATIENT

REVENUE AMOUNTS UNDER SUBSECTION (D).

(B) FOR A HOSPITAL THAT IS NOT A NEW HOSPITAL,

THE DEPARTMENT SHALL CALCULATE THE HOSPITAL'S NET

INPATIENT REVENUE AND NET OUTPATIENT REVENUE AMOUNTS

20230HB1300PN1943 - 15 -

FOR STATE FISCAL YEAR 2018-2019, OR A LATER FISCAL

YEAR THAT HAS BEEN SPECIFIED BY THE SECRETARY IN

ACCORDANCE WITH SECTION 1604-U(E).

CALCULATED UNDER CLAUSE (A) WITH THE AMOUNT

CALCULATED UNDER CLAUSE (B) TO DETERMINE THE COMBINED

NET INPATIENT REVENUE AND NET OUTPATIENT REVENUE

AMOUNTS FOR THE MERGED OR CONSOLIDATED HOSPITALS.

(4) A SINGLE COVERED HOSPITAL IS LIABLE FOR ANY

OUTSTANDING ASSESSMENT AMOUNTS, INCLUDING OUTSTANDING AMOUNTS

RELATED TO PERIODS PRIOR TO THE CHANGE OF OWNERSHIP OR

CONTROL, OF ANY COVERED HOSPITAL THAT WAS MERGED OR

CONSOLIDATED.

IN OPERATION.--EXCEPT AS PROVIDED IN SUBSECTION (B)(3), A

COVERED HOSPITAL THAT CLOSES OR THAT BECOMES AN EXEMPT HOSPITAL

DURING A FISCAL YEAR IS LIABLE FOR BOTH:

(1) THE ANNUAL ASSESSMENT AMOUNT FOR THE FISCAL YEAR IN

WHICH THE CLOSURE OR CHANGE OCCURS PRORATED BY THE NUMBER OF

DAYS IN THE FISCAL YEAR DURING WHICH THE COVERED HOSPITAL WAS

IN OPERATION; AND

(2) ANY OUTSTANDING ASSESSMENT AMOUNTS RELATED TO

PERIODS PRIOR TO THE CLOSURE OR CHANGE IN OPERATION.

(D) CALCULATION OF ASSESSMENT FOR NEW HOSPITALS.--A HOSPITAL

THAT BEGINS OPERATION AS A COVERED HOSPITAL AFTER JULY 1, 2018,

SHALL BE ASSESSED AS FOLLOWS:

(1) DURING THE STATE FISCAL YEAR IN WHICH A COVERED

HOSPITAL BEGINS OPERATION OR IN WHICH A HOSPITAL BECOMES A

COVERED HOSPITAL, THE COVERED HOSPITAL SHALL NOT BE SUBJECT

TO THE ASSESSMENT.

20230HB1300PN1943 - 16 -

(2) FOR THE STATE FISCAL YEAR FOLLOWING THE STATE FISCAL

YEAR UNDER PARAGRAPH (1), THE DEPARTMENT SHALL CALCULATE THE

COVERED HOSPITAL'S ASSESSMENT AMOUNT USING THE NET INPATIENT

REVENUE AND NET OUTPATIENT REVENUE FROM THE STATE FISCAL YEAR

IN WHICH THE COVERED HOSPITAL BEGAN OPERATION OR BECAME A

COVERED HOSPITAL THROUGH THE END OF THE STATE FISCAL YEAR.

(3) FOR THE STATE FISCAL YEAR FOLLOWING THE FIRST FULL

STATE FISCAL YEAR UNDER PARAGRAPH (2), THE DEPARTMENT SHALL

CALCULATE THE COVERED HOSPITAL'S ASSESSMENT AMOUNT USING THE

NET INPATIENT REVENUE AND NET OUTPATIENT REVENUE FROM THE

PRIOR STATE FISCAL YEAR. FOR SUBSEQUENT STATE FISCAL YEARS,

THE DEPARTMENT SHALL USE THE NET INPATIENT REVENUE AND NET

OUTPATIENT REVENUE CALCULATED UNDER THIS PARAGRAPH OR A LATER

FISCAL YEAR THAT HAS BEEN SPECIFIED BY THE SECRETARY IN

ACCORDANCE WITH SECTION 1604-U(E).

(4) IF ESTIMATED NET INPATIENT REVENUE AND NET

OUTPATIENT REVENUE IS USED IN CALCULATING A COVERED

HOSPITAL'S ASSESSMENT UNDER THIS SUBSECTION, THE DEPARTMENT

SHALL RECONCILE ANY AMOUNTS RECEIVED BASED ON REPORTED ACTUAL

NET INPATIENT REVENUES AND NET OUTPATIENT REVENUES.

(E) PAYMENT.--A COVERED HOSPITAL SHALL PAY THE ASSESSMENT

AMOUNT DUE FOR A FISCAL YEAR IN FOUR QUARTERLY INSTALLMENTS.

PAYMENT OF A QUARTERLY INSTALLMENT SHALL BE MADE ELECTRONICALLY

ON OR BEFORE THE FIRST DAY OF THE SECOND MONTH OF THE QUARTER OR

30 DAYS FROM THE DATE OF THE NOTICE OF THE QUARTERLY ASSESSMENT

AMOUNT, WHICHEVER IS LATER.

