0001| SENATE BILL 445 | 0002| 42ND LEGISLATURE - STATE OF NEW MEXICO - SECOND SESSION, | 0003| 1996 | 0004| INTRODUCED BY | 0005| MANNY M. ARAGON | 0006| | 0007| | 0008| | 0009| | 0010| | 0011| AN ACT | 0012| RELATING TO INDIGENT HEALTH CARE REVENUES; INCREASING AMOUNTS | 0013| THAT COUNTIES ARE REQUIRED TO DEDICATE TO THE COUNTY-SUPPORTED | 0014| MEDICAID FUND; PROVIDING FOR CERTAIN HOSPITAL PAYMENTS FROM THE | 0015| COUNTY-SUPPORTED MEDICAID FUND; AMENDING SECTIONS OF THE NMSA | 0016| 1978. | 0017| | 0018| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO: | 0019| Section 1. Section 27-5-6 NMSA 1978 (being Laws 1965, | 0020| Chapter 234, Section 6, as amended) is amended to read: | 0021| "27-5-6. POWERS AND DUTIES OF THE BOARD.--The board: | 0022| A. shall administer claims pursuant to the | 0023| provisions of the Indigent Hospital and County Health Care Act; | 0024| B. shall prepare and submit a budget to the board of | 0025| county commissioners for the amount needed to defray claims made | 0001| upon the fund and to pay costs of administration of the Indigent | 0002| Hospital and County Health Care Act, which costs of | 0003| administration shall in no event exceed the following | 0004| percentages of revenues based on the previous fiscal year | 0005| revenues for a fund that has existed for at least one fiscal | 0006| year or based on projected revenues for the year being budgeted | 0007| for a fund that has existed for less than one fiscal year. The | 0008| percentage of the revenues in the fund that may be used for | 0009| administrative costs is equal to the sum of the following: | 0010| (1) ten percent of the amount in the fund not | 0011| over five hundred thousand dollars ($500,000); | 0012| (2) eight percent of the amount in the fund | 0013| over five hundred thousand dollars ($500,000) but not over one | 0014| million dollars ($1,000,000); and | 0015| (3) four and one-half percent of the amount in | 0016| the fund over one million dollars ($1,000,000); | 0017| C. shall make rules and regulations necessary to | 0018| carry out the provisions of the Indigent Hospital and County | 0019| Health Care Act; provided that the standards for eligibility and | 0020| allowable costs for county indigent patients shall be no more | 0021| restrictive than the standards for eligibility and allowable | 0022| costs prior to December 31, 1992; | 0023| D. shall set criteria and cost limitations for | 0024| medical care in licensed out-of-state hospitals, ambulance | 0025| services or health care providers; | 0001| E. shall cooperate with appropriate state agencies | 0002| to use available funds efficiently and to make health care more | 0003| available; | 0004| F. shall cooperate with the department in making any | 0005| investigation to determine the validity of claims made upon the | 0006| fund for any indigent patient; | 0007| G. may accept contributions or other county | 0008| revenues, which shall be deposited in the fund; | 0009| H. may hire personnel to carry out the provisions of | 0010| the Indigent Hospital and County Health Care Act; | 0011| I. shall review all claims presented by a hospital, | 0012| ambulance service or health care provider to determine | 0013| compliance with the rules and regulations adopted by the board | 0014| or with the provisions of the Indigent Hospital and County | 0015| Health Care Act, determine whether the patient for whom the | 0016| claim is made is an indigent patient and determine the allowable | 0017| medical or ambulance service costs; provided that the burden of | 0018| proof of any claim shall be upon the hospital, ambulance service | 0019| or health care provider; | 0020| J. shall state in writing the reason for rejecting | 0021| or disapproving any claim and shall notify the submitting | 0022| hospital, ambulance service or health care provider of the | 0023| decision; | 0024| K. shall pay all claims that are not matched with | 0025| federal funds under the state medicaid program and that have | 0001| been approved by the board from the fund; | 0002| L. shall determine by county ordinance the types of | 0003| health care providers that will be eligible to submit claims | 0004| under the Indigent Hospital and County Health Care Act; and | 0005| [M. shall review, verify and approve all medicaid | 0006| sole community provider hospital payment requests in accordance | 0007| with rules and regulations adopted by the board prior to their | 0008| submittal by the hospital to the department for payment