Code of the District of Columbia

Chapter 6A. Medicaid Hospital Outpatient Supplemental Payments and Medicaid Hospital Inpatient Rate Supplements.


Subchapter I. 2013 - 2014 Medicaid Hospital Inpatient Rate Supplement. [Expired]

§ 44–631. Definitions. [Expired]

Expired.


(Sept. 24, 2010, D.C. Law 18-223, § 5012, 57 DCR 6242.)

Emergency Legislation

For temporary (90 day) addition, see § 1102 of Fiscal Year 2010 Balanced Budget Support Emergency Act of 2010 (D.C. Act 18-450, June 28, 2010, 57 DCR 5635).

For temporary (90 day) addition, see § 5012 of Fiscal Year 2011 Budget Support Emergency Act of 2010 (D.C. Act 18-463, July 2, 2010, 57 DCR 6542).

For temporary (90 day) addition, see §§ 1102 of Fiscal Year 2010 Balanced Budget Support Congressional Review Emergency Act of 2010 (D.C. Act 18-531, August 6, 2010, 57 DCR 8109).

Temporary Legislation

Section 1102 of D.C. Law 18-222 added a section to read as follows:

“Sec. 1102. Definitions.

“For the purposes of this act, the term:

“(1) ‘Hospital’ has the same meaning as set forth in section 2(a)(1) of the Health-Care and Community Residence Facility, Hospice and Home Care Licensure Act of 1983, effective February 24, 1984 (D.C. Law 5-48; D.C. Official Code § 44-501(a)(1)), but excludes St. Elizabeths Hospital and any hospital operated by the federal government.

“(2) ‘Medicaid’ means the medical assistance programs authorized by title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C.§ 1396 et seq.), and by section 1 of An Act To enable the District of Columbia to receive Federal financial assistance under title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02), and administered by the Department of Health Care Finance.”

Section 2002(b) of D.C. Law 18-222 provided that the act shall expire after 225 days of its having taken effect.


§ 44–632. Hospital Fund. [Expired]

Expired.


(Sept. 24, 2010, D.C. Law 18-223, § 5013, 57 DCR 6242.)

Section References

This section is referenced in § 44-633.

Emergency Legislation

For temporary (90 day) addition, see § 1103 of Fiscal Year 2010 Balanced Budget Support Emergency Act of 2010 (D.C. Act 18-450, June 28, 2010, 57 DCR 5635).

For temporary (90 day) addition, see § 5013 of Fiscal Year 2011 Budget Support Emergency Act of 2010 (D.C. Act 18-463, July 2, 2010, 57 DCR 6542).

For temporary (90 day) addition, see § 1103 of Fiscal Year 2010 Balanced Budget Support Congressional Review Emergency Act of 2010 (D.C. Act 18-531, August 6, 2010, 57 DCR 8109).

Temporary Legislation

Section 1103 of D.C. Law 18-222 added a section to read as follows:

“Sec. 1103. Hospital Fund.

“(a) There is established as a nonlapsing fund the Hospital Fund, which shall be used solely to fund District State Medicaid services.

“(b) There shall be deposited into the Hospital Fund:

“(1) Assessments collected under this act;

“(2) Interest and penalties collected under this act;

“(3) Matching federal funds on assessments; and

“(4) Other amounts collected under this act.

“(c) All funds deposited in the Hospital Fund, and any interest earned on those funds, shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time, but shall be continually available for the purpose set forth in subsection (a) of this section without regard to fiscal year limitation, subject to authorization by Congress.”

Section 2002(b) of D.C. Law 18-222 provided that the act shall expire after 225 days of its having taken effect.


§ 44–633. Assessments on hospitals. [Expired]

Expired.


(Sept. 24, 2010, D.C. Law 18-223, § 5014, 57 DCR 6242; Apr. 8, 2011, D.C. Law 18-370, § 512, 58 DCR 1008; Sept. 14, 2011, D.C. Law 19-21, § 8182, 58 DCR 6226; Sept. 26, 2012, D.C. Law 19-171, § 111, 59 DCR 6190.)

Effect of Amendments

D.C. Law 18-370, in subsec. (a)(2), substituted “$2,000” for “$1,500”.

D.C. Law 19-21, in subsec. (a)(2), substituted “For fiscal year 2011, $2,529 per licensed bed and for fiscal years 2012 through 2014, $3,788 per licensed bed, ” for “For fiscal years 2011 through 2014, $1,500 per licensed bed,”.

The 2012 amendment by D.C. Law 19-171 made a technical correction to D.C. Law 19-21 which did not affect this section as codified.

Emergency Legislation

For temporary (90 day) addition, see § 1104 of Fiscal Year 2010 Balanced Budget Support Emergency Act of 2010 (D.C. Act 18-450, June 28, 2010, 57 DCR 5635).

For temporary (90 day) addition, see § 5014 of Fiscal Year 2011 Budget Support Emergency Act of 2010 (D.C. Act 18-463, July 2, 2010, 57 DCR 6542).

For temporary (90 day) addition, see §§ 1104 of Fiscal Year 2010 Balanced Budget Support Congressional Review Emergency Act of 2010 (D.C. Act 18-531, August 6, 2010, 57 DCR 8109).

For temporary (90 day) amendment of section, see § 512 of Fiscal Year 2011 Supplemental Budget Support Emergency Act of 2010 (D.C. Act 18-694, January 19, 2011, 58 DCR 662).

Temporary Legislation

Section 1104 of D.C. Law 18-222 added a section to read as follows:

“Sec. 1104. Assessments on hospitals.

“(a) Each hospital in the District of Columbia shall pay to the Mayor an annual assessment as follows:

“(1) For fiscal year 2010, $500 per licensed bed, which shall be paid by September 1, 2010, and which shall be deposited in the Medical Liability Captive Trust Fund, established by section 12 of the District of Columbia Medical Liability Captive Insurance Agency Establishment Act of 2008, effective July 18, 2008 (D.C. Law 17-196; D.C. Official Code § 1-307.91), to be used for the purposes of this fund.

“(2) For fiscal years 2011 through 2014, $1,500 per licensed bed, which shall be paid based on a schedule determined by the Mayor and which shall be deposited in the Hospital Fund, established by section 1103 to be used for the purpose of this fund.

“(b) The Chief Financial Officer may determine the manner in which payments are to be made under this act, including whether payments owed by each hospital pursuant to subsection (a) of this section shall be paid electronically.”

Section 2002(b) of D.C. Law 18-222 provided that the act shall expire after 225 days of its having taken effect.

Short Title

Short title: Section 511 of D.C. Law 18-370 provided that subtitle B of title V of the act may be cited as “Hospital Assessment Amendment Act of 2010”.

Short title: Section 8181 of D.C. Law 19-21 provided that subtitle S of title VIII of the act may be cited as “Hospital Assessment Amendment Act of 2011”.

Editor's Notes

Section 513 of D.C. Law 18-370 provided: “Sec. 513. Applicability. This subtitle shall apply as of October 1, 2010.”


§ 44–634. Interest and penalties. [Expired]

Expired.


(Sept. 24, 2010, D.C. Law 18-223, § 5015, 57 DCR 6242.)

Emergency Legislation

For temporary (90 day) addition, see § 1105 of Fiscal Year 2010 Balanced Budget Support Emergency Act of 2010 (D.C. Act 18-450, June 28, 2010, 57 DCR 5635).

For temporary (90 day) addition, see § 5015 of Fiscal Year 2011 Budget Support Emergency Act of 2010 (D.C. Act 18-463, July 2, 2010, 57 DCR 6542).

For temporary (90 day) addition, see §§ 1104 of Fiscal Year 2010 Balanced Budget Support Congressional Review Emergency Act of 2010 (D.C. Act 18-531, August 6, 2010, 57 DCR 8109).

For temporary (90 day) amendment of section, see § 512 of Fiscal Year 2011 Supplemental Budget Support Emergency Act of 2010 (D.C. Act 18-694, January 19, 2011, 58 DCR 662).

For temporary (90 day) amendment of section, see § 8032 of Fiscal Year 2012 Budget Support Emergency Act of 2011 (D.C. Act 19-93, June 29, 2011, 58 DCR 5599).

Temporary Legislation

Section 1105 of D.C. Law 18-222 added a section to read as follows:

“Sec. 1105. Interest and penalties.

“(a) If a hospital fails to pay the full amount of an assessment by the date required by this act, or by rules issued pursuant to this act, the hospital shall pay, in addition to the required assessment:

“(1) Interest at the rate of 1.5% of the assessment per month or any fraction thereof, which shall be added to the unpaid balance; and

“(2) An administrative penalty of 10% of the assessment.

