Health care delivery and access assessment; rate and

calculation; notification. A. Except as otherwise provided in Subsection C of this section, an assessment is imposed on inpatient hospital services and outpatient hospital services provided by an eligible hospital. The assessment rate and assessment amounts shall be annually calculated by the authority pursuant to Subsection D of this section, and the taxation and revenue department shall collect the assessment. The inpatient assessment shall be based on assessed days and the outpatient assessment shall be based on assessed outpatient revenue. The assessment provided by this section may be referred to as the "health care delivery and access assessment". B. The rate of the health care delivery and access assessment on a rural hospital and special hospital shall be reduced by fifty percent, and the rate of the assessment on a small urban hospital shall be reduced by ninety percent; provided that the amount of the assessment qualifies for a waiver of the uniformity requirement for provider assessment from the centers for medicare and medicaid services. The authority may adjust these percentages and establish eligibility requirements as necessary to qualify for the waiver. C. The health care delivery and access assessment shall not be imposed for any period for which the centers for medicare and medicaid services has not approved a necessary waiver or other applicable authorization required to ensure that the assessment is a permissible source of non-federal funding for medicaid program expenditures, or for which the centers for medicare and medicaid services has not approved the distribution of the medicaid-directed payment program payments. D. The authority shall annually calculate the health care delivery and access assessment amount to be paid by each eligible hospital and shall annually notify the taxation and revenue department and all hospitals of the applicable rates. The authority shall calculate the assessment amount by applying the assessment rate to an eligible hospital's assessed days and assessed outpatient revenue so that total revenue from the assessment will equal the lesser of: (1) the amount needed, in combination with other funds deposited or expected to be deposited in the health care delivery and access fund for the subsequent fiscal year, including unexpended and unencumbered money in the fund, to provide sufficient funding for: (a) the non-federal share of medicaid-directed payment program payments for inpatient and outpatient hospital services for eligible hospitals at a level such that the total reimbursement for medicaid managed care patients, including any other inpatient or outpatient hospital directed payments, is equivalent to the average commercial rate or such other maximum level as may be set by the centers for medicare and medicaid services; and (b) the purposes of the health care delivery and access fund; or (2) the amount specified in Section 1903(w)(4)(C)(ii) of the federal Social Security Act, above which an indirect guarantee is determined to exist, with such amount determined each year based on the most recent available net patient revenue data. E. The authority shall notify an eligible hospital and the taxation and revenue department of the health care delivery and access assessment amount for the eligible hospital pursuant to the following schedule: (1) by November 1, 2024 for the period beginning on July 1, 2024 and ending on December 31, 2024; provided that the assessment amount shall be based on assessed days and assessed outpatient revenue for a full year; and (2) by November 1 of the preceding calendar year for each calendar year thereafter. F. The authority may require hospitals, regardless of whether they are eligible hospitals, to report information or data necessary to implement and administer the Health Care Delivery and Access Act. If the authority requires such reporting, it shall specify the frequency and due dates. G. The authority shall determine how the health care delivery and access assessment is applied to newly created hospitals and hospitals that are merged, acquired or closed. H. A hospital shall not specifically list the cost of the health care delivery and access assessment on any invoice, claim or statement sent to a patient, insurer, self-insured employer program or other responsible party.