(F) RECORDS.--UPON REQUEST BY THE DEPARTMENT, A COVERED

HOSPITAL SHALL FURNISH TO THE DEPARTMENT ANY RECORDS AS THE

DEPARTMENT MAY SPECIFY IN ORDER FOR THE DEPARTMENT TO VALIDATE

THE NET INPATIENT REVENUE AND NET OUTPATIENT REVENUE AMOUNTS

20230HB1300PN1943 - 17 -

REPORTED BY THE COVERED HOSPITAL OR TO DETERMINE THE ASSESSMENT

FOR A FISCAL YEAR OR THE AMOUNT OF THE ASSESSMENT DUE FROM THE

COVERED HOSPITAL OR TO VERIFY THAT THE COVERED HOSPITAL HAS PAID

THE CORRECT AMOUNT DUE.

(G) UNDERPAYMENTS AND OVERPAYMENTS.--IN THE EVENT THAT THE

DEPARTMENT DETERMINES THAT A COVERED HOSPITAL HAS FAILED TO PAY

AN ASSESSMENT OR THAT THE COVERED HOSPITAL HAS UNDERPAID AN

ASSESSMENT, THE DEPARTMENT SHALL NOTIFY THE COVERED HOSPITAL IN

WRITING OF THE AMOUNT DUE, INCLUDING INTEREST, AND THE DATE ON

WHICH THE AMOUNT DUE MUST BE PAID, WHICH SHALL NOT BE LESS THAN

30 DAYS FROM THE DATE OF THE NOTICE. IN THE EVENT THAT THE

DEPARTMENT DETERMINES THAT A COVERED HOSPITAL HAS OVERPAID AN

ASSESSMENT, THE DEPARTMENT SHALL NOTIFY THE COVERED HOSPITAL IN

WRITING OF THE OVERPAYMENT AND, WITHIN 30 DAYS OF THE DATE OF

THE NOTICE OF THE OVERPAYMENT, SHALL OFFSET THE AMOUNT OF THE

OVERPAYMENT AGAINST ANY AMOUNT THAT MAY BE OWED TO THE

DEPARTMENT FROM THE COVERED HOSPITAL.

SECTION 1606-U. RESTRICTED ACCOUNT.

(A) ESTABLISHMENT.--THERE IS ESTABLISHED A RESTRICTED

ACCOUNT, KNOWN AS THE QUALITY CARE ASSESSMENT ACCOUNT, IN THE

GENERAL FUND FOR THE RECEIPT AND DEPOSIT OF REVENUES COLLECTED

UNDER THIS ARTICLE. FUNDS IN THE ACCOUNT ARE APPROPRIATED TO THE

DEPARTMENT FOR THE FOLLOWING:

(1) MAKING MEDICAL ASSISTANCE PAYMENTS TO HOSPITALS FOR

INPATIENT SERVICES IN ACCORDANCE WITH SECTION 443.1(1.1) OF

THE ACT OF JUNE 13, 1967 (P.L.31, NO.21), KNOWN AS THE HUMAN

SERVICES CODE, AND OUTPATIENT SERVICES, INCLUDING FOR

OBSERVATION SERVICES IN ACCORDANCE WITH SECTION 443.3(A)(1.1)

OF THE HUMAN SERVICES CODE AND AS OTHERWISE SPECIFIED IN THE

COMMONWEALTH'S APPROVED TITLE XIX STATE PLAN.

20230HB1300PN1943 - 18 -

(2) MAKING PAYMENTS TO MEDICAL ASSISTANCE MANAGED CARE

ORGANIZATIONS FOR ADDITIONAL PAYMENTS FOR INPATIENT HOSPITAL

SERVICES IN ACCORDANCE WITH SECTION 443.1(1.2), (1.3) AND

(1.4) OF THE HUMAN SERVICES CODE AND OUTPATIENT SERVICES.

(3) ANY OTHER PURPOSE APPROVED BY THE SECRETARY FOR

INPATIENT HOSPITAL, OUTPATIENT HOSPITAL AND HOSPITAL-RELATED

SERVICES.

(B) LIMITATIONS.--

(1) FOR THE FIRST YEAR OF THE ASSESSMENT, THE AMOUNT

USED FOR THE MEDICAL ASSISTANCE PAYMENTS FOR HOSPITALS AND

MEDICAID MANAGED CARE ORGANIZATIONS MAY NOT EXCEED THE

AGGREGATE AMOUNT OF ASSESSMENT FUNDS COLLECTED FOR THE YEAR

LESS $121,000,000.

(2) FOR THE SECOND YEAR OF THE ASSESSMENT, THE AMOUNT

USED FOR THE MEDICAL ASSISTANCE PAYMENTS FOR HOSPITALS AND

MEDICAL ASSISTANCE MANAGED CARE ORGANIZATIONS MAY NOT EXCEED

THE AGGREGATE AMOUNT OF ASSESSMENT FUNDS COLLECTED FOR THE

YEAR LESS $109,000,000.

(3) (RESERVED).

(4) FOR THE THIRD YEAR OF THE ASSESSMENT, THE AMOUNT

USED FOR THE MEDICAL ASSISTANCE PAYMENT FOR HOSPITALS AND

MEDICAL ASSISTANCE MANAGED CARE ORGANIZATIONS MAY NOT EXCEED

THE AGGREGATE AMOUNT OF THE ASSESSMENT FUNDS COLLECTED FOR

THE YEAR LESS $109,000,000.