“(b) The District of Columbia shall have a lien upon a hospital’s real and personal property located in the District of Columbia for any assessments, interest, or administrative penalties that are due under this act, or rules issued pursuant to this act.

“(c) An action brought to enforce the provisions of this section shall be brought in the Superior Court of the District of Columbia by the Attorney General for the District of Columbia in the name of the District of Columbia.”

Section 2002(b) of D.C. Law 18-222 provided that the act shall expire after 225 days of its having taken effect.


§ 44–635. Appeals. [Expired]

Expired.


(Sept. 24, 2010, D.C. Law 18-223, § 5016, 57 DCR 6242.)

Emergency Legislation

For temporary (90 day) addition, see § 1106 of Fiscal Year 2010 Balanced Budget Support Emergency Act of 2010 (D.C. Act 18-450, June 28, 2010, 57 DCR 5635).

For temporary (90 day) addition, see § 5016 of Fiscal Year 2011 Budget Support Emergency Act of 2010 (D.C. Act 18-463, July 2, 2010, 57 DCR 6542).

For temporary (90 day) addition, see §§ 1106 of Fiscal Year 2010 Balanced Budget Support Congressional Review Emergency Act of 2010 (D.C. Act 18-531, August 6, 2010, 57 DCR 8109).

Temporary Legislation

Section 1106 of D.C. Law 18-222 added a section to read as follows:

“Sec. 1106. Appeals.

“(a) A hospital may contest the amount of an assessment, including any interest or administrative penalties, imposed under this act, or by rules issued pursuant to this act, by filing a notice of appeal with the Office of Administrative Hearings within 60 days after the date of the notice of a determination or redetermination of an assessment based on an audit of information.

“(b) The Office of Administrative Hearings shall conduct a hearing on the appeal filed under subsection (a) of this section subject to the provisions of Title I of the District of Columbia Administrative Procedure Act, approved October 21, 1968 (82 Stat. 1204; D.C. Official Code § 2-501 et seq.), governing adjudication of contested cases, and pursuant to the rules of the Office of Administrative Hearings.

“(c) Before filing an appeal pursuant to subsection (a) of this section, the hospital shall pay to the Mayor the assessment and any administrative penalties and interest due on the assessment. The filing of a notice of appeal shall not act as a stay on the requirement to pay payment of the assessment, interest, and administrative penalties.”

Section 2002(b) of D.C. Law 18-222 provided that the act shall expire after 225 days of its having taken effect.


§ 44–636. Federal determinations; suspension and termination of assessment. [Expired]

Expired.


(Sept. 24, 2010, D.C. Law 18-223, § 5017, 57 DCR 6242.)

Emergency Legislation

For temporary (90 day) addition, see § 1107 of Fiscal Year 2010 Balanced Budget Support Emergency Act of 2010 (D.C. Act 18-450, June 28, 2010, 57 DCR 5635).

For temporary (90 day) addition, see § 5017 of Fiscal Year 2011 Budget Support Emergency Act of 2010 (D.C. Act 18-463, July 2, 2010, 57 DCR 6542).

For temporary (90 day) addition, see §§ 1107 of Fiscal Year 2010 Balanced Budget Support Congressional Review Emergency Act of 2010 (D.C. Act 18-531, August 6, 2010, 57 DCR 8109).

Temporary Legislation

Section 1107 of D.C. Law 18-222 added a section to read as follows:

“Sec. 1107. Federal determinations; suspension and termination of assessment.

“(a) If the federal government determines that an assessment imposed on a hospital pursuant to this act does not satisfy the requirements for federal financial participation set forth in section 1903(w) of the Social Security Act, approved July 30, 1965 (70 Stat. 349; 42 U.S.C. § 1396b(w)), the determination shall not affect the validity, amount, applicable rate, or any other terms of an assessment on other hospitals imposed by this act.

“(b) If the federal government determines that an exclusion for hospitals specified under this act would prevent an assessment imposed by this act from qualifying as a broad-based health care related tax, as that term is defined in section 1903(w)(3)(B) of the Social Security Act, approved July 30, 1965 (79 Stat. 349; 42 U.S.C. § 1396b(w)(3)(B)), the exclusion shall not be made.”

Section 2002(b) of D.C. Law 18-222 provided that the act shall expire after 225 days of its having taken effect.


§ 44–637. Rules. [Expired]

Expired.


(Sept. 24, 2010, D.C. Law 18-223, § 5018, 57 DCR 6242.)

Emergency Legislation

For temporary (90 day) addition, see § 1108 of Fiscal Year 2010 Balanced Budget Support Emergency Act of 2010 (D.C. Act 18-450, June 28, 2010, 57 DCR 5635).

For temporary (90 day) addition, see § 5018 of Fiscal Year 2011 Budget Support Emergency Act of 2010 (D.C. Act 18-463, July 2, 2010, 57 DCR 6542).

For temporary (90 day) addition, see §§ 1108 of Fiscal Year 2010 Balanced Budget Support Congressional Review Emergency Act of 2010 (D.C. Act 18-531, August 6, 2010, 57 DCR 8109).

Temporary Legislation

Section 1108 of D.C. Law 18-222 added a section to read as follows: “Sec. 1108. Rules. ”The Mayor, pursuant to Title I of the District of Columbia Administrative Procedure Act, approved October 21, 1968 (82 Stat. 1204; D.C. Official Code § 2-501 et seq.), may issue rules to implement the provisions of this act.”

Section 2002(b) of D.C. Law 18-222 provided that the act shall expire after 225 days of its having taken effect.


§ 44–638. Sunset.

This chapter shall expire on September 30, 2014.


(Sept. 24, 2010, D.C. Law 18-223, § 5019, 57 DCR 6242.)

Emergency Legislation

For temporary (90 day) addition, see § 5019 of Fiscal Year 2011 Budget Support Emergency Act of 2010 (D.C. Act 18-463, July 2, 2010, 57 DCR 6542).


Subchapter II. 2013 - 2014 Medicaid Hospital Outpatient Supplemental Payment. [Expired]

§ 44–651. Definitions. [Expired]

Expired.


(Dec. 24, 2013, D.C. Law 20-61, § 5072, 60 DCR 12472.)

Emergency Legislation

For temporary (90 days) addition of this section, see § 5072 of the Fiscal Year 2014 Budget Support Emergency Act of 2013 (D.C. Act 20-130, July 30, 2013, 60 DCR 11384, 20 DCSTAT 1827).

For temporary (90 days) addition of this section, see § 5072 of the Fiscal Year 2014 Budget Support Congressional Review Emergency Act of 2013 (D.C. Act 20-204, October 17, 2013, 60 DCR 15341, 20 DCSTAT 2311).

Short Title

Section 5071 of D.C. Law 20-61 provided that Subtitle H of Title V of the act may be cited as the “Medicaid Hospital Outpatient Supplemental Payment Act of 2013”.

Editor's Notes

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.


§ 44–652. Hospital Provider Fee Fund. [Expired]

Expired.


(Dec. 24, 2013, D.C. Law 20-61, § 5073, 60 DCR 12472.)

Section References

This section is referenced in § 44-653.

Emergency Legislation

For temporary (90 days) addition of this section, see § 5073 of the Fiscal Year 2014 Budget Support Emergency Act of 2013 (D.C. Act 20-130, July 30, 2013, 60 DCR 11384, 20 DCSTAT 1827).

For temporary (90 days) addition of this section, see § 5073 of the Fiscal Year 2014 Budget Support Congressional Review Emergency Act of 2013 (D.C. Act 20-204, October 17, 2013, 60 DCR 15341, 20 DCSTAT 2311).

Short Title

Section 5071 of D.C. Law 20-61 provided that Subtitle H of Title V of the act may be cited as the “Medicaid Hospital Outpatient Supplemental Payment Act of 2013”.

Editor's Notes

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.


§ 44–653. Hospital provider fee. [Expired]

Expired.


(Dec. 24, 2013, D.C. Law 20-61, § 5074, 60 DCR 12472.)

Section References

This section is referenced in § 44-654, § 44-656, and § 44-657.

Emergency Legislation

For temporary (90 days) addition of this section, see § 5074 of the Fiscal Year 2014 Budget Support Emergency Act of 2013 (D.C. Act 20-130, July 30, 2013, 60 DCR 11384, 20 DCSTAT 1827).

