(a) Establishment.--There is established a restricted account, known as the Quality Care Assessment Account, in the General Fund for the receipt and deposit of revenues collected under this article. Funds in the account are appropriated to the department for the following:
(1) Making medical assistance payments to hospitals for inpatient services in accordance with section 443.1(1.1),1 and outpatient services, including for observation services in accordance with section 443.3(a)(1.1),2 and as otherwise specified in the Commonwealth's approved Title XIX State Plan.
(2) Making payments to medical assistance managed care organizations for additional payments for inpatient hospital services in accordance with section 443.1(1.2), (1.3) and (1.4) and outpatient services.
(3) Any other purpose approved by the secretary for inpatient hospital, outpatient hospital and hospital-related services.
(b) Limitations.--
(1) For the first year of the assessment, the amount used for the medical assistance payments for hospitals and Medicaid managed care organizations may not exceed the aggregate amount of assessment funds collected for the year less $121,000,000.
(2) For the second year of the assessment, the amount used for the medical assistance payments for hospitals and medical assistance managed care organizations may not exceed the aggregate amount of assessment funds collected for the year less $109,000,000.
(3) Deleted by 2011, June 30, P.L. 89, No. 22, § 10, effective July 1, 2011.
(4) For the third year of the assessment, the amount used for the medical assistance payment for hospitals and medical assistance managed care organizations may not exceed the aggregate amount of the assessment funds collected for the year less $109,000,000.
(4.1) For State fiscal years 2013-2014 and 2014-2015, the amount used for the medical assistance payment for hospitals and medical assistance managed care organizations may not exceed the aggregate amount of the assessment funds collected for the year less $150,000,000.
(4.2) For State fiscal years 2015-2016, 2016-2017 and 2017-2018, the amount used for the medical assistance payment for hospitals and medical assistance managed care organizations may not exceed the aggregate amount of the assessment funds collected for the year less $220,000,000.
(4.3) For State fiscal years 2018-2019, 2019-2020 and 2020-2021, the amount used for the medical assistance payment for hospitals and medical assistance managed care organizations may not exceed the aggregate amount of the assessment funds collected for the year less $295,000,000.
(4.4) For State fiscal years 2021-2022 and 2022-2023, the amount used for the medical assistance payment for hospitals and medical assistance managed care organizations may not exceed the aggregate amount of the assessment funds collected for the year less $300,000,000.
(4.5) For State fiscal year 2023-2024, the amount used for the medical assistance payment for hospitals and medical assistance managed care organizations may not exceed the aggregate amount of the assessment funds collected for the year less $368,000,000.
(4.6) For State fiscal years 2024-2025, 2025-2026, 2026-2027 and 2027-2028, the amount used for the medical assistance payment for hospitals and medical assistance managed care organizations may not exceed the aggregate amount of the assessment funds collected for the year less $452,000,000.
(5) The amounts retained by the department pursuant to paragraphs (1), (2), (4), (4.1), (4.2), (4.3), (4.4), (4.5) and (4.6) and any additional amounts remaining in the restricted accounts after the payments described in subsection (a)(1) and (2) are made shall be used for purposes approved by the secretary under subsection (a)(3), subject to paragraph (7).
(6) Not later than 180 days following the end of the State fiscal year, the department shall prepare a revenue reconciliation schedule for the prior State fiscal year that includes information supporting the amounts received or deposited into and paid out of the restricted account to support actual payments to hospitals and managed care organizations pursuant to subsection (a)(1) and (2).
(7) Any positive balance remaining in the restricted account in excess of $10,000,000 annually, which is not used by the Commonwealth to obtain Federal matching funds and paid out for hospital payments, shall be factored into the calculation of a new assessment rate by reducing the amount of hospital assessment funds that must be generated during the next fiscal year in which the department is able to calculate a new rate. If a new assessment rate is not calculated, the funds remaining in the restricted account shall be refunded to the covered hospital that paid the assessment in proportion to the covered hospital's assessment amount paid in the fiscal year.
(c) Lapse.--Funds in the Quality Care Assessment Account shall not lapse to the General Fund at the end of a fiscal year. If this article expires, the department shall use any remaining funds for the purposes stated in this section until the funds in the Quality Care Assessment Account are exhausted.
Credits
1967, June 13, P.L. 31, No. 21, art. 8-G, § 805-G, added 2010, July 9, P.L. 336, No. 49, § 3, retroactive effective July 1, 2010. Amended 2011, June 30, P.L. 89, No. 22, § 10, effective July 1, 2011. Reenacted and amended 2013, July 9, P.L. 369, No. 55, § 12.3, imd. effective. Amended 2015, Dec. 28, P.L. 500, No. 92, § 14, imd. effective; 2018, June 22, P.L. 258, No. 40, § 7, effective July 1, 2018; 2023, Oct. 23, P.L. 63, No. 15, § 6, imd. effective.