but no | 0009| later than January 1 of each year; | 0010| N. shall transfer to the state treasurer by the last | 0011| day of March, June, September and December of each year an | 0012| amount equal to one-fourth of the county's payment for support | 0013| of sole community provider payments as calculated by the | 0014| department for that county for the current fiscal year. This | 0015| money shall be deposited in the sole community provider fund; | 0016| and | 0017| O.] M. may provide for the transfer of money from | 0018| the county indigent hospital claims fund to the county-supported | 0019| medicaid fund to meet the requirements of the Statewide Health | 0020| Care Act." | 0021| Section 2. Section 27-5-6.1 NMSA 1978 (being Laws 1993, | 0022| Chapter 321, Section 18) is amended to read: | 0023| "27-5-6.1. SOLE COMMUNITY PROVIDER FUND CREATED.-- A. The "sole community provider fund" is created in | 0024| the state treasury. The sole community provider fund, which | 0025| shall be administered by the [human services] department, | 0001| shall consist of funds [provided by counties] transferred | 0002| from the county-supported medicaid fund to match federal funds | 0003| for medicaid sole community provider hospital payments. Money | 0004| in the sole community provider fund shall be invested by the | 0005| state treasurer as other state funds are invested. Any | 0006| unexpended or unencumbered balance remaining in the fund at the | 0007| end of any fiscal year shall not revert. | 0008| B. Money in the sole community provider fund is | 0009| appropriated to the [human services] department to make sole | 0010| community provider hospital payments pursuant to the state | 0011| medicaid program. No sole community provider hospital payments | 0012| or money in the sole community provider fund shall be used to | 0013| supplant any general fund support for the state medicaid | 0014| program. | 0015| C. Money in the sole community provider fund shall | 0016| [be remitted back to the individual counties from which it | 0017| came] revert to the county-supported medicaid fund if federal | 0018| medicaid matching funds are not received for medicaid sole | 0019| community provider hospital payments." | 0020| Section 3. Section 27-5-7 NMSA 1978 (being Laws 1965, | 0021| Chapter 234, Section 7, as amended) is amended to read: | 0022| "27-5-7. COUNTY INDIGENT HOSPITAL CLAIMS FUND.-- | 0023| A. There is created in the county treasury of each | 0024| county a "county indigent hospital claims fund". | 0025| B. Collections under the levy made pursuant to the | 0001| Indigent Hospital and County Health Care Act and all payments | 0002| shall be placed into the fund, and the amount placed in the fund | 0003| shall be budgeted and expended only for the purposes specified | 0004| in the Indigent Hospital and County Health Care Act, by warrant | 0005| upon vouchers approved by a majority of the board and signed by | 0006| the chairman of the board. Payments for indigent | 0007| hospitalizations shall not be made from any other county fund. | 0008| C. The fund shall be audited in the manner that | 0009| other state and county funds are audited, and all records of | 0010| payments and verified statements of qualification upon which | 0011| payments were made from the fund shall be open to the public. | 0012| D. Any balance remaining in the fund at the end of | 0013| the fiscal year, [pursuant to Subsections F and G] except as | 0014| otherwise provided in Subsection F of this section, shall carry | 0015| over into the ensuing year, and that balance shall be taken into | 0016| consideration in the determination of the ensuing year's budget | 0017| and certification of need for purposes of making a tax levy. | 0018| E. Money may be transferred to the fund from other | 0019| sources, but no transfers may be made from the fund for any | 0020| purpose other than those specified in the Indigent Hospital and | 0021| County Health Care Act. | 0022| F. On [June 30 of each fiscal year, beginning in | 0023| 1996] September 30, 1996 and on each September 30 thereafter, | 0024| the board shall [tranfer] transfer to the county-supported | 0025| medicaid fund that amount of the balance in the county indigent | 0001| hospital claims fund on the preceding June 30 that exceeds two | 0002| hundred thousand dollars ($200,000) or that exceeds the amount | 0003| equal to thirty percent of the income to the fund during | 0004| [that] the preceding fiscal year, whichever is greater. | 0005| [Beginning in 1996, the transfer shall be made by September 1 | 0006| of each fiscal year.] Any amount transferred to the county-supported medicaid fund pursuant to this subsection is in | 0007| addition to the county's obligation pursuant to Section 27-10-4 | 0008| NMSA 1978." | 0009| Section 4. Section 27-5-7.1 NMSA 1978 (being Laws 1993, | 0010| Chapter 321, Section 16) is amended to read: | 0011| "27-5-7.1. COUNTY INDIGENT HOSPITAL CLAIMS FUND--AUTHORIZED USES OF THE FUND.