For temporary (90 days) addition of this section, see § 5074 of the Fiscal Year 2014 Budget Support Congressional Review Emergency Act of 2013 (D.C. Act 20-204, October 17, 2013, 60 DCR 15341, 20 DCSTAT 2311).

Short Title

Section 5071 of D.C. Law 20-61 provided that Subtitle H of Title V of the act may be cited as the “Medicaid Hospital Outpatient Supplemental Payment Act of 2013”.

Editor's Notes

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.


§ 44–654. Applicability of fees. [Expired]

Expired.


(Dec. 24, 2013, D.C. Law 20-61, § 5075, 60 DCR 12472.)

Section References

This section is referenced in § 44-652 and § 44-653.

Emergency Legislation

For temporary (90 days) addition of this section, see § 5075 of the Fiscal Year 2014 Budget Support Emergency Act of 2013 (D.C. Act 20-130, July 30, 2013, 60 DCR 11384, 20 DCSTAT 1827).

For temporary (90 days) addition of this section, see § 5075 of the Fiscal Year 2014 Budget Support Congressional Review Emergency Act of 2013 (D.C. Act 20-204, October 17, 2013, 60 DCR 15341, 20 DCSTAT 2311).

Short Title

Section 5071 of D.C. Law 20-61 provided that Subtitle H of Title V of the act may be cited as the “Medicaid Hospital Outpatient Supplemental Payment Act of 2013”.

Editor's Notes

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.


§ 44–655. Medicaid outpatient hospital access payments. [Expired]

Expired.


(Dec. 24, 2013, D.C. Law 20-61, § 5076, 60 DCR 12472.)

Section References

This section is referenced in § 44-652, § 44-654, and § 44-656.

Emergency Legislation

For temporary (90 days) addition of this section, see § 5076 of the Fiscal Year 2014 Budget Support Emergency Act of 2013 (D.C. Act 20-130, July 30, 2013, 60 DCR 11384, 20 DCSTAT 1827).

For temporary (90 days) addition of this section, see § 5076 of the Fiscal Year 2014 Budget Support Congressional Review Emergency Act of 2013 (D.C. Act 20-204, October 17, 2013, 60 DCR 15341, 20 DCSTAT 2311).

Short Title

Section 5071 of D.C. Law 20-61 provided that Subtitle H of Title V of the act may be cited as the “Medicaid Hospital Outpatient Supplemental Payment Act of 2013”.

Editor's Notes

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.


§ 44–656. Quarterly notice and collection. [Expired]

Expired.


(Dec. 24, 2013, D.C. Law 20-61, § 5077, 60 DCR 12472.)

Emergency Legislation

For temporary (90 days) addition of this section, see § 5077 of the Fiscal Year 2014 Budget Support Emergency Act of 2013 (D.C. Act 20-130, July 30, 2013, 60 DCR 11384, 20 DCSTAT 1827).

For temporary (90 days) addition of this section, see § 5077 of the Fiscal Year 2014 Budget Support Congressional Review Emergency Act of 2013 (D.C. Act 20-204, October 17, 2013, 60 DCR 15341, 20 DCSTAT 2311).

Short Title

Section 5071 of D.C. Law 20-61 provided that Subtitle H of Title V of the act may be cited as the “Medicaid Hospital Outpatient Supplemental Payment Act of 2013”.

Editor's Notes

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.


§ 44–657. Multi-hospital systems, closure, merger, and new hospitals. [Expired]

Expired.


(Dec. 24, 2013, D.C. Law 20-61, § 5078, 60 DCR 12472.)

Emergency Legislation

For temporary (90 days) addition of this section, see § 5078 of the Fiscal Year 2014 Budget Support Emergency Act of 2013 (D.C. Act 20-130, July 30, 2013, 60 DCR 11384, 20 DCSTAT 1827).

For temporary (90 days) addition of this section, see § 5078 of the Fiscal Year 2014 Budget Support Congressional Review Emergency Act of 2013 (D.C. Act 20-204, October 17, 2013, 60 DCR 15341, 20 DCSTAT 2311).

Short Title

Section 5071 of D.C. Law 20-61 provided that Subtitle H of Title V of the act may be cited as the “Medicaid Hospital Outpatient Supplemental Payment Act of 2013”.

Editor's Notes

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.


§ 44–658. Rules. [Expired]

Expired.


(Dec. 24, 2013, D.C. Law 20-61, § 5079, 60 DCR 12472.)

Emergency Legislation

For temporary (90 days) addition of this section, see § 5079 of the Fiscal Year 2014 Budget Support Emergency Act of 2013 (D.C. Act 20-130, July 30, 2013, 60 DCR 11384, 20 DCSTAT 1827).

For temporary (90 days) addition of this section, see § 5079 of the Fiscal Year 2014 Budget Support Congressional Review Emergency Act of 2013 (D.C. Act 20-204, October 17, 2013, 60 DCR 15341, 20 DCSTAT 2311).

Short Title

Section 5071 of D.C. Law 20-61 provided that Subtitle H of Title V of the act may be cited as the “Medicaid Hospital Outpatient Supplemental Payment Act of 2013”.

Editor's Notes

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.


§ 44–659. Applicability date; sunset.

(a) This chapter shall apply as of May 1, 2013.

(b) This chapter shall sunset as of September 30, 2014.


(Dec. 24, 2013, D.C. Law 20-61, § 5080, 60 DCR 12472.)

Emergency Legislation

For temporary (90 days) addition of this section, see § 5080 of the Fiscal Year 2014 Budget Support Emergency Act of 2013 (D.C. Act 20-130, July 30, 2013, 60 DCR 11384, 20 DCSTAT 1827).

Short Title

Section 5071 of D.C. Law 20-61 provided that Subtitle H of Title V of the act may be cited as the “Medicaid Hospital Outpatient Supplemental Payment Act of 2013”.

Editor's Notes

Applicability of D.C. Law 20-61: Section 11001 of D.C. Law 20-61 provided that, except as otherwise provided, the act shall apply as of October 1, 2013.


Subchapter III. 2015 - 2016 Medicaid Hospital Outpatient Supplemental Payment. [Expired]

§ 44–661.01. Definitions. [Expired]

Expired.


(Oct. 22, 2015, D.C. Law 21-36, § 5062, 62 DCR 10905.)

Emergency Legislation

For temporary (90 days) addition of this chapter, see §§ 5062-5070 of the Fiscal Year 2016 Budget Support Emergency Act of 2015 (D.C. Act 21-127, July 27, 2015, 62 DCR 10201).


§ 44–661.02. Hospital Provider Fee Fund. [Expired]

Expired.


(Oct. 22, 2015, D.C. Law 21-36, § 5063, 62 DCR 10905.)


§ 44–661.03. Hospital provider fee. [Expired]

Expired.


(Oct. 22, 2015, D.C. Law 21-36, § 5064, 62 DCR 10905.)


§ 44–661.04. Applicability of fees. [Expired.]

Expired.


(Oct. 22, 2015, D.C. Law 21-36, § 5065, 62 DCR 10905.)


§ 44–661.05. Medicaid outpatient hospital access payments. [Expired]

Expired.


(Oct. 22, 2015, D.C. Law 21-36, § 5066, 62 DCR 10905.)


§ 44–661.06. Quarterly notice and collection. [Expired]

Expired.


(Oct. 22, 2015, D.C. Law 21-36, § 5067, 62 DCR 10905.)


§ 44–661.07. Multi-hospital systems, closure, merger, and new hospitals. [Expired.]

Expired.


(Oct. 22, 2015, D.C. Law 21-36, § 5068, 62 DCR 10905.)


§ 44–661.08. Rules. [Expired]

Expired.


(Oct. 22, 2015, D.C. Law 21-36, § 5069, 62 DCR 10905.)


§ 44–661.09. Sunset.

This chapter shall expire on September 30, 2016.


(Oct. 22, 2015, D.C. Law 21-36, § 5070, 62 DCR 10905.)


Subchapter IV. 2015 - 2016 Medicaid Hospital Inpatient Rate Supplement. [Expired]

§ 44–662.01. Definitions.

For the purposes of this chapter, the term:

(1) “Department” means the Department of Health Care Finance.

(2) “Hospital” shall have the same meaning as provided in § 44-501(a)(1) but excludes any hospital operated by the federal government and any specialty hospital, as defined by the District of Columbia’s Medicaid State Plan (“State Plan”), or a hospital that is reimbursed under a specialty hospital reimbursement methodology under the State Plan.

(3) “Hospital system” means any group of hospitals licensed separately but operated, owned, or maintained by a common entity.