(5) FOR STATE FISCAL YEARS 2013-2014 AND 2014-2015, THE

AMOUNT USED FOR THE MEDICAL ASSISTANCE PAYMENT FOR HOSPITALS

AND MEDICAL ASSISTANCE MANAGED CARE ORGANIZATIONS MAY NOT

EXCEED THE AGGREGATE AMOUNT OF THE ASSESSMENT FUNDS COLLECTED

FOR THE YEAR LESS $150,000,000.

(6) FOR STATE FISCAL YEARS 2015-2016, 2016-2017 AND

20230HB1300PN1943 - 19 -

2017-2018, THE AMOUNT USED FOR THE MEDICAL ASSISTANCE PAYMENT

FOR HOSPITALS AND MEDICAL ASSISTANCE MANAGED CARE

ORGANIZATIONS MAY NOT EXCEED THE AGGREGATE AMOUNT OF THE

ASSESSMENT FUNDS COLLECTED FOR THE YEAR LESS $220,000,000.

(7) FOR STATE FISCAL YEARS 2018-2019, 2019-2020 AND

2020-2021, THE AMOUNT USED FOR THE MEDICAL ASSISTANCE PAYMENT

FOR HOSPITALS AND MEDICAL ASSISTANCE MANAGED CARE

ORGANIZATIONS MAY NOT EXCEED THE AGGREGATE AMOUNT OF THE

ASSESSMENT FUNDS COLLECTED FOR THE YEAR LESS $295,000,000.

(8) FOR STATE FISCAL YEARS 2021-2022 AND 2022-2023, THE

AMOUNT USED FOR THE MEDICAL ASSISTANCE PAYMENT FOR HOSPITALS

AND MEDICAL ASSISTANCE MANAGED CARE ORGANIZATIONS MAY NOT

EXCEED THE AGGREGATE AMOUNT OF THE ASSESSMENT FUNDS COLLECTED

FOR THE YEAR LESS $300,000,000.

(9) FOR STATE FISCAL YEAR 2023-2024, THE AMOUNT USED FOR

THE MEDICAL ASSISTANCE PAYMENT FOR HOSPITALS AND MEDICAL

ASSISTANCE MANAGED CARE ORGANIZATIONS MAY NOT EXCEED THE

AGGREGATE AMOUNT OF THE ASSESSMENT FUNDS COLLECTED FOR THE

YEAR LESS $368,000,000.

(10) FOR STATE FISCAL YEARS 2024-2025, 2025-2026, 2026-

2027 AND 2027-2028, THE AMOUNT USED FOR THE MEDICAL

ASSISTANCE PAYMENT FOR HOSPITALS AND MEDICAL ASSISTANCE

MANAGED CARE ORGANIZATIONS MAY NOT EXCEED THE AGGREGATE

AMOUNT OF THE ASSESSMENT FUNDS COLLECTED FOR THE YEAR LESS

$452,000,000.

(11) THE AMOUNTS RETAINED BY THE DEPARTMENT UNDER

PARAGRAPHS (1), (2), (4), (5), (6), (7), (8), (9) AND (10)

AND ANY ADDITIONAL AMOUNTS REMAINING IN THE RESTRICTED

ACCOUNTS AFTER THE PAYMENTS DESCRIBED IN SUBSECTION (A)(1)

AND (2) ARE MADE SHALL BE USED FOR PURPOSES APPROVED BY THE

20230HB1300PN1943 - 20 -

SECRETARY UNDER SUBSECTION (A)(3), SUBJECT TO PARAGRAPH (13).

(12) NOT LATER THAN 180 DAYS FOLLOWING THE END OF THE

STATE FISCAL YEAR, THE DEPARTMENT SHALL PREPARE A REVENUE

RECONCILIATION SCHEDULE FOR THE PRIOR STATE FISCAL YEAR THAT

INCLUDES INFORMATION SUPPORTING THE AMOUNTS RECEIVED OR

DEPOSITED INTO AND PAID OUT OF THE RESTRICTED ACCOUNT TO

SUPPORT ACTUAL PAYMENTS TO HOSPITALS AND MANAGED CARE

ORGANIZATIONS IN ACCORDANCE WITH SUBSECTION (A)(1) AND (2).

(13) ANY POSITIVE BALANCE REMAINING IN THE RESTRICTED

ACCOUNT IN EXCESS OF $10,000,000 ANNUALLY THAT IS NOT USED BY

THE COMMONWEALTH TO OBTAIN FEDERAL MATCHING FUNDS AND PAID

OUT FOR HOSPITAL PAYMENTS SHALL BE FACTORED INTO THE

CALCULATION OF A NEW ASSESSMENT RATE BY REDUCING THE AMOUNT

OF HOSPITAL ASSESSMENT FUNDS THAT MUST BE GENERATED DURING

THE NEXT FISCAL YEAR IN WHICH THE DEPARTMENT IS ABLE TO

CALCULATE A NEW RATE. IF A NEW ASSESSMENT RATE IS NOT

CALCULATED, THE FUNDS REMAINING IN THE RESTRICTED ACCOUNT

SHALL BE REFUNDED TO THE COVERED HOSPITAL THAT PAID THE

ASSESSMENT IN PROPORTION TO THE COVERED HOSPITAL'S ASSESSMENT

AMOUNT PAID IN THE FISCAL YEAR.