-- | 0012| A. The fund shall be used | 0013| [(1) to meet the county's contribution for | 0014| support of sole community provider payments as calculated by the | 0015| department for that county; and | 0016| (2)] to pay all claims that have been approved by | 0017| the board that are not matched with federal funds under the | 0018| state medicaid program. | 0019| B. The fund may be used to meet the county's | 0020| obligation under Section 27-10-4 NMSA 1978. | 0021| C. Until June 30, 1996, the cash reserves from the | 0022| fund may be used to meet the county's obligation under Section | 0023| 27-10-4 NMSA 1978." | 0024| Section 5. Section 27-10-3 NMSA 1978 (being Laws 1991, | 0025| Chapter 212, Section 3, as amended) is amended to read: | 0001| "27-10-3. COUNTY-SUPPORTED MEDICAID FUND CREATED--USE-- | 0002| APPROPRIATION BY THE LEGISLATURE.-- | 0003| A. There is created in the state treasury the | 0004| "county-supported medicaid fund". The fund shall be invested by | 0005| the state treasurer as other state funds are invested. Income | 0006| earned from investment of the fund shall be credited to the | 0007| county-supported medicaid fund. The fund shall not revert in | 0008| any fiscal year. | 0009| B. Money in the county-supported medicaid fund is | 0010| subject to appropriation by the legislature to support the state | 0011| medicaid program, [and] to institute primary care health care | 0012| services pursuant to Subsection E of Section 24-1A-3.1 NMSA 1978 | 0013| [Of the amount appropriated each year, nine percent] and make | 0014| distributions to hospitals that provide a disproportionate share | 0015| of care to indigent patients or that are sole community | 0016| providers. After setting aside fifteen percent of the total | 0017| amount transferred annually by counties to the county-supported | 0018| medicaid fund, nine percent of the remaining amount available | 0019| for appropriation each year shall be appropriated to the | 0020| department of health to institute primary care health care | 0021| services pursuant to Subsection E of Section 24-1A-3.1 NMSA | 0022| 1978. | 0023| C. Fifteen percent of the total amount transferred | 0024| annually by counties to the county-supported medicaid fund shall | 0025| be distributed in quarterly payments to hospitals that provide a | 0001| disproportionate share of care to indigent patients or that are | 0002| sole community provider hospitals as that term is defined in the | 0003| Indigent Hospital and County Health Care Act. The New Mexico | 0004| health policy commission, in consultation with the department of | 0005| health and the human services department, shall adopt | 0006| regulations by September 15, 1996 providing for distribution of | 0007| the funds. The distribution formula shall give priority to | 0008| maintaining the sole community provider payments pursuant to the | 0009| state medicaid program so long as federal funds are available to | 0010| match. Any amount to be used for sole community provider | 0011| payments shall be transferred to the sole community provider | 0012| fund. | 0013| [C.] D. Up to [three] one percent of the | 0014| county-supported medicaid fund each year may be expended for | 0015| administrative costs related to medicaid or developing new | 0016| primary care health care centers or facilities. | 0017| [D.] E. In the event federal funds for medicaid | 0018| are not received by New Mexico for any eighteen-month period, | 0019| the unencumbered balance remaining in the county-supported | 0020| medicaid fund and the sole community provider fund at the end of | 0021| the fiscal year following the end of any eighteen-month period | 0022| shall be paid within a reasonable time to each county for | 0023| deposit in the county indigent hospital claims fund in | 0024| proportion to the payments made by each county through tax | 0025| revenues or transfers in the previous fiscal year as certified | 0001| by the local government division of the department of finance | 0002| and administration. The department will provide for budgeting | 0003| and accounting of payments to the fund." | 0004| Section 6. Section 27-10-4 NMSA 1978 (being Laws 1991, | 0005| Chapter 212, Section 4, as amended) is amended to read: | 0006| "27-10-4. ALTERNATIVE REVENUE SOURCE TO IMPOSITION OF | 0007| COUNTY HEALTH CARE GROSS RECEIPTS TAX--TRANSFER TO COUNTY-SUPPORTED MEDICAID FUND.