(4) “Inpatient net patient revenue” means the amount calculated in accordance with generally accepted accounting principles for hospitals as derived from each hospital’s filed Hospital and Hospital Health Care Complex Cost Report (Form CMS-2552-10), filed for the period ending between October 1, 2012, and June 30, 2013, using the references below:

(A) The sum of: Worksheet G-2; Column 1; Lines 1, 2, 3, 4, 16 and 18.

(B) Minus: The ratio of the sum of Worksheet G-2; Column 1; Lines 5, 6, and 7 divided by Worksheet G-2; Column 1; Line 17 multiplied by Worksheet G-2; Column 1; Line 18.

(C) Divided by: Worksheet G-2; Column 3; Line 28

(D) Multiplied by: Worksheet G-2; Column 1; Line 3

(5) “Medicaid” means the medical assistance programs authorized by Title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C. § 1396 et seq.) (“Social Security Act”), and by § 1-307.02, and administered by the Department.


(Oct. 22, 2015, D.C. Law 21-36, § 5072, 62 DCR 10905.)

Emergency Legislation

For temporary (90 days) addition of this chapter, see §§ 5072-5079 of the Fiscal Year 2016 Budget Support Emergency Act of 2015 (D.C. Act 21-127, July 27, 2015, 62 DCR 10201).


§ 44–662.02. Hospital Fund.

(a) There is established as a special fund the Hospital Fund (“Fund”), which shall be administered by the Department in accordance with subsection (c) of this section.

(b) Revenue from the following sources shall be deposited in the Fund:

(1) Fees collected under this chapter;

(2) Interest and penalties collected under this chapter; and

(3) Other amounts collected under this chapter.

(c) Money in the Fund shall be used solely as set forth in § 44-662.03.

(d)(1) The money deposited in the Fund, and interest earned, shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time.

(2) Subject to authorization in an approved budget and financial plan, any funds appropriated in the Fund shall be continually available without regard to fiscal year limitation; provided, that any remaining money in the Fund at the end of each fiscal year shall be refunded to hospitals in proportion to the amounts paid by them.


(Oct. 22, 2015, D.C. Law 21-36, § 5073, 62 DCR 10905.)


§ 44–662.03. Hospital provider fee.

(a)(1) Beginning October 1, 2015, and except as provided in subsection (b) of this section and § 44-662.06, the District, through the Office of Tax and Revenue, may charge each hospital a fee based on its inpatient net patient revenue.

(2) The fee shall be charged at a uniform rate necessary to generate no more than $10.4 million. Of this amount, $1.4 million may be used to support the Medicaid Managed Care Organization rates for inpatient hospitalization. The remaining amount shall be used to support the maintenance of inpatient Medicaid Fee-for-Service rates at the District Fiscal Year (“DFY”) 2015 level of 98% of cost to non-specialty hospitals.

(3) The fee collected pursuant to this section shall be deposited in the Hospital Fund, established by § 44-662.02.

(b) A psychiatric hospital that is an agency or a unit of the District government is exempt from the fee imposed under subsection (a) of this section, unless the exemption is adjudged to be unconstitutional or otherwise invalid, in which case a psychiatric hospital that is an agency or a unit of the District government shall pay the fee imposed by subsection (a) of this section.

(c) By August 1, 2015, the Department shall submit a provider tax waiver application to the Center for Medicare and Medicaid Services to ensure the provisions of this chapter qualify as a broad-based health care related tax, as that term is defined in section 1903(w)(3)(B) of the Social Security Act.


(Oct. 22, 2015, D.C. Law 21-36, § 5074, 62 DCR 10905.)


§ 44–662.04. Quarterly notice and collection.

(a) The fee imposed under § 44-662.03 shall be due and payable by the 15th of the last month of each DFY quarter.

(b) The fee imposed under § 44-662.03 shall be calculated, due, and payable on a quarterly basis, but shall not be due and payable until the District issues written notice to each hospital informing the hospital of its fee rate, inpatient net patient revenue subject to the fee, and the fee amount owed on a quarterly basis, including, in the initial written notice from the District to the hospital, all fee amounts owed beginning with the period October 1, 2015, to ensure all applicable fee obligations have been identified.

(c)(1) If a hospital fails to pay the full amount of its fee by the date required, the unpaid balance shall accrue interest at the rate of 1.5% per month or any fraction thereof, which shall be added to the unpaid balance.

(2) The Chief Financial Officer may arrange a payment plan for the amount of the fee and interest in arrears.

(d) The payment by the hospital of the fee created in this chapter shall be reported as an allowable cost for purposes of Medicaid hospital reimbursement.


(Oct. 22, 2015, D.C. Law 21-36, § 5075, 62 DCR 10905.)


§ 44–662.05. Multi-hospital systems, closure, merger, and new hospitals.

(a) If a hospital system conducts, operates, or maintains more than one hospital licensed by the Department of Health, the hospital system shall pay the fee for each hospital separately.

(b)(1) Notwithstanding § 44-662.03, if a hospital system or person that is subject to a fee under § 44-662.03 ceases to conduct, operate, or maintain a hospital, as evidenced by the transfer or surrender of a hospital license, the fee for the DFY in which the cessation occurs shall be adjusted by multiplying the fee computed under § 44-662.03 by a fraction, the numerator of which is the number of days in the year during which the hospital system or person conducts, operates, or maintains the hospital and the denominator of which is 365.

(2) Immediately upon ceasing to conduct, operate, or maintain a hospital, the hospital system or person shall pay the fee for the year as so adjusted, to the extent not previously paid.

(c) Notwithstanding any other provision of this chapter, a hospital system or person who conducts, operates, or maintains a hospital, upon notice by the Department, shall pay the fee required under §  44-662.03 in accordance with subsection (a) of this section on the due date stated in the notice and on the regular installment due dates for the DFY occurring after the due date of the initial notice.


(Oct. 22, 2015, D.C. Law 21-36, § 5076, 62 DCR 10905.)


§ 44–662.06. Federal determinations; suspension and termination of assessment.

(a) If the Centers for Medicare and Medicaid Services determines that an assessment imposed on a hospital pursuant to this chapter does not satisfy the requirements for federal financial participation set forth in section 1903(w) of the Social Security Act that determination shall not affect the validity, amount, applicable rate, or any other terms of an assessment on other hospitals imposed by this chapter.

(b) If the Centers for Medicare and Medicaid Services determines that an exclusion for specialty hospitals under this chapter would prevent an assessment imposed by this chapter from qualifying as a broad-based health care related tax, as that term is defined in section 1903(w)(3)(B) of the Social Security Act, the exclusion of specialty hospitals shall not be made.


(Oct. 22, 2015, D.C. Law 21-36, § 5077, 62 DCR 10905.)


§ 44–662.07. Rules.

The Mayor, pursuant to subchapter I of Chapter 2 of Title 5 [§  2-501 et seq.], may issue rules to implement the provisions of this chapter.


(Oct. 22, 2015, D.C. Law 21-36, § 5078, 62 DCR 10905.)


§ 44–662.08. Sunset.

This chapter shall expire on September 30, 2016.


(Oct. 22, 2015, D.C. Law 21-36, § 5079, 62 DCR 10905.)


Subchapter V. 2016 - 2017 Medicaid Hospital Outpatient Supplemental Payment. [Expired]

§ 44–663.01. Definitions.

For the purposes of this subchapter, the term:

(1) "Department" means the Department of Health Care Finance.

(2) "Hospital" shall have the same meaning as provided in § 44-501(a)(1), but excludes any hospital operated by the federal government.

(3) "Hospital system" means any group of hospitals licensed separately, but operated, owned, or maintained by a common entity.

(4) "Medicaid" means the medical assistance programs authorized by Title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C. § 1396 et seq.), and by § 1-307.02, and administered by the Department.

(5) "Outpatient gross patient revenue" means the amount calculated in accordance with generally accepted accounting principles for hospitals that is reported as the sum of Lines 18 and 19; Column 2; Worksheet G-2 of the Hospital and Hospital Health Care Complex Cost Report (Form CMS 2552-10), filed for the period ending between October 1, 2013, and September 30, 2014.


(Oct. 8, 2016, D.C. Law 21-160, § 5062, 63 DCR 10775.)

Expiration of Law

Section 5070 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.02. Hospital Provider Fee Fund.

(a) There is established as a special fund the Hospital Provider Fee Fund ("Fund"), which shall be administered by the Department in accordance with subsections (c) and (d) of this section.

(b) Revenue from the following sources shall be deposited in the Fund:

(1) Fees collected under this subchapter; and

(2) Interest and penalties collected under this subchapter.