SHALL NOT LAPSE TO THE GENERAL FUND AT THE END OF A FISCAL YEAR.

IF THIS ARTICLE EXPIRES, THE DEPARTMENT SHALL USE ANY REMAINING

FUNDS FOR THE PURPOSES STATED IN THIS SECTION UNTIL THE FUNDS IN

THE QUALITY CARE ASSESSMENT ACCOUNT ARE EXHAUSTED.

SECTION 1607-U. NO HOLD HARMLESS.

NO COVERED HOSPITAL SHALL BE DIRECTLY GUARANTEED A REPAYMENT

OF ITS ASSESSMENT IN DEROGATION OF 42 CFR 433.68(F) (RELATING TO

PERMISSIBLE HEALTH CARE-RELATED TAXES), EXCEPT THAT, IN EACH

FISCAL YEAR IN WHICH AN ASSESSMENT IS IMPLEMENTED, THE

20230HB1300PN1943 - 21 -

DEPARTMENT SHALL USE THE FUNDS RECEIVED UNDER THIS ARTICLE FOR

THE PURPOSES OUTLINED UNDER SECTION 1606-U TO THE EXTENT

PERMISSIBLE UNDER FEDERAL AND STATE LAW OR REGULATION AND

WITHOUT CREATING AN INDIRECT GUARANTEE TO HOLD HARMLESS, AS

THOSE TERMS ARE USED UNDER 42 CFR 433.68(F)(3)(I). THE SECRETARY

SHALL SUBMIT TO THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN

SERVICES ANY STATE MEDICAID PLAN AMENDMENTS THAT ARE NECESSARY

TO MAKE THE PAYMENTS AUTHORIZED UNDER SECTION 1606-U.

SECTION 1608-U. FEDERAL WAIVER.

TO THE EXTENT NECESSARY IN ORDER TO IMPLEMENT THIS ARTICLE,

THE DEPARTMENT SHALL SEEK A WAIVER UNDER 42 CFR 433.68(E)

(RELATING TO PERMISSIBLE HEALTH CARE-RELATED TAXES) FROM THE

CENTERS FOR MEDICARE AND MEDICAID SERVICES OF THE UNITED STATES

DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE DEPARTMENT SHALL

NOT IMPLEMENT THE ASSESSMENT UNTIL APPROVAL OF THE WAIVER IS

OBTAINED. UPON APPROVAL OF THE WAIVER, THE ASSESSMENT SHALL BE

IMPLEMENTED RETROACTIVE TO THE FIRST DAY OF THE FISCAL YEAR TO

WHICH THE WAIVER APPLIES.

SECTION 1609-U. TAX EXEMPTION.

(A) PROHIBITION.--NOTWITHSTANDING ANY EXEMPTIONS GRANTED BY

ANY OTHER FEDERAL, STATE OR LOCAL TAX OR OTHER LAW, NO COVERED

HOSPITAL OTHER THAN AN EXEMPT HOSPITAL SHALL BE EXEMPT FROM THE

ASSESSMENT.

(B) INTERPRETATION.--THE ASSESSMENT IMPOSED UNDER THIS

ARTICLE SHALL BE RECOGNIZED BY THE COMMONWEALTH AS UNCOMPENSATED

GOODS AND SERVICES UNDER THE ACT OF NOVEMBER 26, 1997 (P.L.508,

NO.55), KNOWN AS THE INSTITUTIONS OF PURELY PUBLIC CHARITY ACT,

AND SHALL BE CONSIDERED A COMMUNITY BENEFIT FOR PURPOSES OF ANY

REQUIRED OR VOLUNTARY COMMUNITY BENEFIT REPORT FILED OR PREPARED

BY A COVERED HOSPITAL.

20230HB1300PN1943 - 22 -

SECTION 1610-U. REMEDIES.

IN ADDITION TO ANY OTHER REMEDY PROVIDED BY LAW, THE

DEPARTMENT MAY ENFORCE THIS ARTICLE BY IMPOSING ONE OR MORE OF

THE FOLLOWING REMEDIES:

(1) WHEN A COVERED HOSPITAL FAILS TO PAY AN ASSESSMENT

OR PENALTY IN THE AMOUNT OR ON THE DATE REQUIRED BY THIS

ARTICLE, THE DEPARTMENT SHALL ADD INTEREST AT THE RATE

PROVIDED IN SECTION 806 TO THE UNPAID AMOUNT OF THE

ASSESSMENT OR PENALTY FROM THE DATE SPECIFIED FOR THE

ASSESSMENT'S PAYMENT UNTIL THE DATE ON WHICH IT IS PAID.

(2) WHEN A COVERED HOSPITAL FAILS TO FILE A REPORT OR TO

FURNISH RECORDS TO THE DEPARTMENT AS REQUIRED BY THIS

ARTICLE, THE DEPARTMENT SHALL IMPOSE A PENALTY AGAINST THE

COVERED HOSPITAL IN THE AMOUNT OF $1,000, PLUS AN ADDITIONAL

AMOUNT OF $200 PER DAY FOR EACH ADDITIONAL DAY THAT THE

FAILURE TO FILE THE REPORT OR FURNISH THE RECORDS CONTINUES.