-- | 0008| [A. In the event a county does not enact an | 0009| ordinance imposing a county health care gross receipts tax | 0010| pursuant to Section 7-20D-3 NMSA 1978, the county shall, by | 0011| ordinance to be effective July 1, 1993, dedicate to the county-supported medicaid fund an amount equal to a gross receipts tax | 0012| rate of one-sixteenth of one percent applied to the taxable | 0013| gross receipts reported during the prior fiscal year by persons | 0014| engaging in business in the county. For purposes of this | 0015| subsection, a county may use funds from any existing authorized | 0016| revenue source of the county.] | 0017| A. Beginning July 1, 1996, each county by ordinance | 0018| shall dedicate to the county-supported medicaid fund, from any | 0019| existing authorized revenue source of the county, an amount | 0020| equal to a gross receipts tax rate of: | 0021| (1) three-sixteenths of one percent applied to | 0022| the taxable gross receipts reported during the prior fiscal year | 0023| by persons engaging in business in the county, if the county | 0024| does not enact an ordinance imposing a county health care gross | 0025| receipts tax pursuant to Section 7-20E-18 NMSA 1978 to be | 0001| effective for that year; or | 0002| (2) one-eighth of one percent applied to the | 0003| taxable gross receipts reported during the prior fiscal year by | 0004| persons engaging in business in the county, if the county has | 0005| enacted an ordinance imposing a county health care gross | 0006| receipts tax pursuant to Section 7-20E-18 NMSA 1978 to be | 0007| effective for that year. | 0008| B. For each county that has in effect an ordinance | 0009| enacted pursuant to Subsection A of this section on July 1 of | 0010| each year, the taxation and revenue department shall certify to | 0011| the county by September 15, 1993 and by September 15 of each | 0012| subsequent fiscal year the amount of gross receipts reported for | 0013| the county for purposes of the gross receipts tax during the | 0014| prior fiscal year. Upon certification by the department, any | 0015| county enacting an ordinance pursuant to Subsection A of this | 0016| section shall transfer to the county-supported medicaid fund by | 0017| the last day of March, June, September and December of each year | 0018| an amount equal to a rate of [one-sixty-fourth] three sixty-fourths of one percent applied to the certified amount if the | 0019| county is subject to the requirement under Paragraph (1) of | 0020| Subsection A of this section or an amount equal to a rate of one | 0021| thirty-second of one percent applied to the certified amount if | 0022| the county is subject to the requirement under Paragraph (2) of | 0023| Subsection A of this section. | 0024| C. The requirements of an ordinance enacted pursuant | 0025| to this section may not be terminated [for a county only on | 0001| the effective date of an ordinance enacted by the county | 0002| imposing the county health care gross receipts tax; provided | 0003| that if the effective date of the ordinance imposing the tax is | 0004| January 1, the termination does not apply to the payments | 0005| required for September and December of that year]." | 0006| Section 7. EFFECTIVE DATE.--The effective date of the | 0007| provisions of this act is July 1, 1996. | 0008|  | 0009| | 0010| | 0011| FORTY-SECOND LEGISLATURE | 0012| SECOND SESSION, 1996 | 0013| | 0014| | 0015| JANUARY 30, 1996 | 0016| | 0017| Mr. President: | 0018| | 0019| Your COMMITTEES' COMMITTEE, to whom has been referred | 0020| | 0021| SENATE BILL 445 | 0022| | 0023| has had it under consideration and finds same to be GERMANE, PURSUANT | 0024| TO CONSTITUTIONAL PROVISIONS, and thence referred to the FINANCE | 0025| COMMITTEE. | 0001| | 0002| Respectfully submitted, | 0003| | 0004| | 0005| | 0006| | 0007| __________________________________ | 0008| SENATOR MANNY M. ARAGON, Chairman | 0009| | 0010| | 0011| | 0012| Adopted_______________________ Not Adopted_______________________ | 0013| (Chief Clerk) (Chief Clerk) | 0014| | 0015| | 0016| Date ________________________ | 0017| | 0018| | 0019| | 0020| S0445CC1 |