(c) Money in the Fund may only be used for the following purposes:

(1) Making Medicaid outpatient hospital access payments to hospitals as required under § 44-663.05;

(2) Payment of administrative expenses incurred by the Department or its agent in performing the activities authorized by this subchapter in an amount not to exceed $150,000 annually; and

(3) Providing refunds to hospitals pursuant to § 44-663.04.

(d) Money in the Fund may not be used to replace money appropriated to the Medicaid program.

(e)(1) The money deposited into the Fund, and interest earned, shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time.

(2) Subject to authorization in an approved budget and financial plan, any funds appropriated in the Fund shall be continually available without regard to fiscal year limitation.


(Oct. 8, 2016, D.C. Law 21-160, § 5063, 63 DCR 10775.)

Expiration of Law

Section 5070 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.03. Hospital provider fee.

(a) Beginning October 1, 2016, and subject to § 44-663.04, the District may charge each hospital a fee based on its outpatient gross patient revenue. The fee shall be charged at a uniform rate necessary to generate the following:

(1) An amount equal to the non-federal share of the total available spending room under the Medicaid upper payment limit for private hospitals applicable to District Fiscal Year ("DFY") 2017 consistent with the federal approval of the authorizing Medicaid State Plan amendment; plus

(2) An amount equal to the non-federal share of the total available spending room under the Medicaid upper payment limit for District-operated hospitals applicable to DFY 2017 consistent with the federal approval of the authorizing Medicaid State Plan amendment; plus

(3) An amount equal to the Department's administrative expenses as described in § 44-663.02(c)(2).

(b) A psychiatric hospital that is an agency or a unit of the District government is exempt from the fee imposed under subsection (a) of this section, unless the exemption is adjudged to be unconstitutional or otherwise invalid, in which case a psychiatric hospital that is an agency or a unit of the District government shall pay the fee imposed by subsection (a) of this section.


(Oct. 8, 2016, D.C. Law 21-160, § 5064, 63 DCR 10775.)

Expiration of Law

Section 5070 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.04. Applicability of fees.

(a) The fee imposed by § 44-663.03 shall not be due and payable until such time that the federal Centers for Medicare and Medicaid Services approves the Medicaid State Plan amendment authorizing the Medicaid payments described in § 44-663.05.

(b) The fee imposed by § 44-663.03 shall cease to be imposed, and any moneys remaining in the Fund shall be refunded to hospitals in proportion to the amounts paid by them, if:

(1) The Department makes changes in its rules that reduce the hospital inpatient or outpatient Medicaid payment rates, including adjustment to payment rates that are in effect on October 1, 2015; or

(2) The payments to hospitals required under § 44-663.05 are modified in any way other than to secure federal approval of such payments as described in § 44-663.05 or are not eligible for federal matching funds under section 1903(w) of the Social Security Act, approved July 30, 1965 (70 Stat. 349; 42 U.S.C. §1396b(w)) ("Social Security Act").

(c) The fee imposed by § 44-663.03 shall not take effect or shall cease to be imposed if the fee is determined to be an impermissible tax under section 1903(w)(3)(B) of the Social Security Act by the Centers for Medicare and Medicaid Services.

(d) Should the fee imposed by § 44-663.03 not take effect or cease to be imposed, moneys in the Fund derived from the imposed fee shall be disbursed in accordance with § 44-663.05 to the extent federal matching is available. If federal matching is not available due to a determination by the Centers for Medicare and Medicaid Services that the fee is impermissible, any remaining moneys shall be refunded to hospitals in proportion to the amounts paid by them.


(Oct. 8, 2016, D.C. Law 21-160, § 5065, 63 DCR 10775.)

Expiration of Law

Section 5070 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.05. Medicaid outpatient hospital access payments.

(a)(1) For visits and services beginning October 1, 2016, quarterly Medicaid outpatient hospital access payments shall be made to each private hospital.

(2) Each payment will be equal to the hospital's DFY 2014 outpatient Medicaid payments divided by the total in District private hospital DFY 2014 outpatient Medicaid payments multiplied by 1/4 of the total outpatient private hospital access payment pool.

(3) The total outpatient private hospital access payment pool is equal to the total available spending room under the private hospital outpatient Medicaid upper payment limit for DFY 2017.

(b)(1) For visits and services beginning October 1, 2016, outpatient hospital access payments shall be made to the United Medical Center.

(2) Each payment will be equal to one quarter of the total outpatient public hospital access payment pool.

(3) The total outpatient public hospital access payment pool is equal to the total available spending room under the District-operated hospital outpatient Medicaid upper payment limit for DFY 2017.

(c) The quarterly Medicaid outpatient hospital access payments shall be made within 15 business days after the end of each DFY quarter for the Medicaid visits and services rendered during that quarter.

(d) No payments shall be made under this section until such time that the federal Centers for Medicare and Medicaid Services approves the Medicaid State Plan amendment authorizing the Medicaid payments described in this subchapter.

(e) The Medicaid payment methodologies authorized under this subchapter shall not be altered in any way unless such alteration is necessary to gain federal approval from the Centers for Medicare and Medicaid Services.


(Oct. 8, 2016, D.C. Law 21-160, § 5066, 63 DCR 10775.)

Expiration of Law

Section 5070 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.06. Quarterly notice and collection.

(a) The fee imposed under § 44-663.03, which shall be calculated, due, and payable on a quarterly basis, shall be due and payable by the 15th of the last month of each DFY quarter; provided, that the fee shall not be due and payable until:

(1) The District issues written notice that the payment methodologies for payments to hospitals required under § 44-663.05 have been approved by the federal Centers for Medicare and Medicaid Services; and

(2) The District issues written notice to the hospital informing the hospital of its fee rate, outpatient gross patient revenue subject to the fee, and the fee amount owed on a quarterly basis, including, in the initial written notice from the District to the hospital, all fee amounts owed beginning with the period commencing on October 1, 2016, to ensure all applicable fee obligations have been identified.

(b)(1) If a hospital fails to pay the full amount of the fee in accordance with this subchapter, the unpaid balance shall accrue interest at the rate of 1.5% per month or any fraction thereof, which shall be added to the unpaid balance.

(2) The Chief Financial Officer may arrange a payment plan for the amount of the fee and interest in arrears.

(c) The payment by the hospital of the fee created in this subchapter shall be reported as an allowable cost for purposes of Medicaid hospital reimbursement.


(Oct. 8, 2016, D.C. Law 21-160, § 5067, 63 DCR 10775.)

Expiration of Law

Section 5070 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.07. Multi-hospital systems, closure, merger, and new hospitals.

(a) If a hospital system conducts, operates, or maintains more than one hospital licensed by the Department of Health, the hospital system shall pay the fee for each hospital separately.

(b)(1) Notwithstanding any other provision in this subchapter, if a hospital system or person ceases to conduct, operate, or maintain a hospital that is subject to a fee under § 44-663.03, as evidenced by the transfer or surrender of the hospital license, the fee for the DFY in which the cessation occurs shall be adjusted by multiplying the fee computed under § 44-663.03 by a fraction, the numerator of which is the number of days in the year during which the hospital system or person conducted, operated, or maintained the hospital, and the denominator of which is 365.

(2) Immediately upon ceasing to conduct, operate, or maintain a hospital, the hospital system or person shall pay the fee for the year as so adjusted, to the extent not previously paid.

(c) Notwithstanding any other provision in this subchapter, a hospital system or person who conducts, operates, or maintains a hospital, upon notice by the Department, shall pay the fee computed under § 44-663.03 and subsection (a) of this section in installments on the due date stated in the notice and on the regular installment due dates for the DFY occurring after the due dates of the initial notice.


(Oct. 8, 2016, D.C. Law 21-160, § 5068, 63 DCR 10775.)

Expiration of Law

Section 5070 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.08. Rules.

The Mayor, pursuant to subchapter I of Chapter 5 of Title 2, may issue rules to implement the provisions of this subchapter.


(Oct. 8, 2016, D.C. Law 21-160, § 5069, 63 DCR 10775.)

Expiration of Law

Section 5070 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.09. Sunset.

This subchapter shall expire on September 30, 2017.


(Oct. 8, 2016, D.C. Law 21-160, § 5070, 63 DCR 10775.)


Subchapter VI. 2016 - 2017 Medicaid Hospital Inpatient Rate Supplement. [Expired]

§ 44–663.11. Definitions.

For the purposes of this subchapter, the term:

(1) "Department" means the Department of Health Care Finance.