(3) WHEN A COVERED HOSPITAL THAT IS A MEDICAL ASSISTANCE

PROVIDER, OR THAT IS RELATED THROUGH COMMON OWNERSHIP OR

CONTROL AS THOSE TERMS ARE DEFINED IN 42 CFR 413.17(B)

(RELATING TO COST TO RELATED ORGANIZATIONS) TO A MEDICAL

ASSISTANCE PROVIDER, FAILS TO PAY ALL OR PART OF AN

ASSESSMENT OR PENALTY WITHIN 60 DAYS OF THE DATE THAT PAYMENT

IS DUE, THE DEPARTMENT MAY DEDUCT THE UNPAID ASSESSMENT OR

PENALTY AND ANY INTEREST OWED THEREON FROM ANY MEDICAL

ASSISTANCE PAYMENTS DUE TO THE COVERED HOSPITAL OR TO ANY

RELATED MEDICAL ASSISTANCE PROVIDER UNTIL THE FULL AMOUNT IS

RECOVERED. THE DEDUCTION SHALL BE MADE ONLY AFTER WRITTEN

NOTICE TO THE COVERED HOSPITAL AND MEDICAL ASSISTANCE

PROVIDER AND MAY BE TAKEN IN INSTALLMENTS OVER A PERIOD OF

TIME, TAKING INTO ACCOUNT THE FINANCIAL CONDITION OF THE

20230HB1300PN1943 - 23 -

MEDICAL ASSISTANCE PROVIDER.

(4) WITHIN 60 DAYS AFTER THE END OF EACH CALENDAR

QUARTER, THE DEPARTMENT SHALL NOTIFY THE DEPARTMENT OF HEALTH

OF ANY COVERED HOSPITAL THAT HAS ASSESSMENT, PENALTY OR

INTEREST AMOUNTS THAT HAVE REMAINED UNPAID FOR 90 DAYS OR

MORE. THE DEPARTMENT OF HEALTH SHALL NOT RENEW THE LICENSE OF

THE COVERED HOSPITAL UNTIL THE DEPARTMENT NOTIFIES THE

DEPARTMENT OF HEALTH THAT THE COVERED HOSPITAL HAS PAID THE

OUTSTANDING AMOUNT IN ITS ENTIRETY OR THAT THE DEPARTMENT HAS

AGREED TO PERMIT THE COVERED HOSPITAL TO REPAY THE

OUTSTANDING AMOUNT IN INSTALLMENTS AND THAT, TO DATE, THE

COVERED HOSPITAL HAS PAID THE INSTALLMENTS IN THE AMOUNT AND

BY THE DATE REQUIRED BY THE DEPARTMENT.

(5) THE SECRETARY MAY WAIVE ALL OR PART OF THE INTEREST

OR PENALTIES ASSESSED AGAINST A COVERED HOSPITAL IN

ACCORDANCE WITH THIS ARTICLE FOR GOOD CAUSE AS SHOWN BY THE

COVERED HOSPITAL.

SECTION 1611-U. REQUEST FOR REVIEW.

A COVERED HOSPITAL THAT IS AGGRIEVED BY A DETERMINATION OF

THE DEPARTMENT AS TO THE AMOUNT OF THE ASSESSMENT DUE FROM THE

COVERED HOSPITAL OR A REMEDY IMPOSED UNDER SECTION 1610-U MAY

FILE A REQUEST FOR REVIEW OF THE DECISION OF THE DEPARTMENT BY

THE BUREAU OF HEARINGS AND APPEALS, WHICH SHALL HAVE EXCLUSIVE

JURISDICTION IN SUCH MATTERS. THE PROCEDURES AND REQUIREMENTS OF

67 PA.C.S. CH. 11 (RELATING TO MEDICAL ASSISTANCE HEARINGS AND

APPEALS) SHALL APPLY TO REQUESTS FOR REVIEW FILED IN ACCORDANCE

WITH THIS SECTION, EXCEPT THAT, IN THE REQUEST FOR REVIEW, A

COVERED HOSPITAL MAY NOT CHALLENGE AN ASSESSMENT PERCENTAGE

DETERMINED BY THE SECRETARY UNDER SECTION 1604-U(B) BUT ONLY

WHETHER THE DEPARTMENT CORRECTLY DETERMINED THE ASSESSMENT

20230HB1300PN1943 - 24 -

AMOUNT DUE FROM THE COVERED HOSPITAL USING THE ASSESSMENT

PERCENTAGE IN EFFECT FOR THE FISCAL YEAR. A NOTICE OF REVIEW

FILED UNDER THIS SECTION SHALL NOT OPERATE AS A STAY OF THE

COVERED HOSPITAL'S OBLIGATION TO PAY THE ASSESSMENT AMOUNT DUE

FOR A FISCAL YEAR AS SPECIFIED IN SECTION 1605-U(E) .

SECTION 1612-U. LIENS.

ANY ASSESSMENTS IMPLEMENTED AND INTEREST AND PENALTIES

ASSESSED AGAINST A COVERED HOSPITAL UNDER THIS ARTICLE SHALL BE

A LIEN ON THE REAL AND PERSONAL PROPERTY OF THE COVERED HOSPITAL

IN THE MANNER PROVIDED BY SECTION 1401, MAY BE ENTERED BY THE

DEPARTMENT IN THE MANNER PROVIDED BY SECTION 1404 AND SHALL

CONTINUE AND RETAIN PRIORITY IN THE MANNER PROVIDED IN SECTION

1404.1.

SECTION 1613-U. REGULATIONS.

THE DEPARTMENT MAY PROMULGATE REGULATIONS AND ISSUE ORDERS AS

MAY BE NECESSARY TO IMPLEMENT THE ASSESSMENT IN ACCORDANCE WITH

THE REQUIREMENTS OF THIS ARTICLE.

SECTION 1614-U. CONDITIONS FOR PAYMENTS.

THE DEPARTMENT SHALL NOT BE REQUIRED TO MAKE PAYMENTS AS

SPECIFIED IN SECTION 443.1(1.1), (1.2), (1.3) AND (1.4) OF THE

ACT OF JUNE 13, 1967 (P.L.31, NO. 21), KNOWN AS THE HUMAN

SERVICES CODE, AND A COVERED HOSPITAL SHALL NOT BE REQUIRED TO

PAY THE ASSESSMENT AS SPECIFIED IN SECTION 1605-U(E) UNLESS ALL

OF THE FOLLOWING HAVE OCCURRED:

(1) THE DEPARTMENT RECEIVES FEDERAL APPROVAL OF A WAIVER

UNDER 42 CFR 433.68(E) (RELATING TO PERMISSIBLE HEALTH CARE-

RELATED TAXES) AUTHORIZING THE DEPARTMENT TO IMPLEMENT THE

ASSESSMENT AS SPECIFIED IN THIS ARTICLE.

(2) THE DEPARTMENT RECEIVES FEDERAL APPROVAL OF A STATE

PLAN AMENDMENT AUTHORIZING THE CHANGES TO ITS PAYMENT METHODS

20230HB1300PN1943 - 25 -

AND STANDARDS SPECIFIED IN SECTION 443.1(1.1)(II) OF THE

HUMAN SERVICES CODE.

(3) THE DEPARTMENT RECEIVES FEDERAL APPROVAL OF

AMENDMENTS TO ITS MEDICAL ASSISTANCE MANAGED CARE

ORGANIZATION CONTRACTS AUTHORIZING ADJUSTMENTS TO ITS

CAPITATION PAYMENTS FUNDED IN ACCORDANCE WITH SECTION 1606-U.

SECTION 1615-U. REPORT.

NOT LATER THAN 180 DAYS PRIOR TO THE EXPIRATION DATE

SPECIFIED IN SECTION 1616-U, THE DEPARTMENT SHALL PREPARE AND

SUBMIT A REPORT TO THE CHAIRPERSON AND MINORITY CHAIRPERSON OF

THE APPROPRIATIONS COMMITTEE OF THE SENATE, THE CHAIRPERSON AND

MINORITY CHAIRPERSON OF THE APPROPRIATIONS COMMITTEE OF THE

HOUSE OF REPRESENTATIVES, THE CHAIRPERSON AND MINORITY

CHAIRPERSON OF THE HEALTH AND HUMAN SERVICES COMMITTEE OF THE

SENATE AND THE CHAIRPERSON AND MINORITY CHAIRPERSON OF THE HUMAN

SERVICES COMMITTEE OF THE HOUSE OF REPRESENTATIVES. THE REPORT

SHALL INCLUDE THE FOLLOWING:

(1) THE NAME, ADDRESS AND AMOUNT OF ASSESSMENT FOR EACH

COVERED HOSPITAL SUBJECT TO THE ASSESSMENT.

(2) THE TOTAL AMOUNT OF ASSESSMENT REVENUE COLLECTED FOR

EACH YEAR.

(3) THE AMOUNT OF ASSESSMENT PAID BY EACH COVERED

HOSPITAL, INCLUDING ANY INTEREST AND PENALTIES PAID.

(4) THE NAME AND ADDRESS OF EACH HOSPITAL RECEIVING

SUPPLEMENTAL PAYMENTS INSTITUTED AS A RESULT OF THE

ASSESSMENT.

(5) THE PAYMENT AMOUNT AND TYPE OF SUPPLEMENTAL PAYMENT

RECEIVED BY EACH HOSPITAL.

(6) THE TOTAL AMOUNT OF FEE-FOR-SERVICE INPATIENT ACUTE

CARE PAYMENT MADE TO EACH HOSPITAL.

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(7) THE NUMBER OF MEDICAL ASSISTANCE PATIENT DAYS AND

DISCHARGES BY HOSPITAL.

(8) ANY PROPOSED CHANGES TO THE PAYMENT METHODOLOGIES

AND STANDARDS.

SECTION 1616-U. EXPIRATION.

THE ASSESSMENT UNDER THIS ARTICLE SHALL EXPIRE JUNE 30, 2028.

ARTICLE XVI-W

PENNSYLVANIA LONG-TERM CARE COUNCIL

SECTION 1601-W. DEFINITIONS.

THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS ARTICLE

SHALL HAVE THE MEANINGS GIVEN TO THEM IN THIS SECTION UNLESS THE

CONTEXT CLEARLY INDICATES OTHERWISE:

"COUNCIL." THE PENNSYLVANIA LONG-TERM CARE COUNCIL

ESTABLISHED UNDER SECTION 1602-W(A).