(2) "Hospital" shall have the same meaning as provided in § 44-501(a)(1), but excludes any hospital operated by the federal government and any specialty hospital, as defined by the District of Columbia's Medicaid State Plan ("State Plan"), or a hospital that is reimbursed under a specialty hospital reimbursement methodology under the State Plan.

(3) "Hospital system" means any group of hospitals licensed separately but operated, owned, or maintained by a common entity.

(4) "Inpatient net patient revenue" means the amount calculated in accordance with generally accepted accounting principles for hospitals as derived from each hospital's filed Hospital and Hospital Health Care Complex Cost Report (Form CMS-2552-10), filed for the period ending between October 1, 2013, and September 30, 2014, using the references below:

(A) The sum of: Worksheet G-2; Column 1; Lines 1, 2, 3, 4, 16 and 18;

(B) Minus: The ratio of the sum of Worksheet G-2; Column 1; Lines 5, 6, and 7 divided by Worksheet G-2; Column 1; Line 17 multiplied by Worksheet G-2; Column 1; Line 18;

(C) Divided by: Worksheet G-2; Column 3; Line 28; and

(D) Multiplied by: Worksheet G-3; Column 1; Line 3.

(5) "Medicaid" means the medical assistance programs authorized by Title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C. § 1396 et seq.) ("Social Security Act"), and by § 1-307.02, and administered by the Department.


(Oct. 8, 2016, D.C. Law 21-160, § 5072, 63 DCR 10775.)

Expiration of Law

Section 5079 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.12. Hospital Fund.

(a) There is established as a special fund the Hospital Fund ("Fund"), which shall be administered by the Department in accordance with subsection (c) of this section.

(b) Revenue from the following sources shall be deposited in the Fund:

(1) Fees collected under this subchapter;

(2) Interest and penalties collected under this subchapter; and

(3) Other amounts collected under this subchapter.

(c) Money in the Fund shall be used solely as set forth in § 44-663.13(a)(2).

(d)(1) The money deposited in the Fund, and interest earned, shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time.

(2) Subject to authorization in an approved budget and financial plan, any funds appropriated in the Fund shall be continually available without regard to fiscal year limitation; provided, that any remaining money in the Fund at the end of each fiscal year shall be refunded to hospitals in proportion to the amounts paid by them.


(Oct. 8, 2016, D.C. Law 21-160, § 5073, 63 DCR 10775.)

Expiration of Law

Section 5079 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.13. Hospital provider fee.

(a)(1) Beginning October 1, 2016, and except as provided in subsection (b) of this section and § 44-663.16, the District, through the Office of Tax and Revenue, may charge each hospital a fee based on its inpatient net patient revenue.

(2) The fee shall be charged at a uniform rate necessary to generate no more than $10.4 million. Of this amount, $1.4 million may be used to support the Medicaid Managed Care Organization rates for inpatient hospitalization. The remaining amount shall be used to support the maintenance of inpatient Medicaid Fee-for-Service rates at the District Fiscal Year ("DFY") 2015 level of 98% of cost to non-specialty hospitals.

(3) The fee collected pursuant to this section shall be deposited in the Hospital Fund, established by § 44-663.12.

(b) A psychiatric hospital that is an agency or a unit of the District government is exempt from the fee imposed under subsection (a) of this section, unless the exemption is adjudged to be unconstitutional or otherwise invalid, in which case a psychiatric hospital that is an agency or a unit of the District government shall pay the fee imposed by subsection (a) of this section.

(c) If necessary, by August 1, 2016, the Department shall submit a provider tax waiver application to the Center for Medicare and Medicaid Services to ensure the provisions of this subchapter qualify as a broad-based health care related tax, as that term is defined in section 1903(w)(3)(B) of the Social Security Act.


(Oct. 8, 2016, D.C. Law 21-160, § 5074, 63 DCR 10775.)

Expiration of Law

Section 5079 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.14. Quarterly notice and collection.

(a) The fee imposed under § 44-663.13 shall be due and payable by the 15th of the last month of each DFY quarter.

(b) The fee imposed under § 44-663.13 shall be calculated, due, and payable on a quarterly basis, but shall not be due and payable until the District issues written notice to each hospital informing the hospital of its fee rate, inpatient net patient revenue subject to the fee, and the fee amount owed on a quarterly basis, including, in the initial written notice from the District to the hospital, all fee amounts owed beginning with the period October 1, 2016, to ensure all applicable fee obligations have been identified.

(c)(1) If a hospital fails to pay the full amount of its fee by the date required, the unpaid balance shall accrue interest at the rate of 1.5% per month or any fraction thereof, which shall be added to the unpaid balance.

(2) The Chief Financial Officer may arrange a payment plan for the amount of the fee and interest in arrears.

(d) The payment by the hospital of the fee created in this subchapter shall be reported as an allowable cost for purposes of Medicaid hospital reimbursement.


(Oct. 8, 2016, D.C. Law 21-160, § 5075, 63 DCR 10775.)

Expiration of Law

Section 5079 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.15. Multi-hospital systems, closure, merger, and new hospitals.

(a) If a hospital system conducts, operates, or maintains more than one hospital licensed by the Department of Health, the hospital system shall pay the fee for each hospital separately.

(b)(1) Notwithstanding § 44-663.13, if a hospital system or person that is subject to a fee under § 44-663.13 ceases to conduct, operate, or maintain a hospital, as evidenced by the transfer or surrender of a hospital license, the fee for the DFY in which the cessation occurs shall be adjusted by multiplying the fee computed under § 44-663.13 by a fraction, the numerator of which is the number of days in the year during which the hospital system or person conducts, operates, or maintains the hospital and the denominator of which is 365.

(2) Immediately upon ceasing to conduct, operate, or maintain a hospital, the hospital system or person shall pay the fee for the year as so adjusted, to the extent not previously paid.

(c) Notwithstanding any other provision of this subchapter, a hospital system or person who conducts, operates, or maintains a hospital, upon notice by the Department, shall pay the fee required under § 44-663.13 in accordance with subsection (a) of this section on the due date stated in the notice and on the regular installment due dates for the DFY occurring after the due date of the initial notice.


(Oct. 8, 2016, D.C. Law 21-160, § 5076, 63 DCR 10775.)

Expiration of Law

Section 5079 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.16. Federal determinations; suspension and termination of assessment.

(a) If the Centers for Medicare and Medicaid Services determines that an assessment imposed on a hospital pursuant to this subchapter does not satisfy the requirements for federal financial participation set forth in section 1903(w) of the Social Security Act, that determination shall not affect the validity, amount, applicable rate, or any other terms of an assessment on other hospitals imposed by this subchapter.

(b) If the Centers for Medicare and Medicaid Services determines that an exclusion for specialty hospitals under this subchapter would prevent an assessment imposed by this subchapter from qualifying as a broad-based health care related tax, as that term is defined in section 1903(w)(3)(B) of the Social Security Act, the exclusion of specialty hospitals shall not be made.


(Oct. 8, 2016, D.C. Law 21-160, § 5077, 63 DCR 10775.)

Expiration of Law

Section 5079 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.17. Rules.

The Mayor, pursuant to subchapter I of Chapter 5 of Title 2, may issue rules to implement the provisions of this subchapter.


(Oct. 8, 2016, D.C. Law 21-160, § 5078, 63 DCR 10775.)

Expiration of Law

Section 5079 of D.C. Law 21-160 provided that this section shall expire on September 30, 2017.


§ 44–663.18. Sunset.

This subchapter shall expire on September 30, 2017.


(Oct. 8, 2016, D.C. Law 21-160, § 5079, 63 DCR 10775.)


Subchapter VII. Hospital Outpatient Supplemental Payment.

§ 44–664.01. Definitions.

For the purposes of this subchapter, the term:

(1) "Department" means the Department of Health Care Finance.

(2) "Hospital" shall have the same meaning as provided in § 44-501(a)(1), but excludes any hospital operated by the federal government.

(3) "Hospital system" means any group of hospitals licensed separately, but operated, owned, or maintained by a common entity.

(4) "Medicaid" means the medical assistance programs authorized by Title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C. § 1396 et seq.), and by § 1-307.02, and administered by the Department.

(5) "Outpatient gross patient revenue" means the amount calculated in accordance with generally accepted accounting principles for hospitals that is reported as the sum of Lines 18 and 19; Column 2; Worksheet G-2 of the Hospital and Hospital Health Care Complex Cost Report (Form CMS 2552-10), filed for the period between October 1 and September 30 of the period 3 fiscal years prior to the fiscal year the fee is assessed.