"DEPARTMENT." THE DEPARTMENT OF AGING OF THE COMMONWEALTH.

SECTION 1602-W. PENNSYLVANIA LONG-TERM CARE COUNCIL.

(A) ESTABLISHMENT.--THE PENNSYLVANIA LONG-TERM CARE COUNCIL

IS ESTABLISHED WITHIN THE DEPARTMENT.

(B) MEMBERSHIP.--THE COUNCIL SHALL BE COMPOSED OF AND

APPOINTED IN ACCORDANCE WITH THE FOLLOWING:

(1) THE SECRETARY OF AGING.

(2) THE SECRETARY OF HEALTH.

(3) THE SECRETARY OF HUMAN SERVICES.

(4) THE INSURANCE COMMISSIONER.

(5) THE ADJUTANT GENERAL.

(6) THE SECRETARY OF TRANSPORTATION.

(7) THE EXECUTIVE DIRECTOR OF THE PENNSYLVANIA HOUSING

FINANCE AGENCY.

(8) TWO MEMBERS OF THE SENATE, ONE APPOINTED BY THE

PRESIDENT PRO TEMPORE AND ONE APPOINTED BY THE MINORITY

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LEADER.

(9) TWO MEMBERS OF THE HOUSE OF REPRESENTATIVES, ONE

APPOINTED BY THE SPEAKER OF THE HOUSE OF REPRESENTATIVES AND

ONE APPOINTED BY THE MINORITY LEADER.

(10) THE FOLLOWING MEMBERS TO BE APPOINTED BY THE

GOVERNOR, IN CONSULTATION WITH THE SECRETARY OF AGING:

(I) ONE REPRESENTATIVE FROM THE PENNSYLVANIA COUNCIL

ON AGING.

(II) ONE MEMBER WHO REPRESENTS THE LOCAL AREA

AGENCIES ON AGING.

(III) SIX MEMBERS WHO REPRESENT CONSUMER ADVOCACY

GROUPS, WITH AT LEAST TWO BEING CONSUMERS OF LONG-TERM

CARE SERVICES.

(IV) ONE MEMBER WHO REPRESENTS THE ELDER LAW SECTION

OF THE PENNSYLVANIA BAR ASSOCIATION.

(V) ONE MEMBER WHO IS A LICENSED INSURANCE PRODUCER

WITH AT LEAST 10 YEARS' EXPERIENCE IN THE LONG-TERM CARE

INSURANCE MARKET.

(VI) SEVEN MEMBERS WHO REPRESENT PROVIDERS

THROUGHOUT THE LONG-TERM CARE CONTINUUM, WITH NO MORE

THAN ONE MEMBER REPRESENTING A SINGLE PROVIDER GROUP, AS

FOLLOWS:

(A) ONE MEMBER REPRESENTING NONPROFIT SKILLED

NURSING FACILITIES.

(B) ONE MEMBER REPRESENTING FOR-PROFIT SKILLED

NURSING FACILITIES.

RESIDENCES OR PERSONAL CARE HOMES.

(D) ONE MEMBER REPRESENTING HOME CARE OR

HOSPICE.

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(E) ONE MEMBER REPRESENTING OLDER ADULT DAILY

LIVING CENTERS.

(F) ONE MEMBER REPRESENTING SENIOR COMMUNITY

CENTERS.

(G) ONE MEMBER REPRESENTING LONG-TERM CARE

MANAGED CARE.

(VII) TWO MEMBERS WITH CAREGIVER EXPERIENCE, AT

LEAST ONE OF WHOM HAS PERSONAL EXPERIENCE AS A FAMILY

CAREGIVER.

(VIII) TWO MEMBERS WHO REPRESENT THE MEDICAL

COMMUNITY, ONE OF WHOM MUST BE A PHYSICIAN WITH AT LEAST

FIVE YEARS' EXPERIENCE IN A LONG-TERM CARE SETTING AND

THE OTHER OF WHOM MUST BE A NURSE WITH AT LEAST FIVE

YEARS' EXPERIENCE IN A LONG-TERM CARE SETTING.

(IX) TWO MEMBERS WHO REPRESENT AN ACADEMIC RESEARCH

INSTITUTION.

(X) ONE MEMBER WHO REPRESENTS THE COUNTY

COMMISSIONERS ASSOCIATION OF PENNSYLVANIA.

(XI) THE CHAIR OF THE STATE VETERANS COMMISSION OR A

DESIGNEE.

(XII) ONE MEMBER WHO REPRESENTS THE OFFICE OF THE

STATE LONG-TERM CARE OMBUDSMAN WITHIN THE DEPARTMENT.

GOVERNMENTAL MEMBERS MAY APPOINT A DESIGNEE TO ATTEND AND VOTE

AT MEETINGS OF THE COUNCIL. EACH GOVERNMENTAL MEMBER WHO

APPOINTS A DESIGNEE SHALL DO SO BY SENDING A LETTER TO THE

CHAIRPERSON STATING THE NAME OF THAT DESIGNEE.

(D) CHAIRPERSON.--THE SECRETARY OF AGING SHALL SERVE AS

CHAIRPERSON.