(Dec. 13, 2017, D.C. Law 22-33, § 5062, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5032(a), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5082(a), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5032(a) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5032(a) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5062 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5062 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.02. Hospital Provider Fee Fund.

(a) There is established as a special fund the Hospital Provider Fee Fund ("Fund"), which shall be administered by the Department in accordance with subsections (c) and (d) of this section.

(b) Revenue from the following sources shall be deposited in the Fund:

(1) Fees collected under this subchapter; and

(2) Interest and penalties collected under this subchapter.

(c) Money in the Fund may only be used for the following purposes:

(1) Making Medicaid outpatient hospital access payments to hospitals as required under § 44-664.05;

(2) Payment of administrative expenses incurred by the Department or its agent in performing the activities authorized by this subchapter in an amount not to exceed $150,000 annually; and

(3) Providing refunds to hospitals pursuant to § 44-664.04.

(d) Money in the Fund may not be used to replace money appropriated to the Medicaid program.

(e)(1) The money deposited into the Fund shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time.

(2) Subject to authorization in an approved budget and financial plan, any funds appropriated in the Fund shall be continually available without regard to fiscal year limitation.


(Dec. 13, 2017, D.C. Law 22-33, § 5063, 64 DCR 7652.)

Emergency Legislation

For temporary (90-day) creation of this section, see § 5063 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5063 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.03. Hospital provider fee.

(a) Beginning October 1, 2019, and subject to § 44-664.04, the District may charge each hospital a fee based on its outpatient gross patient revenue. The fee shall be charged at a uniform rate necessary to generate the following:

(1) An amount equal to the non-federal share of the total available spending room under the outpatient Medicaid upper payment limit for private hospitals applicable to each District Fiscal Year consistent with the federal approval of the authorizing Medicaid State Plan amendment; plus

(2) An amount equal to the non-federal share of the total available spending room under the outpatient Medicaid upper payment limit for District operated hospitals applicable to each District Fiscal Year consistent with the federal approval of the authorizing Medicaid State Plan amendment; plus

(3) An amount equal to the Department's administrative expenses as described in § 44-664.02(c)(2).

(b) A psychiatric hospital that is an agency or a unit of the District government is exempt from the fee imposed under subsection (a) of this section, unless the exemption is adjudged to be unconstitutional or otherwise invalid, in which case a psychiatric hospital that is an agency or a unit of the District government shall pay the fee imposed by subsection (a) of this section.


(Dec. 13, 2017, D.C. Law 22-33, § 5064, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5032(b), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5082(b), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5032(b) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5032(b) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5064 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5064 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.04. Applicability of fees.

(a) The fee imposed by § 44-664.03 shall not be due and payable until such time that the Centers for Medicare and Medicaid Services approves the Medicaid State Plan amendment authorizing the Medicaid payments described in § 44-664.05.

(b) The fee imposed by § 44-664.03 shall cease to be imposed, and any moneys remaining in the Fund shall be refunded to hospitals in proportion to the amounts paid by them, if:

(1) The Department makes changes in its rules that reduce the hospital inpatient or outpatient Medicaid payment rates, including adjustment to payment rates that are in effect on October 1, 2018; or

(2) The payments to hospitals required under § 44-664.05 are modified in any way other than to secure federal approval of such payments as described in § 44-664.05 or are not eligible for federal matching funds under section 1903(w) of the Social Security Act, approved July 30, 1965 (70 Stat. 349; 42 U.S.C. § 1396b(w)) ("Social Security Act").

(c) The fee imposed by § 44-664.03 shall not take effect or shall cease to be imposed if the fee is determined to be an impermissible tax under section 1903(w)(3)(B) of the Social Security Act by the Centers for Medicare and Medicaid Services.

(d) Should the fee imposed by § 44-664.03 not take effect or cease to be imposed, moneys in the Fund derived from the imposed fee shall be disbursed in accordance with § 44-664.05 to the extent federal matching is available. If federal matching is not available due to a determination by the Centers for Medicare and Medicaid Services that the fee is impermissible, any remaining moneys shall be refunded to hospitals in proportion to the amounts paid by them.


(Dec. 13, 2017, D.C. Law 22-33, § 5065, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5032(c), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5082(c), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5032(c) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5032(c) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5065 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5065 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.05. Medicaid outpatient hospital access payments.

(a)(1) For visits and services beginning October 1, 2019, quarterly Medicaid outpatient hospital access payments shall be made to each private hospital.

(2) Each payment will be equal to the hospital's District Fiscal Year outpatient Medicaid payments divided by the total in District private hospital [outpatient Medicaid payments] for the District Fiscal Year 3 years prior to the current fiscal year multiplied by 1/4 of the total outpatient private hospital access payment pool.

(3) The total outpatient private hospital access payment pool is equal to the total available spending room under the private hospital outpatient Medicaid upper payment limit for each District Fiscal Year.

(b)(1) For visits and services beginning October 1, 2019, outpatient hospital access payments shall be made to the United Medical Center.

(2) Each payment shall be equal to 1/4 of the total outpatient public hospital access payment pool.

(3) The total outpatient public hospital access payment pool is equal to the total available spending room under the District-operated hospital outpatient Medicaid upper payment limit for each District Fiscal Year.

(c) The quarterly Medicaid outpatient hospital access payments shall be made within 15 business days after the end of each DFY quarter for the Medicaid visits and services rendered during that quarter.

(d) No payments shall be made under this section until such time that the Centers for Medicare and Medicaid Services approves the Medicaid State Plan amendment authorizing the Medicaid payments described in this subchapter.

(e) The Medicaid payment methodologies authorized under this subchapter shall not be altered in any way unless such alteration is necessary to gain federal approval from the Centers for Medicare and Medicaid Services.


(Dec. 13, 2017, D.C. Law 22-33, § 5066, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5032(d), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5082(d), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5032(d) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5032(d) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5066 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5066 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.06. Quarterly notice and collection.

(a) The fee imposed under § 44-664.03, which shall be calculated, due, and payable on a quarterly basis, shall be due and payable by the 15th of the last month of each DFY quarter; provided, that the fee shall not be due and payable until:

(1) The District issues written notice that the payment methodologies for payments to hospitals required under § 44-664.05 have been approved by the Centers for Medicare and Medicaid Services; and

(2) The District issues written notice to the hospital informing the hospital of its fee rate, outpatient gross patient revenue subject to the fee, and the fee amount owed on a quarterly basis, including, in the initial written notice from the District to the hospital, all fee amounts owed beginning with the period commencing on October 1 of each year, to ensure all applicable fee obligations have been identified.

(b)(1) If a hospital fails to pay the full amount of the fee in accordance with this subchapter, the unpaid balance shall accrue interest at the rate of 1.5% per month or any fraction thereof, which shall be added to the unpaid balance.

(2) The Chief Financial Officer may arrange a payment plan for the amount of the fee and interest in arrears.

(c) The payment by the hospital of the fee created in this subchapter shall be reported as an allowable cost for purposes of Medicaid hospital reimbursement.


(Dec. 13, 2017, D.C. Law 22-33, § 5067, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5032(e), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5082(e), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5032(e) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5032(e) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5067 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5067 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.07. Multi-hospital systems, closure, merger, and new hospitals.

(a) If a hospital system conducts, operates, or maintains more than one hospital licensed by the Department of Health, the hospital system shall pay the fee for each hospital separately.

(b)(1) Notwithstanding any other provision in this subchapter, if a hospital system or person ceases to conduct, operate, or maintain a hospital that is subject to a fee under § 44-664.03, as evidenced by the transfer or surrender of the hospital license, the fee for the DFY in which the cessation occurs shall be adjusted by multiplying the fee computed under § 44-664.03 by a fraction, the numerator of which is the number of days in the year during which the hospital system or person conducted, operated, or maintained the hospital, and the denominator of which is 365.

(2) Immediately upon ceasing to conduct, operate, or maintain a hospital, the hospital system or person shall pay the fee for the year as so adjusted, to the extent not previously paid.

(c) Notwithstanding any other provision in this subchapter a hospital system or person who conducts, operates, or maintains a hospital, upon notice by the Department, shall pay the fee computed under § 44-664.03 and subsection (a) of this section in installments on the due date stated in the notice and on the regular installment due dates for the DFY occurring after the due dates of the initial notice.


(Dec. 13, 2017, D.C. Law 22-33, § 5068, 64 DCR 7652.)

Emergency Legislation

For temporary (90-day) creation of this section, see § 5068 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5068 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.08. Rules.