(E) EXECUTIVE DIRECTOR.--THE SECRETARY OF AGING SHALL

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APPOINT AN EXECUTIVE DIRECTOR OF THE COUNCIL.

(F) TERMS OF MEMBERS.--

(1) THE TERMS OF THOSE MEMBERS WHO SERVE IN ACCORDANCE

WITH SUBSECTION (B)(1), (2), (3), (4), (5), (6) AND (7) SHALL

BE CONCURRENT WITH THEIR SERVICE IN THE OFFICE FROM WHICH

THEY DERIVE THEIR MEMBERSHIP.

(2) MEMBERS APPOINTED IN ACCORDANCE WITH SUBSECTION (B)

(8) AND (9) SHALL SERVE TERMS CONTERMINOUS WITH THEIR

RESPECTIVE APPOINTING AUTHORITIES.

(3) OF THE MEMBERS APPOINTED BY THE GOVERNOR, NO LESS

THAN ONE-THIRD OF THE MEMBERS SHALL BE APPOINTED TO SERVE A

TWO-YEAR INITIAL TERM, NO LESS THAN ONE-THIRD OF THE MEMBERS

SHALL BE APPOINTED TO SERVE A THREE-YEAR INITIAL TERM, AND

THE REMAINING MEMBERS SHALL SERVE A FOUR-YEAR TERM. MEMBERS

OF THE COUNCIL SHALL SERVE FOR TERMS OF FOUR YEARS AFTER

COMPLETION OF THE INITIAL TERMS AS DESIGNATED IN THIS

SECTION.

(4) MEMBERS SHALL BE ELIGIBLE FOR REAPPOINTMENT BUT

SHALL SERVE NO MORE THAN TWO CONSECUTIVE FULL TERMS. MEMBERS

SHALL SERVE UNTIL THEIR SUCCESSORS ARE APPOINTED AND

QUALIFIED, PROVIDED THEY REPRESENT THE INTERESTS OF THE

MEMBERSHIP CLASS FOR WHICH THEY WERE APPOINTED.

(G) VACANCIES.--ANY VACANCY ON THE COUNCIL SHALL BE FILLED

BY THE ORIGINAL APPOINTING AUTHORITY. AN INDIVIDUAL APPOINTED TO

FILL A VACANCY SHALL SERVE THE BALANCE OF THE PREVIOUS MEMBER'S

TERM.

(H) REMOVAL.--IN ADDITION TO THE PROVISIONS OF SUBSECTION

(F)(1) AND (2), MEMBERS MAY BE REMOVED FROM THE BOARD FOR THE

FOLLOWING REASONS:

(1) A MEMBER WHO FAILS TO ATTEND THREE CONSECUTIVE

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MEETINGS SHALL FORFEIT HIS OR HER SEAT UNLESS THE CHAIRMAN,

UPON WRITTEN REQUEST FROM THE MEMBER, FINDS THAT THE MEMBER

SHOULD BE EXCUSED FROM A MEETING.

(2) A MEMBER SHALL FORFEIT HIS OR HER SEAT IF HE OR SHE

NO LONGER REPRESENTS THE INTERESTS OF THE MEMBERSHIP CLASS

FOR WHICH HE OR SHE WAS APPOINTED. SPECIFICALLY, A MEMBER

MEETING THIS THRESHOLD SHALL NO LONGER BE EMPLOYED OR

ASSOCIATED WITH THE INTERESTS OF THE RESPECTIVE QUALIFICATION

FOR WHICH HE OR SHE WAS APPOINTED.

(I) EXPENSES.--MEMBERS MAY NOT RECEIVE COMPENSATION OR

REMUNERATION FOR THEIR SERVICE AS COUNCIL MEMBERS OR AS

COMMITTEE MEMBERS. NONGOVERNMENTAL COUNCIL MEMBERS SHALL BE

ENTITLED TO REIMBURSEMENT FOR TRAVEL AND RELATED ACTUAL EXPENSES

ACCRUED IN THE PERFORMANCE OF THEIR DUTIES AS MEMBERS, IN

ACCORDANCE WITH COMMONWEALTH TRAVEL POLICY. COMMITTEE MEMBERS

WHO ARE NOT MEMBERS OF THE COUNCIL MAY NOT RECEIVE

REIMBURSEMENT.

SECTION 1603-W. POWERS AND DUTIES OF COUNCIL.

(A) GENERAL RULE.--THE COUNCIL SHALL HAVE THE FOLLOWING

POWERS AND DUTIES:

(1) TO CONSULT WITH VARIOUS DEPARTMENTS AND AGENCIES AND

TO MAKE RECOMMENDATIONS ON REGULATIONS, LICENSURE, FINANCING

OR ANY OTHER RESPONSIBILITIES OF THOSE DEPARTMENTS OR

AGENCIES RELATING TO LONG-TERM CARE.

(2) TO PERFORM SUCH OTHER DUTIES AS THE GOVERNOR MAY

ASSIGN RELATING TO LONG-TERM CARE.

(3) TO APPROVE REPORTS PRODUCED BY ANY COMMITTEE

ESTABLISHED UNDER SECTION 1604-W BEFORE RELEASE TO THE PUBLIC

OR THE GENERAL ASSEMBLY.

(4) TO DEVELOP AND ADOPT RULES FOR CONDUCTING COUNCIL

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