The Mayor, pursuant to subchapter I of Chapter 5 of Title 2, may issue rules to implement the provisions of this subchapter.


(Dec. 13, 2017, D.C. Law 22-33, § 5069, 64 DCR 7652.)

Emergency Legislation

For temporary (90-day) creation of this section, see § 5069 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5069 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.09. Sunset.

This subchapter shall expire on September 30, 2029.


(Dec. 13, 2017, D.C. Law 22-33, § 5070, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5032(f), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5082(f), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5032(f) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5032(f) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5070 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5070 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


Subchapter VIII. Hospital Inpatient Rate Supplement.

§ 44–664.11. Definitions.

For the purposes of this subchapter, the term:

(1) "Department" means the Department of Health Care Finance.

(2) "Hospital" shall have the same meaning as provided in § 44-501(a)(1), but excludes any hospital operated by the federal government and any specialty hospital, as defined by the District of Columbia's Medicaid State Plan ("State Plan"), or a hospital that is reimbursed under a specialty hospital reimbursement methodology under the State Plan.

(3) "Hospital system" means any group of hospitals licensed separately but operated, owned, or maintained by a common entity.

(4) "Inpatient net patient revenue" means the amount calculated in accordance with generally accepted accounting principles for hospitals as derived from each hospital's filed Hospital and Hospital Health Care Complex Cost Report (Form CMS-2552-10), filed for the period between October 1 and September 30 of the period 3 fiscal years prior to the fiscal year the fee is assessed, using the references below:

(A) The sum of: Worksheet G-2; Column 1; Lines 1, 2, 3, 4, 16 and 18;

(B) Minus: The ratio of the sum of Worksheet G-2; Column 1; Lines 5, 6, and 7 divided by Worksheet G-2; Column 1; Line 17 multiplied by Worksheet G-2; Column 1; Line 18;

(C) Divided by: Worksheet G-2; Column 3; Line 28; and

(D) Multiplied by: Worksheet G-3; Column 1; Line 3.

(5) "Medicaid" means the medical assistance programs authorized by Title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C. § 1396 et seq.) ("Social Security Act"), and by § 1-307.02, and administered by the Department.


(Dec. 13, 2017, D.C. Law 22-33, § 5082, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5042(a), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5083(a), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5042(a) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5042(a) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5082 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5082 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.12. Hospital Fund.

(a) There is established as a special fund the Hospital Fund ("Fund"), which shall be administered by the Department in accordance with subsection (c) of this section.

(b) Revenue from the following sources shall be deposited in the Fund:

(1) Fees collected under this subchapter;

(2) Interest and penalties collected under this subchapter; and

(3) Other amounts collected under this subchapter.

(c) Money in the Fund shall be used solely as set forth in § 44-664.13(a)(2).

(d)(1) The money deposited in the Fund shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time.

(2) Subject to authorization in an approved budget and financial plan, any funds appropriated in the Fund shall be continually available without regard to fiscal year limitation; provided, that any remaining money in the Fund at the end of each fiscal year shall be refunded to hospitals in proportion to the amounts paid by them.


(Dec. 13, 2017, D.C. Law 22-33, § 5083, 64 DCR 7652.)

Emergency Legislation

For temporary (90-day) creation of this section, see § 5083 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5083 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.13. Hospital provider fee.

(a)(1) Beginning October 1, 2018, and except as provided in subsection (b) of this section and § 44-664.16, the District, through the Office of Tax and Revenue, may charge each hospital a fee based on its inpatient net patient revenue.

(2) The fee shall be charged at a uniform rate necessary to generate no more than $8,814,004 to support the maintenance of inpatient Medicaid Fee-for-Service rates at the District Fiscal Year ("DFY") 2015 level of 98% of cost to non-specialty hospitals.

(3) The fee collected pursuant to this section shall be deposited in the Hospital Fund, established by § 44-664.12.

(b) A psychiatric hospital that is an agency or a unit of the District government is exempt from the fee imposed under subsection (a) of this section, unless the exemption is adjudged to be unconstitutional or otherwise invalid, in which case a psychiatric hospital that is an agency or a unit of the District government shall pay the fee imposed by subsection (a) of this section.

(c) If necessary, by August 1, 2019, the Department shall submit a provider tax waiver application to the Center for Medicare and Medicaid Services to ensure the provisions of this subchapter qualify as a broad-based health care related tax, as that term is defined in section 1903(w)(3)(B) of the Social Security Act.


(Dec. 13, 2017, D.C. Law 22-33, § 5084, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5042(b), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5083(b), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5042(1) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5042(1) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5084 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5084 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.14. Quarterly notice and collection.

(a) The fee imposed under § 44-664.13 shall be due and payable by the 15th of the last month of each DFY quarter.

(b) The fee imposed under § 44-664.13 shall be calculated, due, and payable on a quarterly basis, but shall not be due and payable until the District issues written notice to each hospital informing the hospital of its fee rate, inpatient net patient revenue subject to the fee, and the fee amount owed on a quarterly basis, including, in the initial written notice from the District to the hospital, all fee amounts owed beginning with the period October 1 of each District Fiscal Year, to ensure all applicable fee obligations have been identified.

(c)(1) If a hospital fails to pay the full amount of its fee by the date required, the unpaid balance shall accrue interest at the rate of 1.5% per month or any fraction thereof, which shall be added to the unpaid balance.

(2) The Chief Financial Officer may arrange a payment plan for the amount of the fee and interest in arrears.

(d) The payment by the hospital of the fee created in this subchapter shall be reported as an allowable cost for purposes of Medicaid hospital reimbursement.


(Dec. 13, 2017, D.C. Law 22-33, § 5085, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5042(c), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5083(c), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5042(c) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5042(c) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5085 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5085 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.15. Multi-hospital systems, closure, merger, and new hospitals.

(a) If a hospital system conducts, operates, or maintains more than one hospital licensed by the Department of Health, the hospital system shall pay the fee for each hospital separately.

(b)(1) Notwithstanding § 44-664.13, if a hospital system or person that is subject to a fee under § 44-664.13 ceases to conduct, operate, or maintain a hospital, as evidenced by the transfer or surrender of a hospital license, the fee for the DFY in which the cessation occurs shall be adjusted by multiplying the fee computed under § 44-664.13 by a fraction, the numerator of which is the number of days in the year during which the hospital system or person conducts, operates, or maintains the hospital and the denominator of which is 365.

(2) Immediately upon ceasing to conduct, operate, or maintain a hospital, the hospital system or person shall pay the fee for the year as so adjusted, to the extent not previously paid.

(c) Notwithstanding any other provision of this subchapter, a hospital system or person who conducts, operates, or maintains a hospital, upon notice by the Department, shall pay the fee required under § 44-664.13 in accordance with subsection (a) of this section on the due date stated in the notice and on the regular installment due dates for the DFY occurring after the due date of the initial notice.


(Dec. 13, 2017, D.C. Law 22-33, § 5086, 64 DCR 7652.)

Emergency Legislation

For temporary (90-day) creation of this section, see § 5086 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5086 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.16. Federal determinations; suspension and termination of assessment.

(a) If the Centers for Medicare and Medicaid Services determines that an assessment imposed on a hospital pursuant to this subchapter does not satisfy the requirements for federal financial participation set forth in section 1903(w) of the Social Security Act, that determination shall not affect the validity, amount, applicable rate, or any other terms of an assessment on other hospitals imposed by this subchapter.

(b) If the Centers for Medicare and Medicaid Services determines that an exclusion for specialty hospitals under this subchapter would prevent an assessment imposed by this subchapter from qualifying as a broad-based health care related tax, as that term is defined in section 1903(w)(3)(B) of the Social Security Act, the exclusion of specialty hospitals shall not be made.


(Dec. 13, 2017, D.C. Law 22-33, § 5087, 64 DCR 7652.)

Emergency Legislation

For temporary (90-day) creation of this section, see § 5087 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5087 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.17. Rules.

The Mayor, subchapter I of Chapter 5 of Title 2, may issue rules to implement the provisions of this subchapter.


(Dec. 13, 2017, D.C. Law 22-33, § 5088, 64 DCR 7652.)

Emergency Legislation

For temporary (90-day) creation of this section, see § 5088 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5088 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).


§ 44–664.18. Applicability; sunset.

This subchapter shall expire on September 30, 2029.


(Dec. 13, 2017, D.C. Law 22-33, § 5089, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5042(d), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5083(d), 66 DCR 8621.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 5042(d) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5042(d) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5089 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5089 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).